Skip Ribbon Commands
Skip to main content
Safety Recommendation Details

Safety Recommendation H-11-005
Details
Synopsis: On October 22, 2009, about 10:38 a.m. eastern daylight time, a 2006 Navistar International truck-tractor in combination with a 1994 Mississippi Tank Company MC331 specification cargo tank semitrailer (the combination unit), operated by AmeriGas Propane, L.P., and laden with 9,001 gallons of liquefied petroleum gas, rolled over on a connection ramp after exiting Interstate 69 (I-69) southbound to proceed south on Interstate 465 (I-465), about 10 miles northeast of downtown Indianapolis, Indiana. The truck driver was negotiating a left curve in the right lane on the connection ramp, which consisted of two southbound lanes, when the combination unit began to encroach upon the left lane, occupied by a 2007 Volvo S40 passenger car. The truck driver responded to the Volvo’s presence in the left lane by oversteering clockwise, causing the combination unit to veer to the right and travel onto the paved right shoulder. Moments later, the truck driver steered counterclockwise to redirect and return the combination unit from the right shoulder to the right lane. The truck driver’s excessive, rapid, evasive steering maneuver triggered a sequence of events that caused the cargo tank semitrailer to roll over, decouple from the truck-tractor, penetrate a steel W-beam guardrail, and collide with a bridge footing and concrete pier column supporting the southbound I-465 overpass. The collision entirely displaced the outside bridge pier column from its footing and resulted in a breach at the front of the cargo tank that allowed the liquefied petroleum gas to escape, form a vapor cloud, and ignite. The truck-tractor came to rest on its right side south of the I-465 overpasses, and the decoupled cargo tank semitrailer came to rest on its left side, near the bridge footing supporting the southbound I-465 overpass. The truck driver and the Volvo driver sustained serious injuries in the accident and postaccident fire, and three occupants of passenger vehicles traveling on I-465 received minor injuries from the postaccident fire.
Recommendation: TO THE PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION: Conduct a comprehensive analysis of all available accident data on U.S. Department of Transportation specification cargo tanks to identify cargo tank designs and the associated dynamic forces that pose a higher risk of failure and release of hazardous materials in accidents. Once such cargo tanks have been identified, study the dynamic forces acting on susceptible structures under varying accident conditions and develop performance standards to eliminate or mitigate these risks.
Original recommendation transmittal letter: PDF
Overall Status: Open - Acceptable Response
Mode: Highway
Location: Indianapolis, IN, United States
Is Reiterated: No
Is Hazmat: No
Is NPRM: No
Accident #: HWY10MH001
Accident Reports:
Rollover of a Truck-Tractor and Cargo Tank Semitrailer Carrying Liquified Petroleum Gas and Subsequent Fire
Report #: HAR-11-01
Accident Date: 10/22/2009
Issue Date: 9/2/2011
Date Closed:
Addressee(s) and Addressee Status: PHMSA (Open - Acceptable Response)
Keyword(s): Hazmat

