National Transportation Safety Board

490 L/Enfant Plaza

Washington, DC 20594

202 314-6100

www.ntsb.gov

NTSB/SPC-05/02

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The National Transportation 

Safety Board

The National Transportation Safety Board (NTSB) is an independent federal accident investigation agency. Since its creation 

in 1967, the Safety Board’s mission has been to determine the 

probable cause of transportation accidents and to formulate 

safety recommendations to improve transportation safety.

Safety Board’s Scope

The Safety Board’s mission is to determine the probable cause of:

• all U.S. civil aviation accidents and certain public-use 

aircraft accidents;

• selected highway accidents;

• railroad accidents involving passenger trains or 

selected freight train accidents that result in fatalities or 

significant property damage;

• major marine accidents and any marine accident 

involving both a public and a nonpublic vessel;

• pipeline accidents involving fatalities, substantial 

property damage, or significant environmental damage;

• selected accidents resulting in the release of hazardous 

materials in any mode of transportation; and

• selected transportation accidents that involve problems 

of a recurring nature or are catastrophic.

Other Safety Board Responsibilities 

The Independent Safety Board Act of 1974 gives the Board 

authority to: 

• conduct special studies on safety problems;

• maintain official U.S. census of aviation accidents;

• evaluate the effectiveness of government agencies 

involved in transportation safety;

• evaluate the safeguards used in the transportation of 

hazardous materials;

• review appeals from airmen and merchant seamen 

whose certificates have been revoked or suspended;

• review appeals from airmen, mechanics, and repairmen 

who have been assessed civil penalties by the Federal 

Aviation Administration (FAA);

• lead U.S. teams on foreign airline accident 
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investigations to assist foreign authorities under 

the provisions of the International Civil Aviation 

Organization (ICAO) agreements; and 

• evaluate the effectiveness of emergency responses to 

hazardous material accidents.

In 1996, the Aviation Disaster Family Assistance Act assigned to 

the Safety Board the responsibility of coordinating the resources 

of the federal government and other organizations in order to 

support the efforts of local and state authorities and the airlines 

in assisting aviation disaster victims and their families following 

accidents. In addition, a Presidential memorandum directed 

Federal agencies to support the Board when it assumes those 

same responsibilities for major surface transportation accidents.

Safety Board Predecessors 

In aviation’s earliest years, the Air Commerce Act of 1926 

gave the Commerce Department the authority to determine the 

cause of airplane accidents. A small unit within the Commerce 

Department, known as the Aeronautics Branch, performed this 

function. By 1933, the Aeronautics Branch became the Bureau 

of Air Commerce, which was replaced by the Independent Air 

Safety Board. In 1938, the Air Safety Board became the Civil 

Aeronautics Administration, which two years later became the 

Civil Aeronautics Board (CAB). The CAB’s Bureau of Safety 

formed the nucleus of the NTSB, which was created in 1967 as 

an independent agency within the newly created U.S. Department 

of Transportation (DOT). Congress expanded the Safety Board’s 

authority to include accident investigation in four other modes: 

rail, highway, marine, and pipeline. In 1974, Congress passed 

the Independent Safety Board Act, which severed the Board’s 

ties to DOT and gave the Board increased authority in accident 

investigations, per the Aviation Disaster Family Assistance Act.

Safety Board Composition

The Safety Board is composed of five Members who are 

nominated for five-year terms by the President and confirmed by 

the Senate. Two of the Members are designated by the President 

to serve as Chairman and Vice Chairman for two-year terms 

(the Chairman’s term requires separate Senate confirmation). 

The Board’s headquarters is in Washington D.C., with regional 

offices in Chicago, Illinois; Dallas-Fort Worth, Texas; Los 

Angeles, California; Miami, Florida; Seattle, Washington; 
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Parsippany, New Jersey; Anchorage, Alaska; Atlanta, Georgia; 

Denver, Colorado; and Ashburn, Virginia. 

Accident Investigation Go-Teams

One of the more publicly visible aspects of a major accident 

investigation is the Board’s use of the “go-team” concept. Oncall 24 hours a day, seven days a week, the go-team is a group 

of Board personnel who possess a wide range of accident 

investigation skills. In aviation, for example, a go-team includes 

an investigator-in-charge (IIC) and specialists trained in areas 

such as witness interviews, aircraft systems and structures, 

maintenance, operations, air traffic control, and meteorology.

In the case of a railroad accident, the go-team is similar, but 

its members will include specialists trained in track construction 

and maintenance, mechanical systems, signal systems, and 

operations. In the case of a marine accident, the go team 

members will include deck officers, marine engineers, naval 

architects, and specialists in marine lifesaving equipment and 

procedures. Similarly, the Safety Board will call upon the skills 

of its pipeline and highway staff when investigating accidents 

in those modes of transportation. Some go-team members 

have expertise that is completely “intermodal” in that it may be 

applicable to other modes. Human performance and survival 

specialists fall into this category, as do the Board’s metallurgists, 

meteorologists, and hazardous materials specialists.

