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From: barr@ash.mmm.ucar.EDU (Keith Barr)
Subject: Re: URGENT: Information please! Aviation Safety Reporting System
Date: 25 Aug 93 02:53:21 PDT
In article <airliners.1993.558@ohare.Chicago.COM> Pete Mellor writes:
>In his book "Normal Accidents", Charles Perrow refers to an autonomous,
>no-penalty, Air Safety Reporting System managed by the National Transportation
>Safety Board (NTSB) in the US. He cites the existence of this database, and
>its use for early detection of design problems.
>
>According to John J. Nance, "Blind Trust" (Quill William Morrow, New York,
>1986), p.275, the *Aviation* Safety Reporting System was set up by NASA on
>behalf of the FAA in 1975. The FAA guaranteed immunity to any pilot
>who filed a report on the ASRS, but NASA could manage the system independently
>and additionally guarantee anonymity. Around 1978 the immunity provisions were
>substantially restricted, as a result of a campaign for "pilot accountability"
>by Administrator Langhorne Bond.
The Aviation Safety Reporting System (ASRS) is administered by NASA for the
Federal Aviation Administration (FAA). ASRS was set up so a database could
be created that would contain data pertinent to safety in the U.S. Airspace
System.
Pilots, Controllers, and Mechanics are allowed to file ASRS reports on
anything they see/participate in that, in their opinion, affects safety.
I will explain the way the system works from a pilot perspective, because
that is the one I am familiar with. Lets say during a flight an aircrew
for an airline is on an IFR flight from point A to point B and is given
a clearance to climb from 5000 to FL230. Passing through FL180 they forget
to reset their altimeter setting to 29.92, and when they level off at
FL230, they are actually at FL235 (FL stands for flight level, by the way,
and FL230 is roughly 23,000 feet above sea level), so they are 500 feet off
their assigned altitude, which is a violation of the Federal Aviation
Regulations. The controller immediately notices the altitude problem and
tells the pilots that he is showing them 500 feet high. At that point they
realize the altimeter is set wrong, so they reset it and descend back to
FL230.
Once on the ground the crew files ASRS reports, with their names, and
a complete explanation of the occurance. They send these reports to NASA,
who reads the report, and if more information is required, NASA will attempt
to call the pilots involved. After NASA is satisfied that they have all
the information they need, the portion of the form that identifies the
pilots is removed and mailed back to the pilots. It is important to note
that the report will not be de-identified if it is reporting an accident,
a willfull violation of the regs, or a transgression of civil law. In
these cases, the report is immediately forwarded to the FAA.
Since there was a violation of the regs in our little story, and lets just
say the controller was having a bad day, and he decided to report the
occurance to the FAA, who then immediately opens an enforcement
investigation. If the FAA decides that there was indeed a violation, and
they determine that certificate action is required (suspension or
revocation), the pilots can hand in their identification strip to the FAA
as a "get out of jail free card." This dis-allows the FAA from taking any
certificate enforcement action, on the basis that the pilot knows he
made a mistake, and had a safety conscious attitude toward the occurance,
or he wouldn't have reported the mistake to ASRS. Pilots are limited to
using the ASRS escape once every five years, although they are allowed to
file as many reports as they want.
Periodically, NASA compiles reports from the ASRS and reports to the FAA,
making specific comments about the safety of the aviation system. The FAA
is then allowed to use the information in any way they see fit.
Hope this helps.
_____________________________ _____
| Keith Barr \ \ \__ _____
| barr@ncar.ucar.edu \___________\ \/_______\___\_____________
| COMM/AS&MEL/IA/A&IGI / { /_/ ....................... `-.
|_____________________________/ `-----------,----,--------------'
_/____/O
Newsgroups: sci.aeronautics.airliners
From: palmer@icat.larc.nasa.gov (Michael T. Palmer)
Subject: Re: Airline Software-safety database (RISKS-14.08)
Date: 01 Dec 92 13:54:52 PST
Pete Mellor <pm@cs.city.ac.uk> writes:
[etc]
>Incidents in flight must (or should) be reported via offical channels by the
>crews. These reports drive the manufacturers' quality improvement programmes.
>After the fault which caused an incident has been diagnosed, it may result in
>an OEB or similar, and in a modification.
[etc]
>Databases of such incident reports are not generally widely accessible.
>Published reports sometimes appear, however. In addition, there are channels
>for anonymous reporting of incidents. In the UK, "CHIRP" is such a forum. In
>the US, I believe the FAA used to run such a scheme, but it was compromised
>when the guarantee of anonymity was removed.
>For further information I suggest you contact ALPA.
[etc]
>I stand to be corrected if anyone *does* know of an official channel for
>public access to flight incident and system fault reports.
Okay, here goes. In the USA, NASA and the FAA have teamed up to deploy
the Aviation Safety Reporting System (ASRS), which is managed by folks at
NASA Ames Research Center, Moffet Field, CA. I believe the original
poster misunderstood the intent and operation of the ASRS, so I will try
to fill in some details. Anyone from the ASRS Office at Ames is free
to jump in and correct any mistakes I make.
The ASRS collects incident and accident reports for all aviation-related
activities, including flight, air traffic control, and maintenance. The
way it works is that whenever an individual is involved in an incident,
he or she is encouraged to submit an ASRS report describing what happended,
why they think it happended, and what should be done to correct the problem
so it doesn't happen again. The fact that a report is submitted (receipts
are kept for proof) is accepted by the FAA as a sheild from legal
retribution except in cases of gross misconduct or criminal intent. There
is no anonymity, per se, in the filing of the report.
When the reports are collected and entered into the ASRS database, they
have keywords identified to allow easier searches on related topics. At
this time, they are also "de-identified." This may be what the original
poster misunderstood as a guarantee of anonymity. During de-identification,
all references that would lead a later reader of the report to be able to
identify the exact person, place, and aircraft (by N-number) involved are
removed and replaced by generic terms. This protects filers from, say,
unscrupulous company or government people that seek to harrass them later
for possibly unrelated reasons.
Now, for the good part. This database, which is HUGE, is publicly
"accessible." However, the access is controlled, and database search
requests must be submitted to and approved by the ASRS office. This
helps to prevent frivolous or duplicative use, which could rack up *very*
large costs *quickly* due to the sheer size of the database. The actual
searches are performed by Battelle, Inc. under contract to NASA Ames.
The Ames (NASA) person to call for more information about the ASRS is
Vince Mellone at (415) 969-3969 or (415) 604-6467. The database search
requests are actually sent to:
Battelle ASRS Office
625 Ellis Street, Suite 305
Mountain View, CA 94043
If you have never used the ASRS before, I suggest you give Vince a call
first to find out what information you need to provide in your search
request so the Battelle people can help you find what you're actually
looking for.
Note that the ASRS database is NOT "on-line" such that anyone could just
dial in and peruse it at their leisure. So, this may not suffice for
what the original poster had in mind. However, I would venture to guess
that any database with enough information in it to provide a reasonable
basis for design would end up being so large that access MUST be controlled
somehow. I think the ASRS is a good compromise.
--
Michael T. Palmer, M/S 152, NASA Langley Research Center, Hampton, VA 23681
Voice: 804-864-2044, FAX: 804-864-7793, Email: m.t.palmer@larc.nasa.gov
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