Issued: -- | To: Emirates | SR01/2020 |
disseminate, to its pilots, knowledge and information about factors affecting landing distance and flare duration, such as aircraft height and airspeed over the threshold, early flare initiation and weather conditions that may affect aircraft performance during the landing. |
Issued: -- | To: Emirates | SR02/2020 |
enhance the normal go-around and missed approach training standards which should include simulated scenarios for a normal go-around initiated close to the runway and after touchdown when the takeoff/go-around (TO/GA) switches are inhibited. This should also include information on engine response time to achieve go-around thrust. |
Issued: -- | To: Emirates | SR03/2020 |
enhance training standards regarding TO/GA switch inhibiting so that pilots are aware of the effect on FMA annunciations and the flight director, and the availability of the autothrottle after the aircraft becomes airborne during a go-around. |
Issued: -- | To: Emirates | SR04/2020 |
enhance the flight crew training and assessment system to include procedures for managing evaluator comments on pilot performance including pilots who have met the competency standard. |
Issued: -- | To: Emirates | SR05/2020 |
review and enhance the go-around training standards taking into consideration the available analytical flight monitoring data as well as the recommendations made within the industry. For example, the recommendations contained in United Kingdom Civil Aviation Authority Information Notice No. IN-2013/198 Go-around Training for Aeroplanes may be consulted. |
Issued: -- | To: Emirates | SR06/2020 |
implement changes to crew resource management training taking into consideration the lessons of the UAE521 Accident. |
Issued: -- | To: Emirates | SR07/2020 |
reiterate to flight crew the effects on aircraft performance due to wind changes that can affect landing, and the importance of effective monitoring of the flight instrumentation during a windshear warning. |
Issued: -- | To: Emirates | SR08/2020 |
examine the training system to assess its adequacy in enhancing the cockpit instrumentation monitoring skills of flight crew. |
Issued: -- | To: Emirates | SR09/2020 |
enhance the simulated training scenarios for a normal go-around before and after touchdown. The training and simulator sessions should emphasize the importance of performing and verifying each procedural step. |
Issued: -- | To: Emirates | SR10/2020 |
include, in cabin crew training, evacuation scenarios where the escape slides are affected by wind. |
Issued: -- | To: Emirates | SR11/2020 |
for quick access, ensure that the evacuation checklist is displayed securely in a position in the cockpit easily visible to the flight crew. |
Issued: -- | To: Dubai Air Navigation Services | SR12/2020 |
ensure that best practice guidelines for the transmission of air traffic control instructions to flight crew be reviewed and included in unit procedures and continuation training for all current and future air traffic controllers. These guidelines should include, consideration of appropriate times and conditions when air traffic controllers may establish communication and issue instructions, with particular emphasis regarding critical phases of flight. Note: Further reference may be found in EASA Safety Information Bulletin 2014-06 and GCAA Safety Alert 09/2016. |
Issued: -- | To: Dubai Air Navigation Services | SR13/2020 |
implement procedures to ensure that the air traffic control missed approach procedure in the Dubai manual of air traffic service (DMATS) is consistent and aligned with the aeronautical information publication (AIP) of the United Arab Emirates. Note: Reference should be made to European Aviation Safety Agency (EASA) Safety Information Bulletin (SIB) No. 2014-06. |
Issued: -- | To: Dubai Air Navigation Services | SR14/2020 |
implement procedures and guidance that would limit the air traffic controller, to the maximum extent, from distracting the flight crew by issuing instructions modifying the published missed approach procedures in case of a missed approach. Note: Reference should be made to European Aviation Safety Agency (EASA) Safety Information Bulletin (SIB) No. 2014-06. |
Issued: -- | To: Dubai Air Navigation Services | SR15/2020 |
enhance the procedures, and air traffic controllers training, so that whenever windshear warnings are in effect at an aerodrome, essential safety information, such as go-arounds, long/deep landings when reported, wind gust and wind shift, is always transmitted to the flight crew at an appropriate time during the approach. |
Issued: -- | To: Dubai Air Navigation Services | SR16/2020 |
enhance the procedures, and air traffic controllers training, so that whenever windshear warnings are in effect at an aerodrome, when safe to do so, the reason for an aircraft go-around, including wind conditions for aircraft that landed, should be requested by the air traffic controller if the information is not passed by the flight crew. |
Issued: -- | To: Dubai Air Navigation Services | SR17/2020 |