A Board Member usually accompanies the go-team to the 

scene of an accident to serve as spokesperson on scene along 

with a public affairs officer who is assigned to the team to 

coordinate media activities. In addition, members of the Board’s 

Transportation Disaster Assistance staff will launch with the team 

to assist the families of accident victims and coordinate federal 

response efforts.

Parties to the Investigation

DOT modal agencies that have day-to-day oversight of the 

transportation industry assist the NTSB during the course of 

an investigation. These agencies include the FAA, the Federal 

Railroad Administration (FRA), the Research and Special 

Programs Administration (RSPA), the U.S. Coast Guard (USCG), 

the National Highway Traffic Safety Administration (NHTSA), 
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the Federal Highway Administration (FHWA), the Federal Transit 

Administration (FTA), and the Federal Motor Carrier Safety 

Administration (FMCSA). These agencies, as well as other federal 

and state agencies and/or law enforcement organizations, 

often conduct their own parallel investigations for enforcement 

purposes. However, determining the probable cause of NTSBinvestigated transportation accidents is the responsibility solely 

of the Safety Board. It is important to note that the NTSB was 

established as an independent agency because, during the 

course of its investigations, it often must investigate the role that 

the appropriate DOT agency may have played in causing the 

accident.

During the investigation, the NTSB also enlists the support and 

oversees the participation of technically knowledgeable industry 

and labor representatives who have special information and/or 

capabilities. This relationship is known as the “party system.” 

It is through this system, under the direction of the NTSB, that 

much of the background technical information is gathered for 

use in the Board’s factual reports. NTSB staff supervises all 

investigative activities. Only the five Presidentially appointed 

Board Members determine probable cause and issue safety 

recommendations developed through the investigation.

On-Scene Investigative Activities

The amount of time a go-team remains at an accident site varies, 

but generally a team completes its on-scene work in about seven 

to ten days. The NTSB takes its responsibility to keep the public 

informed very seriously. Often, when a major accident occurs and 

the probable cause is not readily apparent, there is considerable 

speculation by the press and public about what happened. To 

minimize this, the Safety Board’s policy is to provide factual 

information on the progress of the investigation by conducting 

press briefings, issuing periodic press statements, and/or having 

a Board Member meet directly with the press to brief them and 

to answer questions in the days following an accident. Only the 

known facts of the investigation are conveyed. The Board does not 

speculate about the possible causes of the accident.

Laboratory Capabilities

The Board operates its own technical laboratories to provide 

NTSB investigators with unbiased analysis. For example, the 
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engineering services laboratory has the ability to “read out” 

aircraft cockpit voice recorders and flight data recorders. These 

so-called “black boxes” provide investigators with a profile of 

an aircraft during the crucial last minutes of the accident flight. 

The Board’s readout capability is not confined to aviation. 

Similar techniques are applied to ships’ voyage data recorders, 

locomotive event recorders, and highway vehicle data recorders.

In addition, materials laboratory engineers and metallurgists perform post-accident analysis of components involved in accidents 

in all modes of transportation, ranging from jet aircraft engines 

to railroad tankcars. The laboratory uses state-of-the-art investigative equipment, such as scanning electron microscopes and 

x-ray analyzers, to document anomalies found during accident 

investigations and to determine causes of materials failures.

The Public Docket

Within six months after an accident, factual reports written by 

NTSB investigators are usually made available in a public docket 

at NTSB headquarters in Washington, D.C. If additional, relevant 

factual material is developed later, it will be added to the docket 

as it becomes available. All of this public information may be 

obtained, at the cost of reproduction of the documents, from the 

NTSB’s Public Inquiries Branch in Washington, D.C.

The Public Hearing

In the months following an accident, the Board may decide to 

hold a public hearing to clarify accident information and to air 

significant safety issues in a public forum. A Board Member 

presides over the hearing, the parties are permitted to participate, 

and witnesses provide technical testimony under oath. 

The Final Report

With the completion of the fact-finding phase, the accident 

investigation process enters its final stage. The Board’s staff 

analyzes the factual findings and makes their recommendation(s) 

of an accident’s probable cause. Major investigations result in a 

draft accident report that is presented to the five Board Members 

for discussion and approval at a public meeting in Washington. 

Accidents investigated by the Board’s field investigators generally 

are written as briefs.
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The entire process—from accident investigation to final report—

normally takes about a year. However, some complex accident 

investigations have taken as long as four or more years to 

complete.

Safety Recommendations

Safety recommendations are the Board’s most important 

product. It is vital to the Board’s basic role of accident 

prevention since it is the lever used to bring about safety changes 

to and improvements in the nation’s transportation system.

