Thanks, Rick — and thank you, Jennifer, for having me. The last time you heard from me was at your fall convention, where I sent in video remarks. So, of course, I jumped at Caitlyn’s invitation to come see you in person. To all you out-of-towners: welcome to D.C.!
While you’re here, check out the C&O Canal. It’s among the top 10 most visited National Parks, and for good reason. There’s a 184.5-mile towpath that’s perfect for walking and biking. Canals like the C&O were envisioned by George Washington and Thomas Jefferson. The canals became a navigable route a few years after Washington’s death. All that’s to say: America’s waterways have been essential since our earliest days.
And the tugboat, towboat, and barge industry is essential to our economy, employing more than 33,000 American mariners aboard vessels and moving goods more efficiently than other modes of transportation.
As someone whose background is in the rail, pipeline, and commercial trucking industries, I was blown away to learn that just one 15 barge-tow can move the equivalent of 216 rail cars or 1,050 semitrailer-trucks.
Given the increasing number of fatalities and serious injuries on our nation’s roads, it’s clear the industry isn’t just an economic engine and job creator, but it also provides tremendous safety benefits.
Just this morning, the National Highway Traffic Safety Administration released projections that an estimated 42,915 people died in motor vehicle traffic crashes last year, the highest number of fatalities on our roads since 2005.
What I hope you take away from our discussion today is how essential a partner you are to the NTSB, and I mean that!
The NTSB has one mission: to save lives, and you’re key to our success, which is why I value our work together.
If you don’t know me, I’m tough. I’m a strong advocate for the NTSB and its mission and I don’t pull any punches when it comes to safety. I will challenge you to do better, go farther, but I will also recognize when you do great work.
So, I want to start out with a heartfelt THANK YOU and CONGRATULATIONS on behalf of the NTSB and the public who we represent.
AWO and its members have led the charge when it comes to the creation and broad implementation of safety management systems in the maritime industry.
The NTSB has long advocated for SMS in all modes of transportation because we’ve seen tremendous success in terms of tragedies avoided and lives saved.
That’s why SMS remains on our Most Wanted List of Transportation Safety Improvements.
AWO saw the importance of SMS and worked with the Coast Guard to help shape Subchapter M regulations, their implementation, and incorporate a Towing Safety Management System option.
That’s not all: You also made compliance with a third-party-audited safety management system a requirement for AWO membership more than two decades ago and created the AWO Responsible Carrier Program: a template for member companies to use in developing company-specific safety programs.
The Responsible Carrier Program is so good that the Coast Guard accepts it as a Towing Safety Management System that meets the Subchapter M requirements.
Now that’s proactive safety leadership!
This afternoon, I’d like to challenge each of you to build on your incredible commitment to safety.
- Containing engine room fires; and
- Watertight integrity.
These priorities come from our most recent marine safety investigations, which identify safety issues that are growing concerns for the NTSB and include recommendations to prevent tragedies from reoccurring.
In addition, we annually publish a Safer Seas Digest that provides important lessons from our marine reports.
I’m sure Morgan Turrell, Director of our Office of Marine Safety, brought copies of our latest digest. I want to take a moment to also introduce Leah Walton from our transportation safety advocacy team, Jennifer Gabris from media relations, and Stephen Stadius, who serves as my confidential assistant.
Now, I understand a big deadline is coming up in 64 days: On July 19th, 100% of towing vessels must have valid Coast Guard-issued Certificates of Inspection on board, meaning the industry has to fully implement Subchapter M on all their vessels or implement a TSMS.
I know AWO and its membership has worked hard to ensure smooth implementation for both the Coast Guard and TSMS options.
But compliance with regulations is only the first step.
We have repeated in one investigation after another that merely meeting minimum safety standards or having an SMS isn’t sufficient to prevent catastrophes. You have to be proactive when it comes to safety and go above and beyond.
I recently visited the Staten Island Ferry. The head of safety showed me notebooks that contained their SMS and she said something important: an SMS isn’t a notebook of policies and procedures sitting on a shelf. It’s not stagnant. It’s an evolutionary process.