as the GCAA-certificated meteorological service provider at Dubai Airports, install the required meteorological equipment necessary for detection and alerting of lowlevel windshear, that will enhance the accuracy and conciseness of the weather information broadcasted from the National Center of Meteorology (NCM) aviation meteorological forecasters and air traffic controllers. |
Issued: -- | To: Dubai Air Navigation Services | SR18/2020 |
implement changes to the procedures so that following an aircraft emergency, and the flight crew is not available, there are effective means of obtaining and transmitting to the search and rescue and firefighting services, information related to persons on board and dangerous goods within an acceptable time. This should be aligned with recommended practices as stated in the International Civil Aviation Organization (ICAO) Doc 4444 chapter on Emergency Procedures and ICAO Doc 9137 - Airport Services Manual, Part 7 - Airport Emergency Planning. |
Issued: -- | To: Dubai Airports | SR19/2020 |
enhance training for the Airport rescue and firefighting service (ARFFS) personnel to enable them to identify confined heat sources based on indicators and smoke traces. This training should enable the fire commander to understand the fire dynamic and determine the appropriate tactics, depending on the site circumstances and considering utilization of unique capabilities of the fire vehicles. This should be supported by sufficient training in incident command. |
Issued: -- | To: Dubai Airports | SR20/2020 |
enhance the ARFFS personnel practical training exercises by including new scenarios based on appropriate simulated techniques, that challenge the firefighters, crew managers, and fire commanders to assess fire dynamics and develop tactics. The scenarios should replicate the circumstances of actual accidents, with various aircraft states. Different weather and environmental conditions should also be considered. |
Issued: -- | To: Dubai Airports | SR21/2020 |
periodically test the Airport passenger evacuation management system (PEMS) using properly-developed exercises, to ensure that the system is effective in providing a high level of safety to the evacuees from the time of evacuation to the time of assembly in the survivors reception center (SRC). |
Issued: -- | To: Boeing | SR22/2020 |
enhance the Boeing 777 crew alerting system to include aircraft configuration inconsistency when a go-around maneuver is commanded and the engine thrust is insufficient for the maneuver. |
Issued: -- | To: Boeing | SR23/2020 |
enhance the Boeing 777 flight crew operations manual (FCOM) and flight crew training manual (FCTM) for consistency in TO/GA switches inhibiting information. In addition, it is recommended to appropriately highlight, in the FCOM and FCTM, the significance of the effects on the A/T due to the TO/GA switches inhibit logic. |
Issued: -- | To: Boeing | SR24/2020 |
include in the Boeing 777 Go-Around and Missed Approach Procedure, and amend the FCOM and FCTM accordingly, requirements for the pilot flying to give call outs for thrust setting with verbal verifications of thrust increase being made by the pilot monitoring. In addition, emphasis should be made on the importance of guarding the thrust levers. The existing thrust setting callout in the take-off procedure could be referred to. |
Issued: -- | To: Boeing | SR25/2020 |
study the benefits of adding callouts to the Boeing 777 flight mode annunciations (FMA) changes at the initiation of the Go-Around and Missed Approach Procedure, and amend the FCOM and FCTM accordingly. |
Issued: -- | To: Boeing | SR26/2020 |
conduct a safety study to determine the benefits of developing a common procedure for the Boeing 777 normal go around and missed approach. This procedure should consider manual advancement of the thrust levers at low altitude and after touchdown, and the requirements for go-around after touchdown including flap position, aircraft rotation speed and crew awareness of associated warning/alert messages. |
Issued: -- | To: GCAA | SR27/2020 |
implement measures that could improve the audit program and checklist used by the inspectors so that the effectiveness of the oversight function related to flight crew training and flight operations is enhanced. |
Issued: -- | To: GCAA | SR28/2020 |
establish a position within the GCAA and induct a subject matter expert in aviation meteorology who is appropriately trained, qualified and experienced inspectorate. |
Issued: -- | To: GCAA | SR29/2020 |
publish recommendations for air navigation service providers: (a) to implement procedures and guidance that would limit the air traffic controller, to the maximum extent, from issuing instructions to flight crews that would modify the published missed approach procedures in case of go around with the sole exception of transmitting essential instructions to ensure air safety; (b) to emphasize the benefits of consistently applying the published missed approach procedure and the risks associated with modifications to such procedure at a time of high flight crew workload when potential for distraction must be minimized; (c) to emphasize, during all phases of air traffic controller training, the importance of correctly timed, concise and effective communication to flight crew performing a missed approach; (d) to incorporate appropriate details of the accident described in this report and the lessons learned into air traffic controller training; |