Timeliness is an essential part of the recommendation 

process. As a result, the Board occasionally issues safety 

recommendations as soon as a problem is identified, without 

waiting for an accident investigation to be completed and the 

probable cause determined.

In its mandate to the Board, Congress emphasized 

the importance of safety recommendations, saying the 

Board will “advocate meaningful responses to reduce the 

likelihood of recurrence of transportation accidents.” In each 

recommendation, the Board designates the person, or the 

party, expected to take action, describes the action the Board 

recommends, and clearly states the safety need to be satisfied. 

Although the Board’s recommendations are not mandatory, to 

emphasize their importance, Congress requires DOT to respond 

to recommendations made to it and its agencies within 90 days.

The Safety Board established its “Most Wanted” safety 

recommendations program to highlight recommendations that 

would have the greatest impact on transportation safety at the 

national level. Although the NTSB actively advocates for the 

acceptance of all of its recommendations, follow-up efforts for 

those recommendations on the “Most Wanted” list are generally 

more aggressive.

Aviation Safety

The Board investigates thousands of aviation accidents annually, 

including all air carrier, commuter and air taxi accidents, inflight collisions, and fatal general aviation accidents. The Board 

also participates in the investigation of major airline crashes 

in other countries that involve U.S. carriers, U.S.-manufactured 
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or -designed equipment, or U.S. obligations under ICAO. The 

Board also conducts safety studies of aviation issues that allow 

it to go beyond single accident investigations to examine safety 

problems from a broader perspective. In the past, the Board 

has conducted safety studies on air traffic control, weather, 

crashworthiness, in-flight collisions, and commuter airlines. Most 

of the Board’s air safety recommendations are directed to the 

FAA and have resulted in a wide range of safety improvements 

such as pilot training, aircraft maintenance and design, air traffic 

control procedures, and post-accident survival.

Highway Safety

Selecting a manageable number of highway accidents for 

investigation requires careful screening of millions of traffic 

accidents every year. The Board generally investigates accidents 

involving issues with wide-ranging safety significance such 

as collapses of highway bridge structures, fatalities on public 

transportation vehicles (such as intercity buses), and collisions 

at grade crossings involving trains and public transportation or 

hazardous materials vehicles. 

The investigative team is usually composed of an automotive 

engineer, a civil engineer, a motor carrier specialist, a 

crashworthiness engineer, and a human factors specialist. 

As part of the Board’s responsibilities, it also examines the 

safety programs of the DOT modal agencies. In addition, the 

Board recently concluded a major highway safety initiative 

that examined federal and state oversight of the truck and bus 

industries, technological applications for heavy vehicle safety, 

safety issues related to the implementation of the North American 

Free Trade Agreement, and the effectiveness of the Commercial 

Driver’s License program. The Board’s recommendations in 

the highway mode are usually issued to DOT, NHTSA, FHWA, 

FMCSA, as well as state and local agencies, operators, 

manufacturers, and trade associations.

Marine Safety

The Safety Board investigates major marine accidents on 

navigable waters of the United States, involving U.S. merchant 

vessels in international waters, as well as collisions involving U.S. 

public and nonpublic vessels. In addition, it investigates selected 

marine accidents that involve public transportation or those 
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of a recurring nature. Under joint regulations promulgated 

by the Safety Board and the USCG, the USCG conducts the 

preliminary investigations of all marine accidents and notifies 

the Board if an accident is a major marine accident (involves 

the loss of six or more lives); involves the loss of a self-propelled 

vessel of 100 or more gross tons or property damage estimated 

at more than $500,000; or involves a serious threat from 

hazardous materials. The NTSB then responds by conducting 

an independent investigation, by participating in a joint Safety 

Board/USCG investigation, or by asking the USCG to conduct 

an investigation for the Board. As a result of its investigations, 

the Safety Board issues safety recommendations to agencies 

such as the Coast Guard, the U.S. Army Corps of Engineers, 

shipping firms, and other maritime organizations.

Railroad, Pipeline, and Hazardous 

Materials Safety

The Safety Board investigates many railroad accidents, including 

freight train collisions and derailments; however, it places special 

emphasis on train accidents that involve the traveling public, 

such as passenger train and rail rapid transit accidents. The 

Board’s criteria for investigating a railroad accident include 

accidents involving a fatality or substantial damage. As a 

result of railroad accident investigations, the Board issues 

safety recommendations to agencies such as the FRA, the FTA, 

the National Railroad Passenger Corporation (Amtrak), state 

regulatory agencies, rapid transit agencies, trade associations, 

and common carriers. Safety studies in the rail mode have 

examined areas such as the transportation of hazardous 

materials and rapid transit systems.

