Concerned by mounting losses in emergency medical services (EMS) flights, the NTSB has added the safety of such flights to its 2009 Most Wanted List of Safety Improvements.

“Our Most Wanted List, which was created in 1990, was designed to raise the public’s awareness and support for transportation safety issues,” said NTSB chairman Mark Rosenker. “The safety issues on this list are critical to improving transportation safety. When acted upon, these recommendations will reduce accidents and save lives.”

A concerted effort must be made to improve the safety of EMS flights, the Board said. Although the NTSB previously has issued recommendations to improve EMS safety, the FAA has not implemented the changes. In the past 11 months, there have been nine EMS accidents resulting in 35 fatalities.

Four other aviation safety issues remain on the Most Wanted List. These are: improving runway safety, reducing dangers to aircraft flying in icing conditions, requiring cockpit image recorders and improving crew resource management training for Part 135 on-demand carriers.

Since the list first came out nearly 20 years ago, improvement of runway safety has been on it. In the past two decades, the Safety Board has issued numerous safety recommendations addressing this issue and now believes that implementing a safety system for ground movement with direct warnings to flight crews will improve runway safety.

Another recommendation in this issue area would require pilots to conduct landing distance assessments before every landing based on existing performance data, actual conditions and incorporating a minimum safety margin of 15 percent. Also, a new recommendation was added to this subject area that would provide pilots with information alerts in the cockpit regarding attempted takeoffs from a taxiway or the wrong runway.

The NTSB noted that the FAA has yet to complete efforts to revise icing certification criteria, testing requirements and restrictions on operating in icing conditions. A recommendation added this year on de-ice boots addresses a widely held, but incorrect, belief that activation of de-ice boots be delayed rather than started immediately upon entering icing conditions.

The agency also urged the FAA

to require image recorders because conventional cockpit voice recorders (CVR) and flight data recorders (FDR) do not show the initial cockpit environment leading to a crash.

According to the Safety Board, image recording systems, a supplement to the CVR and FDR that are currently on large aircraft, would provide critical information about the actions inside the cockpit before and during the accident. In addition, image recorders could be retrofitted on smaller airplanes that do not have voice recorders.

One aviation issue–elimination of flammable fuel/air vapors in fuel tanks on transport category aircraft–was removed from the list. On July 21, the FAA published a final rule that requires fuel/air mixtures in all fuel tanks to be below a prescribed flammability level for all newly manufactured aircraft that have more than 30 seats, as well as modifications to passenger-carrying aircraft manufactured after Jan. 1, 1992.

The Board kept the issue of improving crew resource management training for on-demand Part 135 carriers on the list with no changes.

Another safety improvement that has been on the Most Wanted List since its inception is human fatigue in aviation, marine and pipeline operations. The NTSB has long been concerned about the effects of fatigue on people performing critical functions in all modes of transportation.

Fatigue in the railroad industry also had been included, but was removed from the latest list due to the Railroad Safety Improvement Act of 2008, a provision to expand the Department of Transportation’s regulatory authority over railroad working hours.

Noting that fatigue in the transportation industry exposes the traveling public to unnecessary risk, the NTSB said that setting work-hour limits based on fatigue research, circadian rhythms and sleep/rest requirements will reduce that risk.

“All of these safety-related issues highlighted in the Most Wanted List should be addressed promptly,” Rosenker said. “Though we are encouraged by progress being made, resulting in some items being removed from the list, several of these safety concerns have been on the list since its inception. That is unacceptable.”