Tag Archives: RAIB

UK: RAIB Launches investigation into pedestrian fatality

22 Mar
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Grimston Lane Footpath level crossing (source RAIB)

The independent Rail Accident Investigation Branch (RAIB) has announced that it is investigating the February 23rd, 2016 pedestrian fatality on Grimston Lane footpath level crossing in Trimley St Martin, Near Felixstowe, Suffolk.

This level crossing, which is over a single railway track, links two parts of Grimston Lane, an unclassified tarmac road on the western edge of Trimley St Martin, leading through farmland to Trimley Lower Street.

The RAIB investigation will identify the sequence of events which led to the accident and consider any factors which may have influenced the actions of the pedestrian. It will also consider whether the design and/or management of the crossing were factors in the accident.

The RAIB report will be published in due course.

 

Woodbridge, UK: RAIB report recommendations have wide implications for user worked level crossings

15 Dec

The Rail Accident Investigation Branch (RAIB) has published the report of its investigation into the collision that occurred on the passive Jetty Avenue user worked crossing (UWC) in Woodbridge, Suffolk, on July 14th, 2013. The report contains five recommendations that have implications for the management of UWCs in Great Britain (these are detailed in full at the end of this blog post). The early evening collision involved a passenger train approaching Woodbridge station in daylight and at low speed. The train was not derailed, but the car driver suffered minor injuries.

The car driver was using the level crossing to access a private boatyard situated between the railway and the River Deben. He was a volunteer, assisting in removing equipment following a local regatta which had been held partly on land owned by the boatyard earlier in the day. The car driver had used the level crossing on previous occasions, but had not been briefed on its use.

There were no telephones or warning lights at the crossing so safe use depended on vehicle drivers looking for approaching trains. The car driver, who was an occasional user of the level crosssing, normally relied on checking for trains by looking up and down the railway when swinging open the vehicular gates on foot. He did this because he was aware that his view of the railway would be obscured as he returned to the car and drove it towards the crossing. A curve in the railway meant that the train involved in the accident was not visible to the car driver when he was at the crossing, and could only be seen from this location after the driver had begun to return to his car. The driver did not become aware of the train until he had driven his car into its path.

The RAIB investigation has found that instructions given to car drivers using this, and similar, user worked level crossings were inadequate. It also found that Network Rail’s method for ensuring that vehicle drivers have an adequate view of approaching trains was incompatible with the characteristics of both the car involved in the accident and many of the vehicles expected to use crossings of this type.

The RAIB believes it is possible that the accident at Jetty Avenue UWC could have been avoided by full implementation of two Recommendations in its title=”2009 report”>http://www.raib.gov.uk/publications/investigation_reports/reports_2009/report132009.cfm) 2009 report: Investigation into safety at user worked crossings’. These relate to guiding vehicle drivers to stop at an appropriate place before deciding whether it is safe to cross the railway.

RAIB has made five recommendations. Four recommendations are addressed to Network Rail and cover the management of level crossings where safe use of the crossing relies on road vehicle drivers seeing approaching trains. One recommendation is made to the Office of Rail Regulation and seeks clarification of its guidance on this issue.

1. The intent of this recommendation is to reduce the short-term risk associated with inadequate sighting of approaching trains at user worked crossings by checking that sufficient allowance is made for the position of the driver in the types of vehicle likely to use the crossing. This recommendation should be implemented pending the completion of research referred to at Recommendation 2.

Network Rail should implement a time-bound plan for the re-assessment of the sighting of approaching trains at all user worked crossings where safe use depends on vehicle drivers sighting approaching trains. The time-bound plan should also cover implementation of any mitigation needed to permit safe use of such crossings. The objective of the re- assessment process shall be to verify that drivers seated in the normal driving position of their vehicle have sufficient sighting of approaching trains when the front of their vehicle is stopped a safe distance clear of the line (paragraphs 103 and 105). In providing guidance to staff, Network Rail should consider:

  • the range of vehicle stopping positions
  • the types of vehicles likely to use each crossing (particularly the distances of the driver’s eyes from the front of the vehicle); and
  • any effects due to crossing gates being open, including obstruction of sighting by signs on the gate, when vehicle drivers are looking for trains

2. The intent of this recommendation is to identify measures which complement those achieved by Recommendation 1. It is intended to assist risk management until such time as all UWCs are equipped with technology capable of providing reliable advice to crossing users.

