FAA SPECIAL AIRWORTHINESS
Aviation Safety INFORMATION BULLETIN
SAIB: CE-10-33R1
SUBJ: Engine Exhaust Date: August 16, 2010
This is information only. Recommendations aren’t mandatory.
Introduction
This Special Airworthiness Information Bulletin (SAIB) communicates an airworthiness concern to
all owners and operators of reciprocating engine-powered airplanes that use an exhaust system heat
exchanger for cabin heat. This revision clarifies the airworthiness concern is for aircraft that use an
exhaust system heat exchanger for cabin heat.
At this time, this airworthiness concern is not considered an unsafe condition that would warrant an
airworthiness directive action under Title 14 of the Code of Federal Regulations (14 CFR), part 39.
Background
The Federal Aviation Administration tasked Wichita State University to conduct research that
focuses on carbon monoxide safety issues as they apply to general aviation products. A technical
report titled “Detection and prevention of carbon monoxide exposure in General Aviation Aircraft,
Document No. DOT/FAA/AR-09/49, dated October 2009” is available from the National Technical
Information Services using the contact information noted below and is also available electronically at
http://www.tc.faa.gov/its/worldpac/techrpt/ar0949.pdf.
The report shows that after researching National Transportation Safety Board (NTSB) accidents
related to carbon monoxide (CO) poisoning, the muffler system was the top source of CO. For the
CO-related cases where the muffler was identified as the source of the CO leakage, 92 percent had a
muffler with more than 1,000 hours of service.
When developing this SAIB, the FAA considered the NTSB investigation of an accident on
December 17, 2000, where a Beech Model BE-23 aircraft impacted terrain killing the commercial-
rated pilot, the sole occupant of the airplane. The NTSB determined the probable cause of the
accident was in part “the pilot’s incapacitation due to carbon monoxide (CO) and a fractured
muffler.”
Recommendation
The FAA recommends that you do the following:
1. Replace the mufflers on reciprocating engine-powered airplanes that use an exhaust
system heat exchanger for cabin heat with more than 1,000 hours on the muffler and at
each 1,000-hour interval, unless the manufacturer recommends or FAA regulations
require a more frequent replacement.
2. Review and continue to follow the guidance for exhaust system inspections and
maintenance in SAIB CE-04-22, dated December 17, 2003, and Advisory Circular 43-
16A, Aviation Maintenance Alert (AMA), issued October 2006, All Powered Models,
Carbon Monoxide Poisoning Potential.
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3. Use CO detectors while operating your aircraft as recommended by SAIB CE-10-19R1,
dated March 17, 2010.
4. Continue to inspect the complete engine exhaust system during 100-hour/annual
inspections and at inspection intervals recommended by the aircraft and engine
manufacturers following their applicable maintenance manual instructions.
For Further Information Contact
Sarjapur Nagarajan, Aerospace Engineer, FAA Small Airplane Directorate, 901 Locust, Kansas City,
Room 301, Missouri 64106; phone: (816) 329-4145; fax: (816) 329-4090; email:
sarjapur.nagarajan@faa.gov
For Related Information on the Technical Report, Contact:
U.S. Department of Commerce
National Technical Information Services (NTIS)
Alexandria, Virginia 22312
(703) 605-6000 or 1-800-553-6847