It establishes your commitment to continually improving safety. It identifies and analyzes hazards, addresses those hazards, and then evaluates and re-evaluates the effectiveness of measures based on outcomes. And it includes training, communication, and other actions to create a positive safety culture within all levels of the workforce.
In 2018, the towing vessel Kristin Alexis was transiting with a crane barge upriver near St. James, Louisiana, when the crane struck the deck of the Sunshine Bridge while passing under the west channel span.
Fortunately, there were no injuries, but the result could have been much different.
According to a U.S. Coast Guard study, between 2004 and 2014, there were 205 reported bridge strikes in the United States. Of those, 125 incidents involved barges and/or towboats.
The study indicated that “the most common fault or reason that a bridge allision occurs is due to a loss of situation awareness, attention to detail, or tasks in voyage planning that needed to be completed during the transit to ensure safe passage.”
It’s important to note that the Eighth Coast Guard District where this accident occurred saw nearly three times as many bridge strikes as any other district, so it was a known risk.
We found that the company wasn’t verifying that crews understood and implemented the safety management system on board the vessel.
At the beginning of employment, the company provided each employee with information from the SMS that the company deemed pertinent to the employee’s expected duties, and employees were required to acknowledge that they had received the information by signing a form.
However, the company didn’t provide any formalized training to ensure that they adequately understood the information and the company’s expectations.
Instead, the company expected each employee to read and understand the information on their own time. That’s a failure of leadership and a sign of poor safety culture.
Additionally, the voyage planning guidance contained in the SMS was deficient. It didn’t provide clear guidance on how to calculate overhead clearance for tows.
In 2017, the crews of an articulated tug and barge were preparing to get under way to proceed into the Port of Corpus Christi in Texas when an explosion and subsequent fire occurred on the bow of the barge. A second and third explosion followed, engulfing the bow in flames. Two barge crewmembers who were on the bow were killed in the explosion.
We know that preventative machinery and hull maintenance is an important component of a functioning SMS.
And we found that the overall condition of the barge was “historically poor and never improved.” At one point, our investigators found, and I quote, “paper-thin steel.”
We determined that the probable cause of the accident was the operator’s ineffective maintenance and safety management practices, despite the fact that they had adopted an SMS!
The poor maintenance, the poor safety practices, allowed crude oil cargo to leak through a corroded bulkhead into the forepeak void space, which formed a vapor, and ignited.
If you’re wondering how we could make broad conclusions about the operator’s practices from a single incident, even one as tragic as this, I’ll tell you: the accident barge was in such bad condition that the Coast Guard initiated a complete inspection of the other 25 barges in the operator’s fleet. They found 251 deficiencies.
Ten of the barges were in such poor condition that they had to take corrective action before returning to regular service. Of these, half had extensive corrosion discovered within cargo tanks and along the hull…even though they transported oil in bulk.
Those barges were just accidents waiting to happen.
The second safety issue we see as a growing concern has to do with containing engine room fires.
The Miss Dorothy was pushing 14 barges on the Mississippi about 20 miles north of Baton Rouge. It was St. Patrick’s Day 2021 when a fire broke out in the engine room.
The eight crewmembers aboard briefly attempted to fight the fire but were unsuccessful and evacuated to the barges. They were rescued by a Good Samaritan vessel.
The fire was extinguished several hours later by first responders and the crew aboard the Good Samaritan vessel.
Fortunately, there were no physical injuries or pollution — but the vessel was a total loss estimated at $2.4 million.
Our investigation determined that the probable cause of the fire was diesel fuel that sprayed from a main engine onto an uninsulated part of the exhaust system, which likely ignited the sprayed fuel.
But the fire was so severe for other reasons as well.
First was the ventilation.
The crew was unable to limit the amount of oxygen feeding the fire. Not only had they left some of the windows open to keep the engine room cooler before the fire, but crewmembers also broke several windows in their attempt to fight the fire.
So, even though they successfully secured the engine room’s mechanical ventilation, it was ineffective — the open door and windows fed the flames.
This was compounded by the fact that the vessel didn’t have a fixed fire-extinguishing system…and some of the firefighting equipment the crew might have used was in the burning engine room.