Network Rail should commission research into measures to improve the safety of UWCs where vehicular users are reliant on sight to detect the approach of trains (paragraph 103). This should utilise and, as necessary, extend existing research findings to include consideration of:

  • the ways in which the behaviour of vehicle drivers can be influenced by the design of the crossing to use the crossing as intended including
  • stopping and looking for trains at an appropriate location;
  • use by different types of vehicle, including heavy commercial and agricultural vehicles;
  • use of the crossing by persons other than those briefed by the authorised user (eg unexpected visitors or delivery vehicles)
  • instructions and/or guidance given to users, including signs and road markings where appropriate; and
  • Instructions and guidance provided to those assessing, maintaining and modifying UWCs.

This research should take into account the safety of pedestrians (including vehicle occupants when opening gates), cyclists and equestrians who may use UWCs.
The findings of this research should be used by Network Rail to improve/ clarify existing standards related to the design (including gates, signage and road markings), management of user worked crossings, guidance provided to users and training/briefing to relevant staff. Network Rail should also identify the need for any modification to the legal requirements relating to level crossing signage requirements, and make suitable representations to government that this be done.

3: The intent of this recommendation is for Network Rail to provide those responsible for checking level crossing signage with information in a user-friendly format needed to establish the signage required at each level crossing.

Network Rail should review, and if found necessary, modify its processes so that staff checking level crossing signage have a practical and easily used means of establishing the signage required at each crossing they are inspecting (paragraph 107).

4: The intent of this recommendation is for Network Rail to review and update its method of calculating crossing times.

Network Rail should, in consultation with ORR, review and if necessary, amend the criteria used to calculate crossing times with reference to vehicle speed, the time taken to reach a decision when to start crossing and vehicle length (paragraph 107).

5: The intent of this recommendation is for the Office of Rail Regulation to provide enhanced guidance relating to user worked crossings, including guidance about how the decision point is determined in order that the sighting of approaching trains is measured from an appropriate location.

The Office of Rail Regulation should provide duty holders with enhanced guidance which:

  • reminds duty holders that, when determining the position of decision points at user worked crossings, they must take due account of the characteristics of vehicles likely to use the crossing and recognise that a minimum dimension of 3 metres from the nearest rail is insufficient for most vehicles; and
  •  takes account of outputs from the research and review undertaken in response to Recommendations 2 and 4.

http://www.raib.gov.uk/cms_resources.cfm?file=/141215_R282014_Jetty_Avenue_UWC.pdf

Attenborough, UK: RAIB reports on “second train” fatal accident

22 Aug

At 14:48 hrs on Saturday 26 October 2013, a pedestrian was struck and fatally injured by a train on Barratt’s Lane No.2 footpath crossing, at Attenborough near Nottingham.
The train was travelling from Nottingham towards Birmingham. At the same time,
a London to Nottingham train was slowly approaching the crossing from the other direction. It is likely that the pedestrian had concentrated her attention on the London train and did not notice the train approaching from the Nottingham direction.
Both trains were fitted with forward facing closed circuit television equipment and the recording from the London to Nottingham train showed that the pedestrian approached the crossing and waited at the gate for 17 seconds before opening it; she started to cross the line 9 seconds later (the train was stopped at a red signal for part of this time). It is most likely that, having seen the London train stopped at the signal, she waited until she had determined that the train was not moving before deciding to cross the line. The sighting distances in both directions were adequate.
Network Rail had assessed the risk at the crossing, in accordance with its standard procedures, and, because the risk rating was relatively high, discussed the options for reducing this risk at a meeting with the highway authority. The chosen option was to divert the footpath and close the crossing. This had not been implemented at the time of the accident as the route of the proposed diversion was obstructed by an equipment room. The room contained signalling equipment that did not become redundant until completion of the Nottingham station resignalling project at the end of August 2013. The equipment room was demolished and the footpath diverted after the accident.
The RAIB has identified one learning point and has made no recommendations.

