Review by the Chief Commissioner The Australian Transport Safety Bureau (ATSB) became a separate statutory agency on 1 July 2009. This was the final step in the transition to independence from being an operational division of the Department of Infrastructure, Transport, Regional Development and Local Government. This Annual Report covers the first year of operations under those new arrangements. Operational start‑up for the new organisation was smooth and well‑controlled, thanks in large part to the hard work of our corporate services staff and our colleagues in the Infrastructure Department…

Most aerodromes in Australia are located in uncontrolled airspace and do not have an air traffic control presence. At these non-towered aerodromes, and in the vicinity of them, pilots are responsible for making themselves aware of nearby aircraft and maintaining separation. This report aims to give pilots an appreciation of the types of safety events that have been associated with operations at non-towered aerodromes and provide education on expected behaviours to assist pilots in being prepared for the risks. Generally, operations at non-towered aerodromes can be considered to be safe, but…

Summary Most aerodromes in Australia are located in uncontrolled airspace and consequently do not have an air traffic control presence. At and around non-controlled aerodromes, pilots are responsible for making themselves aware of nearby aircraft and maintaining separation. This report aims to provide pilots with an appreciation of the types of safety events that are associated with operations at non-controlled aerodromes and provide education on expected behaviours to assist pilots in being prepared for the risks.  Generally, operations at non-towered aerodromes can be considered to be…

With the intensity of agricultural related aviation activity increasing at this time of the year with activities such as locust spotting and spraying, it is important that all aerial work pilots maintain an awareness of the fatal consequences of fatigue while carrying out these activities. The ATSB was recently notified of an incident where a pilot undertaking locust spotting activities needed to be woken by an observer on the aircraft. The pilot reportedly flew part-time, and his fatigue may have been related to his other activities as a farmer. Not only is fatigue brought on by the amount…

Two aviation occurrences in 1999, one of them a fatal mustering incident and the other a wheels-up landing, highlight some of the potential hazards of fatigue on flying performance. Mustering accident A newly-licensed private pilot was fatally injured at Mindaroo Station in Western Australia when mustering sheep with a Cessna 172. The accident happened late in the afternoon at the end of more than eight hours of low-level flying following nine days of intense flying activity. During the nine days, the pilot had flown 68 (tachometer) hours. The flying was both mentally and physically…

The ATSB has issued three safety recommendations arising from the ongoing investigation into the circumstances in which a Piper PA31-350 Chieftain ditched in Spencer Gulf SA with the loss of eight lives during a regular public transport (RPT) service from Adelaide to Whyalla on 31 May 2000 (Occurrence 200002157). The recommendations relate to mixture leaning procedures and the carriage and use of life saving equipment. Immediately prior to the accident the pilot gave a MAYDAY report to Flight Service indicating that the aircraft had experienced two engine failures. The investigation found…

Bob Kells and his investigation team had arrived at the accident site by helicopter. It had been at least a day since the Twin Otter had struck trees nine kilometres south west of Simbai in the Bismark Ranges, Papua New Guinea, when the crew had tried to fly it out of a steep valley. It was an incredible sight. The fuselage was intact. The wings had been taken off by the trees. Ahead of it was a precipice -- a steep drop from which there may have been no survivors had the aircraft gone over. It was a unique situation. Bob had been able to interview the crew in hospital and they talked openly…

The pilot of a Sikorsky S76 helicopter was left with only lateral cyclic control when a loose screw lodged at the base of the cyclic stick. During transition from normal cruise flight to the approach to land the pilot found that the cyclic could not be moved aft. He also found that with any further forward movement of the cyclic stick it could not be moved aft of the new position. The pilot froze the cyclic longitudinal position and the helicopter stabilised in a level pitch attitude at about 85 knots indicated airspeed. Using only lateral cyclic movements to manoeuvre the helicopter, the…

One of the most dangerous situations a pilot operating under Visual Flight Rules (VFR) could be faced with is the complete loss of visual reference. In the last five years, 28 people have been fatally injured in such circumstances. VFR flight into IMC Year Occurrences Accidents Fatalities 1995 38 7 13 1996 34 1 2 1997 33 1 3 1998 39 4 3 1999 36 4 7 On 14 October last year, a VFR pilot with 220 hours flying experience set off from Lightning Ridge for Caloundra in a Cessna 182 in VFR weather. Although the weather forecasts looked reasonable when he took off, by the time he was…

The Avgas contamination event that happened over Christmas 1999 caught everyone by surprise. It had not been seriously considered as a potential hazard to aviation anywhere in the world, therefore the consequences had not been considered. The reasons behind why the fuel became contaminated were unexpected. Mike Watson, one of a team of transport safety investigators who had the task of sifting though an overwhelming amount of data and publishing the final report, gives some insight. No one was hurt as a result of contaminated aviation fuel, and there were no accidents that could be attributed…