On 1 June 2010, a Fairchild Industries Inc. SA226-TC (Metro II) aircraft, registered VH-NGX, was being prepared for a charter passenger service from Perth to the Southern Cross aeroplane landing area (ALA), Western Australia (WA).

Prior to departing, the crew obtained the weather forecasts for the flight. The area forecast (ARFOR), which covered a large area, forecast fog, while the aerodrome forecast (TAF), which covered a particular location, forecast conditions as clear. The crew contacted the Bureau of Meteorology (BoM) to confirm the conditions. The crew received an amended forecast for Southern Cross indicating fog, and visibility reducing to 300 m until 0800 Western Standard Time; after this time conditions were forecast to improve.

Due to the payload requirements of the flight, additional fuel for an alternate aerodrome could not be carried as required if the weather conditions at Southern Cross were unfavourable. Consequently, the crew elected to delay the departure from Perth until 0800.

While en route, the crew observed a band of cloud between Perth and Southern Cross. On arrival at Southern Cross, the conditions were not as expected by the crew, with overcast low cloud and fog present. The crew tracked to the north of the airstrip, where the fog had cleared, and commenced the approach. In order to remain clear of cloud and maintain visual sight with the runway, the aircraft was descended to 337 ft above ground level (AGL). From this point, the crew determined that a straight-in-approach could not be conducted and a low level circling approach to position the aircraft on final for runway 14 was performed. The aircraft landed at about 0915 without further incident.

The BoM conducted a review of this incident and made a number of recommendations, including making forecasters aware of the synoptic conditions behind this incident and its consequential effect on users; and as part of a national review, establishing the minimum observation requirements needed in order to issue and maintain a weather watch on a TAF.

On 1 June 2010, an Airbus A320-232 aircraft, registered VH-VQL, was being operated on a scheduled passenger service from the Gold Coast, Queensland (Qld) to Sydney, New South Wales (NSW). On arrival at Sydney the passengers commenced disembarking through the aircraft's forward and rear doors. During this time, a ground handler drove a cargo loader towards the rear cargo door of the aircraft in preparation for unloading baggage and cargo.

When the loader was about 3 m away from the aircraft, the ground handler stopped the loader, completed the relevant safety checks and then commenced moving towards the aircraft. After moving forward about 0.3 m the loader unexpectedly accelerated towards the aircraft. The ground handler reported he was unable to stop the loader or turn it away from the aircraft prior to it impacting the aircraft just forward of the rear cargo door. The aircraft, cargo loader and rear passenger stairs sustained serious damage. No one was injured in the incident.

A subsequent inspection by the operator identified that when the throttle pedal was depressed to the full open position, the pedal would intermittently become caught on the throttle stop due to a missing striker plate on the back of the pedal assembly.

As a result of this incident, the operator inspected all their cargo loaders of the same model to ensure they were not missing the striker plate. One loader was found to be missing a striker plate and this has since been repaired.

On 30 May 2010, an Airbus Industrie A320-232 aircraft, registered VH-VQZ, departed Sydney, New South Wales (NSW) on a scheduled passenger service to the Gold Coast, Queensland (Qld). The copilot, who was under training, was designated as the pilot flying for the flight.

The aircraft arrived at the Gold Coast and an instrument approach was commenced. During the landing, the flare was initiated early and the aircraft floated along the runway. The pilot in command (PIC) instructed the copilot to lower the nose of the aircraft; however, the aircraft appeared to maintain a level pitch attitude. The PIC determined that the landing could not be achieved and assumed control of the aircraft. The PIC initiated a go around, during which time the aircraft's main landing gear momentarily contacted the runway. The missed approach procedure was commenced, and a second approach was made without further incident.

The failure to identify or execute a go around/missed approach procedure has been cited by the Flight Safety Foundation as one of the major causes of approach-and-landing accidents. This incident highlights the importance of recognising when a go around should be initiated and supports the safety benefits of being 'go-around-prepared' and 'go-around-minded'.

