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Remarks for the Annual Safety at Sea and Marine Electronics Exhibition and Conferences, Amsterdam, Netherlands
Marion C. Blakey
Annual Safety at Sea and Marine Electronics Exhibition and Conferences, Amsterdam, Netherlands

Good morning. Thank you for inviting me to participate in your annual conference - - I am delighted to be here. I also want to thank John Barnes, SASMEX Conference Chairman, Paul Slater, and everyone who worked so hard to organize - - what I am sure will be - - a successful and productive conference.

In 1809, Thomas Jefferson said, "The care of human life and happiness . . . is the first and only legitimate object of good government." I could not agree more. However, this responsibility cannot fall solely on the shoulders of government. Indeed, the responsibility for the safety our fellow citizens extends beyond the State to the private sector - - not just because this obligation is right and moral, but because the private sector has so much to offer. For example, cutting edge technology, research, training, talent, and expertise - - so much of this has originated in industry and the corporate community. Your work to advance maritime safety not only bolsters the global economy, but more importantly saves lives.

As we gather here today, we are fulfilling our responsibilities - - together. The National Transportation Safety Board and the representatives and members participating in this week's conference all share the same objective - - to ensure the safety of the world's citizens as they travel across the seas. It is the Safety Board's goal to strengthen our collective approach to improve marine safety.

In fact, this is the same cooperative spirit that forms the basis for the Safety Board's accident investigation process. For more than 30 years, the Safety Board has been charged with investigating accidents and determining their probable cause because our mission is to prevent accidents. We conduct thorough, independent, and objective investigations and issue recommendations to correct the problems we discover. Together with organizations and companies that provide specific expertise needed in particular investigations, our small agency of less than 500 employees has investigated thousands of aviation, railroad, marine, highway, and pipeline accidents.

And, we have worked cooperatively on many accident investigations abroad. In marine, the Board is charged with the responsibility to determine "the facts, circumstances and probable cause of a major marine casualty (except one involving only a public vessel) on the navigable waters or territorial sea of the United States, or involving a vessel of the United States, under regulations prescribed jointly by the Board and the head of the department in which the Coast Guard is operating."

As our accident investigation process demonstrates - - we all benefit when government and industry work together to achieve a common goal. With the oversight of government - - and the tools, technology and dedication of the private sector - - we forge a stronger safety chain.

Like the links in the chain that secure the ship to its anchor, each of us plays an important role. The many companies, organizations and regulatory agencies are each responsible for the strength of the whole endeavor. Failure of any individual link compromises our effort.

After an accident takes place, the Safety Board, with the help of the interested parties, will examine each link in the chain to determine which links failed, why they failed and what measures can be taken to prevent future failures.


The Marine safety chain is composed of several critical links:

  • The ship owners, operators and managers;
  • Insurance underwriters;
  • The classification societies;
  • The vessel's flag state; and finally
  • The port state.

How are these links connected? The interrelationship between the links is best understood by examining the questions that the Safety Board asks during a typical marine accident investigation:

  • First, the Board examines whether the ship owner, operator or manager properly maintained the vessel. Was strong oversight and training in safety procedures exercised? Did staff or managers engage in behavior that would degrade human performance?

  • Second, did the underwriters perform proper inspections? Were insurance requirements complete and strictly adhered to? Did underwriters demand the latest in technology and equipment - - capable of preventing accidents and reducing liability?

  • Third, did classification societies do all they could to promote the adoption of uniform standards? Did they strive to create a consistent, single approach to safety?

  • Finally, were the flag state's and port state's regulations and inspection requirements adequate? Were they properly enforced?

A Safety Board marine investigation seeks answers to all these questions. A Safety Board investigation includes all parties involved in the accident as well as those that offer particular expertise - - often indispensable in identifying and evaluating physical evidence and extracting crucial information.