Safety Recommendation History
From: PHMSA
To: NTSB
Date: 10/30/2019
Response: -From Howard R. Elliott, Administrator: PHMSA and the Federal Motor Carrier Safety Administration (FMCSA) have reviewed all available data on the performance of Department of Transportation specification cargo tanks in accidents. We have insufficient data available to us to identify the cargo tank designs and associated dynamic forces acting on the tank that pose a higher risk of failure and release of hazardous materials in an accident. However, through review of the accident data, PHMSA and FMCSA have identified human factors that are associated with initiation of rollover accidents. PHMSA and FMCSA believe that the most appropriate way to address these safety recommendations is by addressing the human factors that lead to rollover accidents, while supplementing our actions with advancements in cargo tank design. Our shared goal is to reduce the impact to society caused by rollover accidents by reducing the rate and severity of rollover accidents through improved driver training, awareness campaigns against distracted driving, highway signage, and the implementation of advanced vehicle safety technology. That is, the best solution is to keep the CTMV upright and avoid accidents. Designing a new cargo tank specification to meet all the potential dynamic forces in diverse accident scenarios is a challenging exercise and may result in unforeseen safety and economic impacts that we must also consider. However, the dynamic forces acting on cargo tanks during normal transportation conditions and some common rollover scenarios are well understood. To that end, PHMSA has proposed to incorporate by reference the American Society of Mechanical Engineers (ASME) Boiler and Pressure Vessel Code (BPVC) Section XII-Rules for Construction and Continued Service of Transport Tanks ("Section XII") into the Hazardous Materials Regulations (HMR) (see HM-24 11) for cargo tank construction, which will complement the currently incorporated by reference ASME BPVC Section VIII -Rules for Construction of Pressure Vessels, Division 1. Section XII construction requirements account for the design stresses of transportation. Cargo tanks built to Section XII requirements take into consideration static and dynamic load conditions that assist in mitigating rollovers. Human Factors Research In March 2017, the John A. Volpe National Transportation Systems Center ("Volpe") issued the Cargo Tank Incident Study (hereinafter referred to as the "Volpe Study") 2 for PHMSA. The Volpe Study examined 93 CTMV rollover accidents that occurred from 2011 to 2014 using data from PHMSA Incident Reports, Police Accident Reports (PARs), PHMSA Surveys, Google Maps, the Motor Carrier Management Information System, National Automotive Sampling System (NASS) General Estimates System (GES), and stakeholder outreach to identify the associated factors and make recommendations to PHMSA and FMCSA. Volpe identified five specific recommendations to address the human factors associated with CTMV rollover accidents. 1. Create a Model Tank Vehicle Endorsement Curriculum 2. Revise Section 8: Tank Vehicles of the Model CDL Manual 3. Provide Curve/Ramp Rollover Prevention Signage Specific to Tankers 4. Incentivize the Adoption of Advanced Safety Technologies 5. Revise 49 CFR § 177.8 16(c) PHMSA and FMCSA have made significant progress toward meeting these recommendations. Please see Appendix A: PHMSA and FMCSA Progress Report on Volpe Human Factors Study and Recommendations for further details on the Volpe Study and our progress in meeting the recommendations identified therein. Other Human Factor Actions FMCSA and industry groups have aggressively addressed human factors leading to rollover accidents beyond those recommendations identified in the Volpe Study. FMCSA continues to update the Rollover Prevention Toolbox 3, and its cargo tank rollover prevention video 4 has received over 75,000 hits. Starting in 2017, the industry group National Tank Truck Carriers (NTTC) has engaged in a program of public outreach5 intended to end the practice of distracted driving. PHMSA and FMCSA believe that these ongoing and continuous targeted outreach efforts will improve driver awareness of the risks of distracted driving, which is identified in the Volpe Study as a contributing factor to driver errors that lead to rollover accidents. ASME Section XII ASME Section XII includes advancements in design, material, construction, repair and inspection of transport tanks, including CTMVs. Incorporating by reference Section XII in the HMR will allow manufacturers and owners of CTMVs to be flexible in the materials that they use to build tanks, how they build tanks, and how they test and inspect tanks, while providing the same level of safety as currently provided by incorporation by reference of Section VIII, Division 1 in the HMR. ASME Section XII standards were developed by voluntary consensus standards development organizations comprised of all stakeholders involved in the design, certification, continued qualification and maintenance of transport tanks, including manufacturers of tanks and PHMSA engineers. These individuals have expert knowledge of how to design, construct and maintain tanks to withstand the unique dynamic conditions and stresses of a transportation environment. Several research and development projects supported the adoption of Section XII. These projects include studies on CTMV rollovers, design margins, and puncture resistance. Specifically, PHMSA contracted Thompson Tank Inc. to conduct a rollover and drag test (see PHMSA-2010-0019-00196) on an aluminum MC 305 cargo tank. PHMSA and Thompson Tank analyzed the damage that resulted. The results demonstrated the weaknesses in the tank structure and were used to develop built-in rollover protection in Section XII. Separately, PHMSA reviewed puncture tests on stainless steel and carbon steel tank heads of different thicknesses (see PHMSA-2010-0019-00127) to determine puncture resistance for the different metals. PHMSA used the results of the test in the development of Section XII, specifically to determine the types of materials authorized and additional safety requirements for materials authorized in Section XII. As a result of years of study and testing, cargo tanks constructed to Section XII will be better able to withstand the conditions encountered in transportation, including rollover accidents. Conclusion PHMSA believes that, based on the data available to us, the most effective way to mitigate the impact of CTMV rollover accidents is by addressing the human factors that lead to these accidents through improved driver training and risk awareness, coupled with advancements in the cargo tank design and technology used on CTMVs. Improvement of cargo tank design through the incorporation by reference of Section XII will contribute to an improvement in the survivability of cargo tanks involved in rollover accidents as construction of cargo tanks to the standard becomes more commonplace. PHMSA and FMCSA have begun addressing the Volpe Study recommendations and will continue to engage stakeholders to address the human factors that lead to rollover accidents. Both agencies will consider future rulemakings, outreach campaigns, and the development of documents and training curricula to reduce the rate of CTMV rollover accidents and will continue to provide updates to the NTSB on our ongoing efforts.