On 16 May 2010, an Embraer ERJ 190 aircraft, registered VH-ZPF, was being operated on a positioning flight from Adelaide, South Australia (SA) to Brisbane, Queensland (Qld). After arriving in Brisbane, the pilot in command (PIC) reported that the load and trim sheet for the aircraft was inaccurate due to certain items being counted twice in the aircraft's load and trim calculations.

It was found that an error occurred when the Adelaide airport movements coordinator (AMCO), during a period of high workload, inadvertently selected the incorrect aircraft configuration in the company's computerised load and trim system.

The aircraft was not operated outside its weight and balance limitations; however, there were implications for how the pitch trim was set prior to takeoff.

The operator has raised an amendment to its flight operations manual to clarify the correct configuration to use when compiling a load and trim sheet for a positioning flight. The operator has also implemented changes to its load control system software to prevent the inadvertent selection of the incorrect configuration while preparing a load and trim sheet.

At about 1253 Eastern Standard Time on 20 May 2010, a Bell Helicopter 206L LongRanger III helicopter, registered VH-OSU, commenced forestry spraying operations about 37 km south-south-west of Latrobe Valley Airport, Victoria. At about 1354 the pilot commenced a final spray run that resulted in the helicopter's flightpath crossing a powerline that was known to the pilot. The helicopter contacted the wire, seriously damaging the helicopter's flight control system and main rotor mast, which likely rendered it uncontrollable. The helicopter subsequently impacted the ground. The pilot was fatally injured.

The investigation found that it was likely that the pilot failed to recall the existence of the wire. The inherent difficulty of visually detecting the wire, combined with the operating groundspeed, meant that the pilot would not have had sufficient time to avoid the wire after seeing it. An examination of the wreckage of the helicopter did not find any mechanical abnormalities that might have contributed to the accident.

No permanent or temporary high visibility devices were attached to the powerlines, nor were they required to be. The helicopter was not fitted with wirestrike protection system (WSPS) equipment, nor was it required to be by aviation regulation. The investigation was unable to determine if a WSPS might have altered the outcome of the wirestrike.

As a result of this accident, Energy Safe Victoria issued a wire safety alert to aerial work operators and infrastructure providers. The Australian Transport Safety Bureau (ATSB) issued a Safety Advisory Notice to Energy Networks Australia and operators and pilots that are involved in low-level operations. The notice suggested that, where wires exist in areas where low-level activity occurs, operators and pilots consider the need for any powerlines to be marked in accordance with AS 3891.2, 2008, Part 2: Marking of overhead cables for planned low level flying operations. In addition, the ATSB has published an educational report aimed at increasing awareness among low-level operators and those agencies organising such activities. The ATSB has also commenced a research investigation that seeks to more fully understand the wirestrike risk in Australia.

At 1845 Singapore Time on 27 May 2010, an Airbus A321-231, registered VH-VWW and operating as Jetstar flight JQ57, was undertaking a landing at Singapore Changi International Airport. The aircraft was not in the correct landing configuration by 500 ft height above the aerodrome and, as required by the operator's procedures in the case of an unstable approach, the crew carried out a missed approach.

The investigation identified several events on the flight deck during the approach that distracted the crew to the point where their situation awareness was lost, decision making was affected and inter‑crew communication degraded. In addition, it was established that the first officer's performance was probably adversely affected by fatigue.

The investigation did not identify any organisational or systemic issues that might adversely impact the future safety of aviation operations. However, following this occurrence, the aircraft operator proactively reviewed its procedures and made a number of amendments to its training regime and other enhancements to its operation.

Executive summary

On 16 May 2010, the chief engineer of British Sapphire was being medically evacuated using the ship's fast rescue boat for the transfer. The fast rescue boat party consisted of the chief mate, second mate and fourth engineer. The chief engineer, second mate and fourth engineer were injured when, during the launch, the ship's fast rescue boat dropped 18 m and impacted the water below.

