A serious incident which saw a glider and a helicopter come too close to each other shows the dangers and responsibilities that exist at Australia’s non-towered aerodromes.

On 29 June 2013, a Janus glider departed from the Bacchus Marsh aeroplane landing area to conduct a local flight with the pilot and one passenger. At the same time, the pilot of a McDonnell Douglas 500N helicopter was conducting circuits.

The Bacchus Marsh aeroplane landing area is located in uncontrolled airspace and does not have an air traffic control presence. Instead, pilots are responsible for making themselves aware of nearby aircraft and maintaining separation. Key strategies for doing so include making sufficient radio broadcasts so that other pilots know your intention, and maintaining a lookout for other aircraft all times.

As the pilot of the helicopter flew towards the end of the runway from the east, the glider was flying to the same point from the south.

As the pilot of the helicopter flew towards the end of the runway from the east, the glider was flying to the same point from the south. Both pilots had broadcast calls announcing their intentions on the common traffic advisory frequency (CTAF)

As the glider drew near to the end of the runway, the glider-pilot observed the helicopter ahead and below him, approaching the runway. The glider-pilot estimated that the helicopter passed only about 100 ft below the glider. 

Both pilots reported that they had not heard the other’s broadcasts, and the ATSB investigation could not determine why this might have been the case. The Gliding Federation of Australia found that the limited forward and downward view from the rear seat due to the glider’s natural blind spots and the large frame of the front seat occupant may have affected the pilot’s ability to see the helicopter until it was in close proximity.

The issue of safety at non-towered aerodromes is one of the ATSB’s targeted concerns, and forms part of its SafetyWatch warning initiative. A booklet, A pilot’s guide to staying safe in the vicinity of non-towered aerodromes outlines many of the common problems that occur at non-towered aerodromes, and offers useful strategies for pilots to keep themselves and others safe.

Read the final report: Aircraft proximity event between Janus, VH-IZI, and MD500N, VH-KXS, Bacchus Marsh (ALA), Victoria, on 29 June 2013

The ATSB is warning pilots of the dangers of flying over water in low visibility conditions and encouraging pilots to access detailed weather briefings, after four family members died when their aircraft collided with water.

The accident occurred on 1 April 2013, 150 km south-west of Darwin, Northern Territory. A group of pilots were intending to fly various light aircraft from Bullo River homestead to Emkaytee, a private airstrip near Darwin. Their departure was delayed, however, by low cloud. When the group accessed aviation forecasts and weather radar images, they saw that there were isolated thunderstorms, low cloud and rain in the area.

By lunchtime, the weather had lifted at Bullo River, and the weather radar images were indicating improvement along the route. All of the pilots departed between 1300 and 1500, some electing to track via the coast and the rest flying in a more direct route. Among the aircraft was a Cessna 210, carrying a pilot and three family members. That plane would track via the coast.

The group of pilots kept in contact by radio, communicating on a discrete frequency. At about 1510, the pilot of the Cessna 210 reported that he was approaching Cape Ford and the weather ahead was gloomy. He did not sound distressed and at the time no importance was attached to the call. However, that was the last time anyone heard from the Cessna 210.

When the Cessna 210 did not arrive at Emkaytee, search and rescue authorities were notified and some pilots from the group departed in a few aircraft to search the area where the pilot last reported and to check the airstrips in the area.

During the flight from Bullo River to Emkaytee, the pilot continued to track along the planned coastal route towards a thunderstorm, probably encountering conditions such as low cloud, reduced visibility and turbulence, and as a result of one or more of those factors the aircraft descended and collided with water.

Searching in the Cape Ford area was not possible due to continuing storm activity, and fading light forced the return of the search aircraft. The search resumed the next morning until some bodies and a small amount of wreckage from the aircraft were found on the southern part of Anson Bay, about 10 km south-east of Cape Ford. There were no survivors.

The ATSB investigation found that, as the pilot tracked along the planned coastal route, he would have been flying towards a thunderstorm. He would probably have encountered conditions such as low cloud, reduced visibility and turbulence. As a result of one or more of those factors, the aircraft descended and collided with water.

The ATSB is warning pilots of the dangers of flying over water in low visibility conditions and encouraging pilots to access detailed weather briefings, after four family members died when their aircraft collided with water.

When flying in marginal weather conditions, it can be advantageous to track visually via a coastal route. Navigation may be easier, and such a route can ensure an absence of elevated terrain. However, flying over water can mean an increased risk of spatial disorientation when confronted with drastically reduced visibility.