From: NTSB
To: PHMSA
Date: 6/22/2017
Response: We note that the National Transportation Systems Center (Volpe) recently completed its analysis of cargo tank accident data and that you will soon be reviewing its report. We look forward to receiving periodic updates on your progress toward developing the recommended performance standards and compliance requirement. Until such actions are complete, Safety Recommendations H-11-5 and -6 are classified OPEN—ACCEPTABLE RESPONSE.

From: PHMSA
To: NTSB
Date: 5/5/2017
Response: -From Howard W. McMillan, Acting Deputy Administrator: Since the last update, Volpe, The National Transportation Systems Center (Volpe)1 completed on behalf of PHMSA its analysis of 93 cargo tank rollover case studies occurring between 2011 and 2014 under PHMSA's Cargo Tank Incident Study. The study observed various elements of each rollover, focusing on potential human factors associated with each crash. Volpe reported the comparison between rollovers from about 10 years ago to those analyzed in this study and further examined the relationship among training regulations, training curricula, training technology, and advanced safety technology. Volpe used literature reviews, crash analyses, subject matter experts, and stakeholder consultation to inform its research. Volpe recently briefed PHMSA on the study' s findings and plans to submit a draft report to PHMSA by May 2017. PHMSA will continue to provide NTSB with updates on the progress of the Cargo Tank Incident Study and other analyses related to DOT specification cargo tank performance.

From: NTSB
To: PHMSA
Date: 7/8/2013
Response: We support your continued comprehensive analysis of cargo tank rollover accidents and your efforts to ensure collection of complete and accurate data. Pending completion of these projects and the development and implementation of the recommended standards, Safety Recommendations H-11-5 and -6 are classified OPEN—ACCEPTABLE RESPONSE.

From: PHMSA
To: NTSB
Date: 4/24/2013
Response: -From Cynthia L. Quarterman, Administrator: As PHMSA continues to work to ensure that existing and incoming incident data are complete and accurate, we are confident we can use the data to conduct a comprehensive analysis of specification DOT cargo tank motor vehicles to identify those that pose a higher risk. To realize a more complete analysis, on October 1, 2012, PHMSA initiated a 6-month special study to improve the data quality on cargo tank rollover incidents that occur after the study start date. PHMSA will review the 5800.1 forms submitted to us during this time period to ensure quality of data, and will follow-up with the person submitting the form regarding incomplete information (i.e., missing data) and to request additional information. The study will provide supplemental information (copy enclosed) to include: the configuration of the cargo tank motor vehicle (e.g., truck and semi-trailer); the cargo tank type (e.g. , circular); the vehicle gross weight; the degree and direction of rollover; the rollover protection device(s); and the specifics of damage to a tank shell (e.g., length of the dent). PHMSA will continue to provide the NTSB with periodic updates including progress on the special study and any further actions in response to Safety Recommendation H-11-5, and subsequently Safety Recommendation H-11-6.

From: NTSB
To: PHMSA
Date: 1/10/2012
Response: The NTSB is aware that PHMSA sponsors the Hazardous Materials Cooperative Research Program (HMCRP) that is managed by the National Academies, acting through the Transportation Research Board (TRB). Further, we understand that an ongoing HMCRP project, HM-07 Accident Performance Data of Bulk Packages Used for Hazardous Materials Transportation, expected to be completed by late spring 2012, will help PHMSA address these recommendations. The expected outcome of the research is the following: • Recommend methodologies for collecting and analyzing performance data for U.S. DOT-specified hazardous materials bulk packages, such as portable tanks and cargo tank motor vehicles. • Identify and evaluate institutional barriers to data collection and recommendations for overcoming these barriers. Accordingly, Safety Recommendations H-11-5 and -6 are classified OPEN—ACCEPTABLE RESPONSE, pending completion of the project and the development and implementation of the recommended standards.

From: PHMSA
To: NTSB
Date: 11/22/2011
Response: -From Cynthia L. Quarterman, Administrator: PHMSA shares NTSB’s goal of identifying cargo tank designs that pose a higher risk of failure and the potential release of hazardous materials in an accident. PHMSA is the sponsor of the Hazardous Materials Cooperative Research Program (HMCRP) that is managed by the National Academies acting through the Transportation Research Board (TRB). One on-going HMCRP project, HM-07 - Accident Performance Data of Bulk Packages Used for Hazardous Materials Transportation, will help PHMSA respond to these recommendations. The objectives of this research are to: (1) recommend methodologies for collecting and analyzing performance data for U.S. DOT-specified hazardous materials bulk packages (e.g., portable tanks and cargo tank motor vehicles); and (2) identify and evaluate institutional barriers to data collection and recommendations for overcoming these barriers. The HMCRP project HM-07 is expected to be completed by late spring 2012. PHMSA will update NTSB on the progress of this research as it relates to the recommendations.