The investigation determined that, in the process of lowering the rescue boat, the wave compensator mechanism on the fast rescue boat's davit was activated early, before the rescue boat had reached the water. A fail safe interlock device should have prevented this by placing the wave compensator into standby mode, only becoming operational when the fast rescue boat was waterborne. However, the electrical installation of the interlock was incorrect and meant it could not work as designed, allowing the wave compensation unit to always operate and the fast rescue boat to make the uncontrolled descent to the sea.

The investigation identified safety issues relating to the commissioning, maintenance, testing, operating instructions and procedures for the fast rescue boat's wave compensator and its safety interlock system. Further safety issues were identified relating to the job hazard analysis for the use of the fast rescue boat, crew resource management principles and approved training courses for fast rescue boats.

The ATSB is satisfied that the safety action taken by BP Shipping and Davit International addresses these safety issues. The ATSB remains concerned about the adequacy of training in the use of wave compensation units on fast rescue boat davits and has released a safety advisory notice to national and international maritime training institutions about this safety issue.

On 9 May 2010 at 1700 local time, an Airbus Industrie A319-115 aircraft, registered VH-VHD, was being operated on a charter flight from Cocos (Keeling) Island to Christmas Island. On departure, the aircraft taxied with its forward integral air stairs still extended. The aircraft was brought to a halt, the stairs were inspected and then retracted, and the flight continued normally. The warning system designed to inform the crew that the air stairs were extended did not function correctly in this instance.

The operator has advised the Australian Transport Safety Bureau (ATSB) that as a result of this occurrence, it has introduced a number of safety actions, including:

• revised procedures for the management and operation of internal stairs on the A319
• a clear definition of the duties of company engineers when carried on operational flights.

On 12 May 2010, an instructor and student were conducting circuit training in an Eagle Aircraft Australia X-TS 150 aircraft, registered VH-FPP, at Jandakot Aerodrome, Western Australia. Soon after lift-off the engine started to run rough and lost power. The instructor took over control and, maintaining between 50 and 100 ft above ground level, turned the aircraft towards another runway. Near the end of that runway the aircraft pitched nose-up, stalled and collided with the ground, seriously damaging the aircraft and injuring the occupants.

There was no evidence found of an aircraft defect or anomaly likely to have significantly affected engine power. The investigation found that the decision by the instructor to turn downwind significantly increased the aircraft's energy and therefore the risk of aircraft damage and occupant injury in the case of a forced landing.

This report was originally released on 1 April 2011; however, it was subsequently discovered that not all of the directly involved party responses had been considered before the report was approved for release. Those comments have now been considered and this version amends the previously released final report.

On 7 May 2010, at about 1458 Eastern Standard Time (EST), a Boeing 747-422 aircraft, registered N128UA was being operated on a regular public transport flight from Sydney, Australia to San Francisco, USA. Shortly after conducting a reduced-thrust take-off, the crew was advised by Sydney Air Traffic Control that the aircraft had sustained a ground strike. After completing the appropriate checks and dumping fuel, the crew returned the aircraft to Sydney and landed. A subsequent inspection revealed scrape damage to the aircraft's lower rear fuselage consistent with contact with the runway surface.

Analysis of recorded flight data by the aircraft manufacturer indicated that the aircraft was subject to a wind gust during rotation. That, combined with a high instantaneous pitch rate around the time of lift-off and a reduction in lift due to spoiler deployment, reduced the tail to runway clearance. Another contributing factor was the reduced-thrust take-off, which increased the aircraft's exposure to wind variations during rotation. The manufacturer also noted that, had the crew applied a smaller left control wheel input at an earlier stage of the take-off, it was possible that the spoilers would not have deployed, resulting in a small increase in tail clearance.

Although the investigation did not identify any organisational or systemic issues that might adversely affect the future safety of aviation operations, following the occurrence, the aircraft operator revised its flight manual for the 747-422.