The other reason the fire was so powerful has to do with the emergency fuel shutoff valves: the crew couldn’t pull one of the valves due to heat from the fire, and another didn’t function — so they couldn’t stop more fuel from flowing to the engines and the fire in the engine room.
In other words, the fuel system’s tanks were literally adding fuel to the fire.
If the Miss Dorothy crew had a way to starve the fire of oxygen by limiting ventilation and effectively stop more fuel from feeding it… and if the vessel had a fixed fire-extinguishing system in the engine room (it did not) …they may have been able to contain the fire before it got out of hand and risked the lives of not just everyone on board, but also the crew of the Good Samaritan vessel and first responders.
The circumstances surrounding the Miss Dorothy fire are similar to the 2017 engine room fire on the towing vessel J.W. Herron, which was shifting barges near Mobile, Alabama when a fire broke out.
Our investigation found that leaking oil ignited after hitting an exposed hot surface. We attributed the spread of the fire to the “inability to secure ventilation to the engine room,” Due to heat and smoke, the crew couldn’t reach the emergency fuel shutoffs near the exterior engine room doors. Further, the towboat lacked a fixed fire-extinguishing system for the engine room.
And in February 2020, the towing vessel City of Cleveland experienced an engine room fire while pushing barges in Mississippi. We found that the lack of a fixed fire-extinguishing system for the engine room contributed to the severity of the fire. Again, there was no means for the crew to secure ventilation. We found that “without an effective means to fight the fire, the crew was forced to evacuate to their tow” before being rescued by a Good Samaritan vessel.
Miss Dorothy, J.W. Herron, and City of Cleveland have important lessons for towing vessel owners and operators:
- Regularly and thoroughly inspect equipment to prevent flammable liquids from coming into contact with hot surfaces.
- Ensure you can secure ventilation and fuel oil to the engine room to starve a fire of oxygen and fuel.
- Have equipment and procedures in place to quickly contain and suppress engine room fires before they can spread to other spaces.
The final safety issue I want to share with you is watertight integrity, which we’re increasingly seeing threatened by two things: poor hull maintenance and operating with open weathertight deck hatches and doors.
Watertight integrity is critical to the safety of your vessel and your crew, even when you’re in protected waters.
With that, I want to say how thankful I am to have this opportunity to share some of our safety concerns.
I prefer to meet under circumstances like this rather than following a tragedy so that we have an opportunity to get to know one another and share lessons learned and I have an opportunity to hear from you.
When I became Chair, I stated that I wanted to hear from NTSB’s stakeholders to understand how we’re doing because there’s ALWAYS room for improvement. Safety work is never done.
That’s why I’m hosting a Marine Safety Summit this Thursday.
I’m excited that Jennifer and Caitlyn, as well as a host of other stakeholders from the marine community, will be there to contribute to a candid discussion. I’m especially interested in hearing what NTSB can do better.
I can’t think of a better prelude to National Maritime Day than hearing about how we’re serving you, the maritime community, and furthering our mission to ensure a safe transportation system.
There’s one more milestone this week I want to mention before I close: tomorrow is the International Day for Women in Maritime! Between Jennifer and Caitlyn, AWO has some fantastic women in leadership. And now we’ll have Admiral Linda Fagan as not only the first woman to lead the Coast Guard, but also the first woman to lead a branch of the U.S. military. Also, Admiral Ann Phillips was just confirmed as the new Maritime Administrator! And I’m especially pleased to be here today with Polly Trottenberg, Deputy Secretary of the Department of Transportation, who is a staunch advocate for safety. Be sure to celebrate these and other rockstar women in maritime tomorrow — but also take some time to reflect on diversity in your company.
Women make up just 1.2% of the global seafarer workforce. While this represents a nearly 46% jump from 2015, it’s not nearly enough. Having women and men, and multiple races, ethnicities, abilities, and age groups at all levels of your workforce, including senior leadership, means you benefit from the different points of view and approaches that come from a variety of life experiences. I think about this a lot; I’m only the fourth woman to serve as Chair since the NTSB was first established in 1966.
To improve safety for all communities, we must reflect the people we serve. We can all do more to support and encourage women and others in maritime professions.
Thank you for having me here today and thank you again for all you do for safety.