While such expertise is highly valued, the NTSB's investigator-in-charge manages the investigation and is responsible for its integrity. After all the necessary information is gathered, the party's role in the investigation comes to an end. The NTSB's investigators and the board members have the sole responsibility to issue safety recommendations and to determine the probable causes of the accident. As you can imagine, this interplay between the parties and the Board - - by design - - creates a healthy tension.

Once a safety issue is identified, the Board will issue a recommendation and call upon a party or parties to act. Just because a recommendation is directed to a specific party - - however - - does not absolve other parties of their responsibilities. Cooperation between all the links in the safety chain - - in the Board's experience - - has been the most effective means to improve safety.

And, this system has served us well. In our 30-year history, the Board has issued nearly 12,000 recommendations to more than 1,300 recipients. To date, more than 80 percent of these recommendations have been adopted. For the American people - - and countless others worldwide - - these recommendations have improved safety in all modes of transportation.
Maintaining public confidence is no small task - - especially in today's climate, where ensuring safety - - and security - - requires the constant vigilance of everyone within the international transportation community.
Although the Safety Board treats each link within the safety chain as equal in its responsibility, a chain - - by its very nature - - has a sequence. And therefore, like every chain, there must be a first link, a second link and so on. In marine safety, the owner/operator comes first - - and with this position, a high level of responsibility. Indeed, it is the owner/operator first and foremost who is entrusted with the safe transportation of passengers and cargo.

In most cases, improvements in safety - - whether in hardware or the establishment of an operating culture grounded in safety - - lie with the owners and operators. Since the owners and operators set the safety standards for the fleet, they are in the best position to increase safety standards.

Regulatory changes by the International Maritime Organization or the United States Coast Guard - - on average - - take anywhere from 5 to 10 years to implement. Owners and operators, however, can, and frequently do, improve this process by not waiting for regulatory changes to be mandated. They can take proactive steps and respond quickly to safety recommendations.

Two recent NTSB marine accident investigations demonstrate the benefits of owners and operators acting quickly.

On July 20, 1998 a fire erupted on board the Liberian passenger ship Ecstasy in Miami, Florida. As a result of the on scene investigation, the Safety Board issued recommendations to 22 cruise vessel owners and operators of vessels operating from U.S. ports or foreign ports carrying U.S. passengers. These recommendations called for an immediate inspection of ships' laundry ventilation systems - - including ducts, plenums and exhaust terminuses - - for any combustible material. The Board also recommended systems be cleaned and routinely checked for any hazardous material. All simple, practical, not particularly costly, steps.

The cruise industry - - working closely with the Safety Board - - took immediate action. In just over six months, 21 of 22 cruise vessel owners and operators implemented both recommendations. We applaud your positive response and prompt action.

Another recent incident occurred with the Board's May 23, 2000 accident investigation of the Netherlands-registered passenger ship Nieuw Amsterdam in Glacier Bay, Alaska. Like the case of the Ecstasy, this investigation also uncovered a critical fire safety issue. A fire broke out in a crew cabin on a lower deck of the ship. Although the fire was quickly contained, smoke spread upwards, forcing some passengers to crawl to safety.

As with the majority of ships, the Nieuw Amsterdam did not have smoke alarms that sound near the cabins of passengers and crew. As a result, the Safety Board renewed recommendations - - from our Universe Explorer and Vista Fjord investigations in 1996 and 1997 - - for the installation of smoke alarms that sound where the smoke is detected and not just in a remotely located control room.

In addition, we urged the U.S. Coast Guard to work with the International Maritime Organization to implement our recommendations.

Within a few months, 12 companies - - representing about 86 percent of the North American trade - - responded to our recommendations. As of March 2002, most of the responding companies had either installed local sounding smoke alarms or were in the process doing so.

In addition, the Board recommended a review of smoke control policies and a revision of shipboard training procedures to include increased emphasis on management responsibilities during a fire emergency and better command and control of onboard fire fighting activities. The cruise industry responded positively to these recommendations.