For double track lines, kissing gates arranged with the hinge on the right-hand side encourage footpath users to face towards the oncoming traffic on the nearest line as they exit from the gate . This is particularly relevant where the gate is close to the track. RSSB is shortly to provide advice on how the arrangement of gates and barriers at a crossing influences the behaviour of pedestrians (project T984), and will include this in a future update of the level crossing risk management toolkit.

Kemble, UK: RAIB announces investigation of fatal accident

29 Jul
Frampton Mansell UWC, source RAIB

Frampton Mansell UWC, source RAIB

The Rail Accident Investigation Branch (RAIB) has announced that it is investigating a fatal accident that occurred on a level crossing at Frampton Mansell, between Kemble and Stroud, on May 11th, 2014. At about 18.40, a motorcyclist was riding his motorbike across the railway when he was struck by a train travelling from Swindon to Gloucester, and died shortly afterwards.

The crossing, which is over two railway tracks, links an unclassified tarmac road on the northern edge of Frampton Mansell with a track running through farmland towards Sapperton. The unstaffed crossing is provided with simple swing gates, and signs which give warnings and instructions to users on how the crossing is to be used safely. On each side of the crossing are located telephones which are linked to the signalling centre.

RAIB’s investigation will identify the sequence of events which led to the accident and any factors which may have influenced the actions of the user. It will also examine:
  • Network Rail’s management of the crossing;
  • the history of the crossing; and
  • the permitted uses of the track and road on the approaches to the crossing.

RAIB’s investigation is independent of any investigation by the safety authority (the Office of Railway Regulation).

RAIB will publish its findings, including any recommendations to improve safety, at the conclusion of its investigation. These findings will be available on the RAIB website.

Llandovery, UK: RAIB releases investigation report

28 May

The UK’s independent Rail Accident Investigation Branch (RAIB) has released its report into a near-miss incident that occurred when a train proceeded across the level crossing in the town of Llandovery, Carmarthanshire when it was open to road traffic at about 05.56 on JUne 6th, 2013.

The Llandovery level crossing is operated by the train’s conductor using a control panel located on the station platform. The level crossing was still open to road traffic because the conductor of the train in question had not operated the level crossing controls. The conductor did not operate the level crossing because he may have had a lapse in concentration, and may have become distracted by other events at Llandovery station.

The train driver did not notice that the level crossing had not been operated because he may have been distracted by events before and during the train’s stop at Llandovery, and the positioning of equipment provided at Llandovery station relating to the operation of trains over the level crossing was sub-optimal.

The RAIB identified that an opportunity to integrate the operation of Llandovery level crossing into the signalling arrangements (which would have prevented this incident)was missed when signalling works were planned and commissioned at Llandovery between 2007 and 2010. The RAIB also identified that there was no formalised method of work for train operations at Llandovery.

The RAIB has made six recommendations. Four are to the train operator, Arriva Trains Wales, and focus on improving the position of platform equipment, identifying locations where traincrew carry out operational tasks and issuing methods of work for those locations, improvements to its operational risk management arrangements and improving the guidance given to its duty control managers on handling serious operational irregularities such as the one that occurred at Llandovery.

Two recommendations are made to Network Rail. These relate to improvements to its processes for signalling projects, to require the wider consideration of reasonable opportunities to make improvements when defining the scope of these projects, and consideration of the practicability of providing a clear indication to train crew when Llandovery level crossing, and other crossings of a similar design, are still open to road traffic.

The full RAIB report can be found at: http://www.raib.gov.uk/cms_resources.cfm?file=/140515_R112014_Llandovery.pdf.