Under its Congressional mandate, the Safety Board investigates 

all pipeline accidents involving a fatality or substantial property 

damage. Additionally, the Board may investigate accidents of 

a recurring nature. Once notified of an accident, the Board 

dispatches to the site an investigator who takes charge of a 

team composed of investigative personnel from agencies such 

as the state public utility commission, local fire and police 

units, pipeline companies, and DOT. In recent years, the Board 

has conducted investigations of accidents on pipelines that 

transport natural gas, highly volatile liquids, and other petroleum 

products, some of which pass through highly populated urban 

areas. As a result of pipeline accident investigations, the Board 
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issues safety recommendations to agencies such as RSPA, state 

regulatory agencies and utilities, and pipeline companies. The 

Safety Board investigates selected accidents involving the release 

of hazardous materials in all modes of transportation, including 

fatal accidents or those causing major disruptions to a community. 

Safety Board investigations are especially concerned about the 

effects of materials released in public areas, emergency response 

by local authorities, and the adequacy of federal standards for 

the transportation of hazardous materials. When the accident 

is the result of the transport of a hazardous material, the 

investigation focuses on the performance of the containers, the 

preparation for and handling of the material during transport, 

the health and safety hazards of the material, the markings and 

hazard communications for the shipments, and the effectiveness 

of the emergency response. As a result of hazardous materials 

investigations, the Board issues safety recommendations to all 

DOT modal agencies and the transportation community. 

Regional Investigations

Most of the preceding information applies not only to major 

investigations, but also to those investigated in the aviation, 

highway, and railroad modes by the NTSB’s ten regional and 

field offices. Although there is no team of NTSB investigators 

associated with a regional investigation, a limited “party system,” 

under NTSB direction, is still used. 

Unlike major investigations, the media and victims’ family 

members receive information regarding a regional investigation 

from the IIC instead of the NTSB’s headquarters staff. Regional 

accident investigations usually result in a two-page, computerized 

accident brief, rather than full Board-adopted reports. 

Transportation Disaster Assistance

Following a major transportation accident, the Board’s Office 

of Transportation Disaster Assistance coordinates the provision 

of federal services to the survivors and the victims’ families, 

including family counseling, victim identification and forensic 

services, communicating with foreign governments, and 

translation services. The office’s staff also conducts family 

informational briefings at the accident scene, and provides 

periodic updates and answers families’ questions during the 

ensuing investigation.
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NTSB Academy

The NTSB has a training academy in Ashburn, Virginia, aimed 

at improving the training and skills of its own employees, and 

making its safety expertise and know-how more widely available 

to the transportation community. The state-of-the-art, 72,000 

square foot, two-level facility contains 5 classrooms, a large 

laboratory to house the three-dimensional 93-foot reconstruction 

of the forward portion of the TWA flight 800 aircraft’s fuselage 

(and other transportation vehicles), ample laboratory space, 

an outside simulations court, meeting rooms, and student and 

teacher work areas and offices. Information on upcoming 

classes may be obtained on the Board’s website.

Public Inquiries

Records of NTSB investigations, safety recommendations, 

enforcement proceedings, and certain statistical information 

are available to the public for review or duplication at NTSB 

headquarters in Washington, D.C. Also available is a database 

of aviation accidents that have occurred since 1962, including 

the probable cause and contributing factors as determined 

by the Safety Board. Direct public access to much of this 

information is provided through the NTSB Web site at 

<http://www.ntsb.gov>. For more information, contact:

Public Inquiries Branch

National Transportation Safety Board

490 L’Enfant Plaza, SW

Washington, D.C. 20594

(202) 314-6551 or 

(800) 877-6799

Fax: (202) 314-6598

TDD Federal Information Relay Service:

(800 ) 877-8339

Email:

- general inquiries: pubinq@ntsb.gov

- aviation data: avdata@ntsb.gov
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Accident reports, safety studies, special investigation reports, 

statistical reviews, and safety recommendations may be 

downloaded from the NTSB Web site, or printed copies may be 

purchased from:

National Technical Information Service

5285 Port Royal Road

Springfield, Virginia 22161

(703) 487-4630 (Subscription Orders)

(703) 487-4650 (Single-Copy Orders)

(Subscription rates apply to certain recurring publications)

Media Inquiries

A staff of public affairs officers is available to answer media 

inquiries about all aspects of NTSB operations. The Office of 

Public Affairs responds to press inquiries, addresses problems 

and concerns raised by the media, and provides support at 

major accident sites. Anyone may subscribe, via the NTSB Web 

site, to the NTSB Mailing List to receive emails of NTSB press 

releases, other notices, and safety recommendations.

Media inquiries should be directed to

Office of Public Affairs

National Transportation Safety Board

490 L’Enfant Plaza, SW

Washington, D.C. 20594

(202) 314-6100

Fax: (202) 314-6110