Even more heartening is that these Safety Board recommendations exceeded international safety regulations. Yet, they were still embraced by cruise owners. The Safety Board commends cruise owners for their prompt action and we encourage industry to continue to take the lead in developing new fire safety systems.

Raising the bar in all areas of safety management is simply good business. It instills confidence among passengers and clients and strengthens your industry's reputation.

This philosophy of voluntary and continuous safety improvement was articulated nearly 8 years ago at the 1994 SOLAS Convention, at which the IMO General Assembly adopted a resolution entitled "The International Management Code for the Safe Operation of Ships and for Pollution Prevention."

This resolution - - commonly referred to as the ISM Code - - encourages ship owners and operators - - to engage in continuous improvement of safety management skills in the marine community. The ISM Code became effective on July 1, 1998, for all passenger ships, oil tankers, chemical tankers, gas carriers, bulk carriers, and high-speed cargo ships of 500 gross tons or more. In July of this year - - the Code becomes effective for all cargo ships over 500 gross tons.

The marine industry has responded well to the ISM Code - - with the majority adopting it or using its spirit and intent to improve safety by creating a shipboard Safety Management System. Such systems - - coupled with internal and external audits - - have improved marine operation safety.

It is important to recognize the efforts and contributions of the international community in strengthening the safety chain. Through the IMO, the international maritime community has greatly improved marine safety. A few examples are in order:

  • More robust fire safety systems thanks to the SOLAS Retroactive Fire Safety Amendments. These measures include - - enhanced smoke detection and alarm systems, public address systems, and automatic sprinkler and fire detection systems.


  • Strengthened crew training and qualifications pursuant to the International Convention and Code on Standards of Training, Certification and Watchkeeping for Seafarers.


  • Improved management oversight called for by the International Safety Management Code and Shipboard Safety Management System.


  • Enhanced flag state and port state control and oversight; and


  • Improved communications through the implementation of the Global Maritime Distress and Safety System.

The IMO also deserves praise for its adoption of enhanced voyage data recorders. The Safety Board first recommended the use of data collection technology for the marine industry in 1976 and - - as recently as two years ago - - recommended that the IMO require all vessels over 500 gross tons be equipped with voyage data recorders.
In March 2000, the IMO issued new standards for improved voyage data requirements - - including an increased number of parameters and requirements for survivability and reserve power. In addition, the IMO required the installation - - by 2002 - - of recorders on board all new passenger-carrying vessels and cargo vessels engaged in international travel. Retrofit of existing passenger-carrying vessels must be accomplished by 2004. The leadership and accomplishments of the IMO and its members demonstrate the importance of working together to improve safety.
We at the Safety Board look forward to working with everyone here to forge a stronger safety chain. Our action now - - will save countless lives in the future. The Safety Board stands ready to provide our support.
Our commitment to improving international transportation safety is best demonstrated by the development of our new Academy. As you may know, the Safety Board is in the process of building its Training Academy in Virginia on the campus of George Washington University, and it is expected to open in the fall of 2003.
This state of the art facility will provide the training necessary to keep our accident investigators on the cutting edge of investigative technology and performance. However, we will do much more than train our own staff. We are developing a program that will advance transportation safety worldwide. With our increasingly global transportation systems, we have an obligation to insure that high standards and effective techniques are employed no matter where transportation disasters occur around the world.
Our academy also offers the opportunity to train first responders to take appropriate actions so that subsequent investigations can proceed smoothly and properly. And, we are receiving more and more requests from industry, state government and government agencies abroad for training on the appropriate measures to take to assist the victims of transportation disasters and their families.

As we prepare for its opening - - we look forward to receiving your suggestions and input. Let me be the first to extend an invitation to everyone here, as well as the international marine community, to join us when the ribbon is cut.
Indeed - - as Jefferson so cogently stated - - it is the responsibility of good government to care for the safety and happiness of human life. With your help, however, we not only fulfill our responsibilities but - - together - - we create a stronger chain.

Thank you.