Collision Between Tandem Tip Truck and the Indian Pacifi C Passenger Train, 4SA8
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ATSB TRANSPORT SAFETY INVESTIGATION REPORT Rail Occurrence Investigation 2007/008 Final Collision between Tandem Tip Truck and the Indian Pacifi c Passenger Train, 4SA8 Virginia, SA 13 December 2007 ATSB TRANSPORT SAFETY INVESTIGATION REPORT Rail Occurrence Report 2007/008 Final Collision between Tandem Tip Truck and the Indian Pacific Passenger Train, 4SA8 Virginia, SA 13 December 2007 Released in accordance with section 25 of the Transport Safety Investigation Act 2003 - i - Published by: Australian Transport Safety Bureau Postal address: PO Box 967, Civic Square ACT 2608 Office location: 15 Mort Street, Canberra City, Australian Capital Territory Telephone: 1800 621 372; from overseas + 61 2 6274 6440 Accident and incident notification: 1800 011 034 (24 hours) Facsimile: 02 6247 3117; from overseas + 61 2 6247 3117 E-mail: [email protected] Internet: www.atsb.gov.au © Commonwealth of Australia 2008. This work is copyright. In the interests of enhancing the value of the information contained in this publication you may copy, download, display, print, reproduce and distribute this material in unaltered form (retaining this notice). However, copyright in the material obtained from other agencies, private individuals or organisations, belongs to those agencies, individuals or organisations. Where you want to use their material you will need to contact them directly. Subject to the provisions of the Copyright Act 1968, you must not make any other use of the material in this publication unless you have the permission of the Australian Transport Safety Bureau. Please direct requests for further information or authorisation to: Commonwealth Copyright Administration, Copyright Law Branch Attorney-General’s Department, Robert Garran Offices, National Circuit, Barton ACT 2600 www.ag.gov.au/cca ISBN and formal report title: see ‘Document retrieval information’ on page v. - ii - CONTENTS THE AUSTRALIAN TRANSPORT SAFETY BUREAU ................................. vi TERMINOLOGY USED IN THIS REPORT.................................................... vii EXECUTIVE SUMMARY ................................................................................. viii 1 FACTUAL INFORMATION ........................................................................ 1 1.1 Overview .............................................................................................. 1 1.2 Location................................................................................................ 1 1.2.1 Train and crew information ................................................ 3 1.2.2 Truck and truck driver information..................................... 4 1.3 The occurrence ..................................................................................... 5 1.4 Post occurrence..................................................................................... 6 1.5 Toxicology tests.................................................................................... 6 1.6 Loss and damage................................................................................... 7 2 ANALYSIS ...................................................................................................... 8 2.1 Sequence of events analysis.................................................................. 8 2.1.1 Passage of train ................................................................... 8 2.1.2 Passage of truck – truck speed............................................ 9 2.1.3 Sounding of locomotive horn ............................................. 9 2.2 Level crossing traffic control.............................................................. 10 2.2.1 Traffic control system effectiveness ................................. 11 2.2.2 Level crossing compliance................................................ 11 2.2.3 Sighting distance............................................................... 13 2.3 Truck driver behaviour ....................................................................... 14 2.3.1 Crossing awareness........................................................... 14 2.3.2 Fatigue .............................................................................. 15 2.3.3 Expectation ....................................................................... 15 2.4 Other accidents ................................................................................... 16 3 FINDINGS..................................................................................................... 18 3.1 Context................................................................................................ 18 3.2 Contributing safety factors ................................................................. 18 3.3 Other safety factors............................................................................. 18 3.4 Other key findings .............................................................................. 19 - iii - 4 SAFETY ACTIONS...................................................................................... 20 4.1 Department for Transport, Energy and Infrastructure (Level Crossing Unit) .................................................................................... 20 4.1.1 Level crossing risk assessment ......................................... 20 4.2 Australian Rail Track Corporation ..................................................... 20 4.2.1 Reducing road/rail interface risk....................................... 20 4.2.2 Road/rail interface agreement........................................... 21 4.3 City of Playford Council..................................................................... 21 4.3.1 Reducing road/rail interface risk....................................... 21 4.3.2 Road/rail interface agreement........................................... 22 4.4 Pacific National .................................................................................. 22 4.4.1 Sounding of locomotive horn ........................................... 22 APPENDIX A : SOURCES AND SUBMISSIONS............................................ 23 APPENDIX B : MEDIA RELEASE ................................................................... 25 - iv - DOCUMENT RETRIEVAL INFORMATION Report No. Publication date No. of pages ISBN 2007/008 27 June 2008 34 978-1-921490-45-3 Publication title Collision between tandem tip truck and the Indian Pacific passenger train, 4SA8 – Virginia, SA 13 December 2007 Prepared by Reference No. Australian Transport Safety Bureau Jun2008/Infrastructure 08181 PO Box 967, Civic Square ACT 2608 Australia www.atsb.gov.au Acknowledgements The map section identified in this publication is reproduced by permission of Geoscience Australia, Canberra. Crown Copyright ©. All rights reserved. www.ga.gov.au. The satellite view of the Virginia area as depicted at Figure 2 of this publication is reproduced with the permission of Google Earth. The ATSB acknowledges the cooperation of all who participated and assisted in this investigation. Abstract At approximately 1417 on 13 December 2007 a tandem tip truck loaded with a ‘bobcat’ excavator drove into the side of the Indian Pacific passenger train (4SA8) at the passively controlled level crossing of Moloney Road near Virginia in SA. As a result of the collision, the truck driver was seriously injured. The locomotive drivers were shaken but not hurt. There were no injuries to passengers or the train’s hospitality staff. The investigation concluded that the accident occurred because the driver of the truck entered the level crossing while a train was on the crossing and that he did not come to a halt at the level crossing ‘Stop’ sign. It is likely that the truck driver was not expecting a train at the level crossing and accordingly did not stop. Safety actions recommended as a result of the investigation include a review of the Australian Level Crossing Assessment Model (ALCAM) with respect to assessing the risks associated with level crossings having a history of incidents/accidents and measures to reduce the road/rail interface risk at the Moloney Road level crossing. - v - THE AUSTRALIAN TRANSPORT SAFETY BUREAU The Australian Transport Safety Bureau (ATSB) is an operationally independent multi-modal bureau within the Australian Government Department of Infrastructure Transport, Regional Development and Local Government. ATSB investigations are independent of regulatory, operator or other external organisations. The ATSB is responsible for investigating accidents and other transport safety matters involving civil aviation, marine and rail operations in Australia that fall within Commonwealth jurisdiction, as well as participating in overseas investigations involving Australian registered aircraft and ships. A primary concern is the safety of commercial transport, with particular regard to fare-paying passenger operations. The ATSB performs its functions in accordance with the provisions of the Transport Safety Investigation Act 2003 and Regulations and, where applicable, relevant international agreements. Purpose of safety investigations The object of a safety investigation is to enhance safety. To reduce safety-related risk, ATSB investigations determine and communicate the safety factors related to the transport safety matter being investigated. It is not the object of an investigation to determine blame or liability. However, an investigation report must include factual material of sufficient weight to support the analysis and findings. At all times the ATSB endeavours to balance the use of material that could imply adverse