Guest Editorial

Gerard McDonald
Gerard McDonald

The Cycle of Improvement in Aviation Safety

On June 3, 2011, near Bedwell Harbour, B.C., a privately registered Cessna 180 yawed during takeoff causing one wing to touch the water, flipping the aircraft and its passengers into the sea.

"The pilot and the only other occupant had read and used Transport Canada's seaplane safety literature," noted the Transportation Safety Board of Canada (TSB) occurrence report. "They were both able to escape with little or no injury."

At Transport Canada (TC), our employees picked up on that line and it was acknowledged that the collaborative work between TC and industry was benefiting Canadians.

Last year, in July, after a floatplane accident, two passengers claimed the only reason they survived was due to the pre-flight safety briefing. C-FAX 1070, one of the highest rated news/talk radio stations in B.C., aired a segment featuring our own Nicole Girard, Director, Policy and Regulatory Services, to discuss the passengers' story and TC's role in the well-being of those passengers.

"That's why Transport Canada recently increased awareness in this regard," said Nicole. "As we've seen, certainly a good pre-flight briefing can help save lives."

The above incidents represent the end-results of the collective efforts of our employees and those at the TSB. Together, our goal is to minimize incident occurrences and maximize survivability in the event that an accident does occur.

That is the reason for the interdependent relationship between TC and the TSB.

It is about real results for Canadians and perpetual progress in transportation safety.

The TC-TSB relationship

TC and the TSB share a common goal: maintaining and improving transportation safety for Canadians.

The TSB investigates air, marine, rail and pipeline incidents. From these investigations, the TSB identifies causes and recommends improvements to avoid future occurrences. TC uses these recommendations and data from other sources to determine ways to strengthen the aviation safety program.

On March 16, 2010, the TSB released a watchlist of safety recommendations to enhance the safety of transportation. On that watchlist, the TSB highlighted the risk of aircraft under crew control colliding with land and water.

Not long after, the Minister of Transport, Infrastructure and Communities committed to a series of initiatives aimed not only at preventing the type of accident that caused the Cessna to collide with the water, but also at improving a passenger's chances of surviving.

In June of that year, our Civil Aviation employees launched a floatplane safety awareness campaign for passengers and commercial operators. Through this campaign, our employees produced the floatplane safety literature that the pilot and passenger of the Cessna noted reading before takeoff.

This cycle—from the initial TSB recommendation to the work of our employees to the implementation of floatplane safety initiatives—represents the process whereby together we enhance aviation safety in Canada. It is how we realize our shared vision of an improving, evolving transportation safety system for Canadians.

TC is also in the final stages of implementing regulations that would require the installation and operation of Terrain Awareness Warning Systems in commercial air taxi, commuter and airline operations. If implemented, this would drastically reduce the risk of aircraft under crew control colliding with land or water.

How we intend to make the TC-TSB relationship stronger

In the next year, TC is moving to modernize our process to respond to TSB recommendations. Our consultative, transparent approach to rulemaking is one of the best. Yet, this process needs to be quicker. We want to speed up the recommendation-consultation-action cycle, thereby implementing safety initiatives at a much quicker rate and potentially avoiding would-be-accidents.

When this process is complete, we aim for our rulemaking process to be more efficient, more effective and more responsive to safety priorities. We will do this by bringing together the right people at the right time on the right issues through a focus group. This group will then determine the best course of action for a given TSB recommendation. The proposed actions of the focus group will then be put to the larger aviation community.

This model is being tested for a set of recommendations released by the TSB in February, 2011.

A closer look at TC's rulemaking modernization project

On 12 March, 2009, a Sikorsky S-92A on a flight to the Hibernia oil rig struck the water at a high rate of descent after it had a total loss of oil in the transmission's main gear box. Two years later, the TSB concluded its investigation and released its accident report, which contained four recommendations to enhance safety.

This summer, TC created a small, specialized group of stakeholders directly involved in offshore helicopter operations to review the TSB's recommendations. The group will produce a complete package of proposed actions. If a proposed action requires a rule change, TC will consult the larger aviation community.

At the Leading Edge of Aviation Safety

Our business is risk management. We are in the business of percentages. An accident is the result of a single factor or a combination of factors, usually the latter. These factors increase the risk of an incident occurring. Therefore, our mandate is to seek out those contributory factors and eliminate them, thereby reducing the chance of an adverse incident. TSB recommendations support this process. TSB investigations outline the sources of risk; we put the regulatory framework and the oversight structure in place to eliminate those risks.

That is how we manage risks, manage percentages and advance aviation safety.

Canada has one of the safest aviation systems in the world. Together, TC, the TSB and you can make it even better.

Gerard McDonald
Assistant Deputy Minister, Safety and Security
Transport Canada, Civil Aviation

2011-2012 Ground Icing Operations Update

In July 2011, the Winter 2011–2012 Holdover Time (HOT) Guidelines were published by Transport Canada. As per previous years, TP 14052, Guidelines for Aircraft Ground Icing Operations, should be used in conjunction with the HOT Guidelines. Both documents are available for download at the following Transport Canada Web site:

If you have any questions or comments regarding the above, please contact Doug Ingold at

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