In situations where poor weather is forecast, the ATSB urges pilots to access the Bureau of Meteorology detailed weather briefings to assist with understanding the conditions at the time as well as the immediate trend.

Read the final report: Loss of control and collision with water involving Cessna 210, VH-EFB, 160 km south-west of Darwin, Northern Territory, on 1 April 2013

As it came into land, a Cessna 172N struck a powerline, leaving two people injured and one person dead.

The Australian Transport Safety Bureau has released important advice to pilots and the owners of aeroplane landing areas (ALA) after a fatal accident in Victoria.

On 29 October 2012, a Cessna 172N was flying from Coldstream to a private ALA at Bagshot, Victoria, with a pilot and two passengers on board. As the aircraft approached short final on the approach, its nose landing gear contacted a powerline located at the southern end of the airfield.

The powerline significantly reduced the aircraft’s forward speed, sending the Cessna rotating about its nose and impacting the airstrip in an almost inverted attitude. Almost immediately, a fuel-fed fire began at the wing roots. Witnesses assisted the aircraft occupants from the aircraft, however the pilot was seriously injured and the rear seat passenger sustained minor injuries, while the front-seat passenger had died.

The ATSB found that the pilot had been aware of the powerlines, but that his recollection was that they were closer to the tree line in the area leading up to the landing strip. In addition, a lack of adequate warning markings and the fact that the area leading up to the landing strip was mown led him to believe that the entire strip was useable for landing. This perception, combined with the inherent difficulty of visually detecting wires and the distraction of another recently-landed aircraft on the airstrip, reduced the likelihood of his detecting the wire.

There were no high visibility devices attached to the powerlines, nor were any required under the current Australian Standards.

In response to this accident, the owner of the ALA has made significant changes to the runway markings, landing permission procedures affecting operations at the ALA and the available safety and firefighting equipment. In addition, markers have been erected near the powerline.

The ATSB’s investigation report points ALA-owners to resources that can help them manage the risk of collision with obstacles. It also advises pilots to allow themselves sufficient time to make appropriate decision, and urges them to ensure that everyone in their aircraft is wearing seatbelts correctly, affording the best chance of survival in case of an accident.

Read the final report: Wirestrike involving Cessna 172, VH-TKI, 13 km north-east of Bendigo, Victoria, on 29 October 2012

The ATSB is urging drivers to be vigilant at railway level crossings, to observe road warning signs, obey road rules and look out for trains. 

The accident occurred on 19 March 2013 at the Brown Street level crossing in Allansford, Victoria. The El Zorro freight train 9261 was travelling to Warrnambool, Victoria on a scheduled service. 

The level crossing was marked with approach warning signage, road markings and Stop signs for each road approach. Just as the train came to the level crossing, the train’s co-driver, who was seated in the left hand side of the cab, noticed the approaching vehicle. He called out to the train driver to make an emergency brake application. The motor vehicle did not stop at the stop sign, but instead drove onto the level crossing, directly into the path of the freight train, just as the emergency brake was applied. 

The vehicles collided, and the severely damaged motor vehicle came to rest southwest of the level crossing, approximately 33 m from the point of impact. The train continued braking, coming to a stop about 434 m from the level crossing.

The driver of the motor vehicle was fatally injured. Minor damage was sustained by the lead locomotive. There were no injuries to the train crew.

The ATSB found that the south side of the crossing – the direction from which the motor vehicle driver approached the crossing – allowed adequate sighting to the east, the direction from which the train approached. The ATSB concluded that the driver’s familiarity with this crossing, combined with the expectation that a train would not be present due to the low frequency of rail traffic on this line, probably influenced his behaviour.

Warrnambool City Council has temporarily closed the Brown Street Level Crossing until it is equipped with active traffic controls such as lights, bells or boom barriers.

Read the final report: Collision between a motor vehicle and freight train 9261, Brown Street level crossing, Allansford, Victoria, on 19 March 2013

A derailment that spilled about 89 litres of phosphoric acid has shown the critical importance of detecting track defects before they cause an accident.

The derailment occurred on 9 April 2013, near Lowdina in Tasmania. The train, which consisted of five locomotives hauling 28 wagons, was being operated by a single driver. It had departed Burnie that morning, bound for Boyer in Southern Tasmania. 

A few kilometres away from Lowdina, the track made a tight curve to the left, and as the third wagon travelled over the curve, it came into contact with a twist defect in the rails. The leading wheels of the wagon were jolted off the rails, and the rear wheels derailed a few metres later. 