Issued: -- | To: GCAA | SR30/2020 |
enhance the Civil Aviation Regulations for the provision of flight information services related to information regarding significant changes (see Note) in the meteorological conditions, in particular the latest information, if any, on windshear and/or turbulence in the final approach area or in the takeoff or climb-out area, to be transmitted to the aircraft without delay, except when it is known that the aircraft already has received the information. Note. Significant changes in this context include those relating to surface wind direction or speed, visibility, runway visual range or air temperature (for turbineengined aircraft), and the occurrence of thunderstorm or cumulonimbus, moderate or severe turbulence, windshear, hail, moderate or severe icing, severe squall line, freezing precipitation, severe mountain waves, sandstorm, dust storm, blowing snow, tornado or waterspout. |
Issued: -- | To: GCAA | SR31/2020 |
study the benefit of specifying, and incorporating changes to the Civil Aviation Regulations, the required meteorological equipment used for detection of low-level windshear and alerts; placement of anemometers along the runways; and receiving current aircraft wind information, that will enhance the accuracy and conciseness of the weather information broadcasted from the aviation meteorological forecasters and air traffic controllers. |
Issued: -- | To: GCAA | SR32/2020 |
revise the CAR-OPS so that it is aligned with the requirements of ICAO Annex 2 and ICAO Doc 4444 with regarding submission of the operational flight plan and for the GCAA to specify what information is considered relevant in the flight plan. |
Issued: -- | To: GCAA | SR33/2020 |
provide guidance to the air traffic service providers in the United Arab Emirates, aircraft operators and airport operators, so that following an aircraft emergency where the flight crew is not available, there are effective means of obtaining and transmitting to the search and rescue and firefighting services, information related to persons on board and dangerous goods for flights departing and arriving at United Arab Emirates airports within an acceptable time. This should be aligned with recommended practices as stated in ICAO Doc 4444 chapter on Emergency Procedures and ICAO Doc 9137 - Airport Services Manual, Part 7 - Airport Emergency Planning. |
Issued: -- | To: GCAA | SR34/2020 |
perform a safety study, which should include a review of the Civil Aviation Regulations, to determine the effectiveness to include the requirement that passenger safety briefings and passenger safety cards have clear instructions and illustrations that carry-on baggage must not be taken during an emergency situation and to leave carry-on baggage during an evacuation. The Investigation recommends that the GCAA refer to ICAO Document 10086 - Manual on Information and Instructions for Passenger Safety. |
Issued: -- | To: FAA | SR35/2020 |
perform a safety study in consultation with the Aircraft manufacturer for the purpose of enhancing the Boeing 777 windshear alerting system. This study should encompass both predictive and immediate, TSO-C117a/b windshear systems. |
Issued: -- | To: FAA | SR36/2020 |
perform a safety study in consultation with the Aircraft manufacturer, for the purpose of enhancing the Boeing 777 autothrottle system and TO/GA switches inhibit logic that will avoid pilot errors due to overreliance on automation. The study should also include improvement with crew procedures and training of the autothrottle system and TO/GA switches inhibit logic, with consideration of manual advancement of the thrust levers for a go-around initiated at low altitude and for a go-around initiated after touchdown. |
Issued: -- | To: FAA | SR37/2020 |
require Essex Industries (the manufacturer of the protective breathing equipment PBE), to evaluate the current design features of the PBE container (stowage compartment) and pouch, and develop modifications to prove compliance with TSOC116a and TSO-C99a regarding easy access. |
Issued: -- | To: FAA | SR38/2020 |
review the current Federal Aviation Regulations and relevant guidance material to address inadequate performance of escape slides during evacuations with collapsed landing gear. The review should consider the effect of wind on escape slide performance. |
Issued: -- | To: ICAO | SR39/2020 |
to study the benefit of establishing a global, coordinated and structured data sharing within the industry, which derives the precursors to accidents and serious incidents. This initiative, together with participation of the aircraft manufacturers, should provide clear guidance on how these precursors can be identified through data analysis. |
Issued: -- | To: ICAO | SR40/2020 |
to define Standards and Recommended Practices (SARPS) and procedures for air navigation services so that air traffic controllers, except where necessary for safety reasons are aware as to when it is safe to initiate communication with the flight crew during a go-around. Reference should be made to European Aviation Safety Agency (EASA) Safety Information Bulletin (SIB) No. 2014-06. |