Welshpool, UK: RAIB report into harvest-time accident published

4 Apr

LXinfoImage1234-Buttington Hall RAIBThe United Kingdom’s independent Rail Accident Investigation Branch (RAIB)has published the report of its investigation into the causes of an accident on a private level crossing near Welshpool.

The accident occurred at 11.44 on July 16th, 2013 when a passenger train collided with a farmer’s trailer on the Buttington Hall level crossing near Welshpool on the line between Shrewsbury and Machynlleth. The tractor driver and two other people nearby sustained minor injuries and two passengers on the train were injured and taken to hospital, but were discharged later that day.

The train which was carrying a crew of two and 140 passengers was travelling at 75 mph at the time of the collision. . On the day of the accident, the farm crossing was being used by tractors bringing in a harvest from fields on the opposite side of the line to the farm. The farmer had appointed a contractor to carry out the harvesting operation, and an attendant had been provided at the crossing to phone the signaller and operate the gates.

The accident occurred because the system of work in use at the crossing was inherently unsafe, leading to ineffective control of vehicle movements over the crossing and frequent use of the crossing without the signaller being contacted. This system broke down. There were also underlying management factors:
~ The harvest contractor did not implement an effective safe system of work at the crossing
~ Network Rail’s process for risk assessment of these types of crossing did not adequately deal with periods of intensive use
~ Network Rail’s instructions to users of these crossings did not cover periods of intensive use

The RAIB has made three recommendations:
~ Main line infrastructure managers should improve the risk assessment process at these crossings to take into account the increased risk during periods of intensive use
~ Main line infrastructure managers should define safe and practical methods of working to be adopted at these crossings during periods of intensive use
~ RSSB should update the level crossing risk management toolkit to reflect the changes brought about by the second recommendation

The RAIB has also noted a learning point from an observation made during the investigation concerning the prolonged closure of an adjacent level crossing on a main road after the accident.

Please note: The Rail Accident Investigation Branch (RAIB) has released an update (May 2nd, 2014) to its report into a collision at Buttington Hall level crossing, near Welshpool on July 16th, 2013. The report has been revised to correct an error related to the actions of the signaller and to clarify the wording of the learning point.

The full RAIB report can be downloaded at http://www.raib.gov.uk/cms_resources.cfm?file=/140327_R062014_Buttington_Hall.pdf

Taunton, UK: RAIB report brings with it three recommendations

24 Feb

The Rail Accident Investigation Branch (RAIB) has published its report concerning the accident that occurred on Athelney automatic half-barrier (AHB) level crossing, near Taunton, Somerset, on March 21st, 2013. The RAIB has made fourLXinfoImage1226-Athelney AHB LC-source RAIB recommendations variously addressed to Network Rail as owner of the rail infrastructure, The Rail Safety and Standards Board (RSSB) as industry standards body and The Office of Rail Regulation (ORR) as regulator.

The accident occurred at about 06.23 when a car was driven around a lowered half-barrier
barriers. This took the car into the path of a train which was approaching the crossing at high speed. The driver of the car was killed in the resulting collision.

The motorist drove around the barriers without waiting for a train to pass and the barriers to re-open. The level crossing was closed to road traffic for longer than normal before the arrival of the train, because of earlier engineering work that had affected the automatic operation of the crossing.

The motorist may have believed that the crossing had failed with the barriers in the closed position, or that the approaching train had been delayed. He did not contact the signaller by telephone before he drove around the barriers.

The RAIB has made two recommendations to Network Rail. These relate to reducing the risk resulting from extended operating times of automatic level crossings and to modifying the location of the pedestrian stop lines at Athelney level crossing. A further recommendation is addressed to Network Rail in conjunction with RSSB, to consider means of improving the presentation of telephones at automatic level crossings for non-emergency use. One recommendation is addressed to the Office
of Rail Regulation, to incorporate any resulting improvements which are reasonably practicable into the guidance it publishes on level crossings.