The train continued on, however, with the driver unaware of the derailment of the third wagon. At Lowdina, the derailed wagon struck a set of points, and the impact completely derailed the third wagon, dragging the fourth and fifth wagons off the tracks. The wagons separated and spilled their containers around the adjacent area. The third wagon was carrying two containers of sodium hydrosulphite while the fourth wagon held a tank of phosphoric acid solution.  

The separation caused the train’s brakes to apply automatically, and it stopped about 90 m later. The driver notified the train control centre and TasRail employees were dispatched to the site. Phosphoric acid was discovered leaking from the top hatch of the tank and a number of spill kits were deployed to contain the leak.

Early detection and conscientious management of track defects is critical in maintaining safe rail operations.

It was estimated that about 89 litres of phosphoric acid escaped from the tank, most of which was contained on site. Eventually, the site was declared safe and investigation/recovery operations began. Approximately 800 steel sleepers were replaced along with about 24 m of rail and associated fasteners and switch gear.

The ATSB investigation identified the large twist defect as the cause of the initial derailment, and found it likely that a previously undetected, small to medium sized twist defect had developed under the passage of the train.  

Prior to this incident, the network owner/manager (TasRail) had identified the need to renew the track infrastructure in the area of the derailment and anticipates that the track between Colebrook and Campania should be renewed by June 2014.

The ATSB emphasises to all rail operators that early detection and conscientious management of track defects is critical in maintaining safe rail operations.

Read the final report: Derailment of train 331, near Lowdina, Tasmania, on 9 April 2013

The ATSB determined that a combination of hot weather and track disturbance activities resulted in a misalignment of the track and a freight train derailment.

The derailment occurred on 12 February 2013 at Locksley, near Seymour in Victoria. The train, an intermodal freight train, was hauling 33 wagons from West Gate Ports, Melbourne through to Harefield in New South Wales. After traversing the Nagambie-Locksley Road level crossing near Locksley, both drivers saw a large track misalignment ahead of them. The driver throttled off from a speed of 108 km/h in an attempt to ride through the misalignment.

Hot weather in the period leading up to the derailment, along with the trains travelling along the track, probably combined with maintenance activities to affect the concentrations of stress within the track, causing it to buckle.

The train continued over the misalignment and travelled a further kilometre, at which time the driver assumed that the train had passed through safely when he noticed a significant reduction in brake pipe pressure—a possible indicator of a train parting or a derailment. The driver brought the train to a halt, then inspected the train and found that the rear eight wagons had derailed. The last three wagons, though still coupled to the train, had progressively dropped away off the track embankment with the last wagon having completely slipped to the bottom of the formation.

The ATSB investigation found that the track misalignment was most likely the cause of the derailment. Investigators identified several factors that would have combined to buckle the track. The quality of the track was already suffering from ballast contamination, which would have weakened its resistance to lateral forces. Hot weather in the period leading up to the derailment, along with the trains travelling along the track, probably combined with maintenance activities to affect the concentrations of stress within the track, causing it to buckle.

As a result of the accident and the investigation, the Australian Rail Track Corporation (ARTC) has initiated several measures to address the problem. Maintenance staff have received additional training, while the track has been tested at 10 sites near the point of derailment. Meanwhile, the ARTC has implemented a ballast remediation program on the Melbourne-Sydney rail corridor.

The ATSB urges all track managers to take the factors of this accident into account when undertaking maintenance and reviewing the condition of their tracks.

Read the final report: Derailment of freight train 3MC1, near Locksley, Victoria, on 12 February 2013

The benefits of having an operational transponder was recently demonstrated when a Fokker and Cessna’s close proximity activated the collision avoidance system.

The incident occurred on 22 May 2013 at Karratha Airport in Western Australia. A Fokker F28-100 was approaching Karratha on a scheduled passenger flight, flying about 10-11 NM behind a Boeing 717. A Cessna 310R was departing Karratha on a charter flight to Exmouth.

Air traffic control (ATC) advised the Cessna pilot of the Fokker’s presence, but made no mention of the Boeing. The Cessna pilot advised ATC that the traffic had been sighted. The pilot was then instructed to pass behind the aircraft and track to Exmouth. The Cessna pilot, believing the aircraft sighted was the Fokker, commenced tracking to Exmouth. The aircraft sighted was in fact the Boeing, which was ahead of the Fokker.

Shortly after, the Fokker’s traffic collision avoidance system (TCAS) activated. TCAS is an aircraft system that monitors the airspace around an aircraft for other aircraft equipped with a corresponding active transponder and gives warning of possible collision risks.

The pilot of the Cessna saw the Fokker approaching about 1 to 2 NM away and above, and descended the aircraft. Meanwhile, the crew of the Fokker complied with the TCAS instruction to climb. The Cessna passed safely about 700 ft below the Fokker, and both aircraft continued to their destinations.

The incident showed not only the benefits of the TCAS, but also highlighted the importance of ensuring that traffic information be relevant and sufficient.

The incident showed not only the benefits of the TCAS, but also highlighted the importance of ensuring that traffic information be relevant and sufficient.

Read the final report: TCAS warning between Cessna 310R, VH-AEY, and Fokker F28-100, VH-FKJ, near Karratha Airport, Western Australia, on 22 May 2013, which contains links to useful information on Class D airspace and the see-and-avoid principle.

A radio dead zone or an underpowered portable radio may have contributed to a loss of communication between an aircraft and an aviation rescue fire fighting (ARFF) vehicle.

On 26 May 2013, the pilot of a Piper PA-31 aircraft taxied for departure from Port Hedland for a flight to Karratha, Western Australia. The pilot made the necessary common traffic advisory frequency (CTAF) broadcast.

A few minutes later, an ARFF vehicle that had been operating on the eastern side of the airport, entered the taxiway to return to the fire station on the western side. The fire crew made a broadcast to announce their intention to cross the runway. Hearing no response and seeing no aircraft on the runway, the vehicle crossed the runway.

The pilot taxied onto the threshold of runway 32 and commenced the take-off roll. The pilot reported making the required CTAF broadcasts. As the aircraft became airborne, the pilot observed the fire vehicle crossing the runway about 500 m ahead.  The pilot judged it safer to continue the take-off. The aircraft passed over intersection of the runway and taxiway between 300 ft and 400 ft above ground. By that time, the fire vehicle had cleared the runway.

The crew of the ARFF vehicle had not heard any broadcasts, nor did they see the aircraft, possibly due to heat haze.  The ATSB examined recordings of transmissions broadcast on the Port Hedland CTAF and identified a number of broadcasts made by the pilot and the crew of the ARFF vehicle, however, the pilot’s broadcasts made near the runway threshold were not recorded.

The crew of the ARFF vehicle had not heard any broadcasts, nor did they see the aircraft, possibly due to heat haze.

At the time of the incident, the ARFF crew were using a portable radio as the Port Hedland ARFF service was in ‘setup’ mode awaiting approval by the regulator. The radio mounted in the vehicle had not been programmed to the correct frequency. Airservices Australia determined that the transmission power of the portable radio was lower than the radios mounted in the vehicle and that there may have been a radio dead zone near the runway 32 threshold.

Following the incident Airservices Australia is releasing a national operations safety note advising ARFF operators of the efficient use of aviation radio communications when driving on an airfield. They will also undertake a review of radio coverage at Port Hedland as part of radio commissioning works.

Read the final report: Runway incursion between Piper PA-31, VH-KLS and vehicle, at Port Hedland Airport, Western Australia, on 26 May 2013

The ATSB investigation into a fatal helicopter accident has highlighted the dangers of operating overloaded helicopters.

The accident occurred on 9 December 2012, on a property near Mudgee, New South Wales. The Robinson R44 Raven I helicopter was being used to conduct aerial spraying activities. Following a number of spray runs, the helicopter failed to return to the refilling station. The helicopter was later found about 450m up a hill from the refilling station, having collided steeply with terrain. The pilot died in the accident.

The ATSB investigation found that, immediately before the accident, the helicopter was climbing up a hill at reducing speed. It was also about 33 kg above the maximum allowable weight of 1,089 kg and, crucially, too heavy for a high hover at full engine power. As the helicopter’s speed reduced below about 10 kt (20 km/h) it began to descend. The pilot did not have enough time, and possibly height, to recover and the helicopter hit a tree, before crashing steeply into the ground.

The accident tragically demonstrates the dangers of loading helicopters beyond their recommended limits, especially when undertaking operations where performance is critical, such as low flying or aerial spraying operations.

The accident tragically demonstrates the dangers of loading helicopters beyond their recommended limits, especially when undertaking operations where performance is critical, such as low flying or aerial spraying operations. Pilots should always follow manufacturers’ performance data to avoid the dangers associated with this accident.

Read the final report: Loss of control involving Robinson R44 helicopter, VH-WOH, 20 km south-west of Mudgee, New South Wales, on 9 December 2012