Home | Contact Us | Site Map
Rail Safety Recommendations

This page displays a list of safety recommendations that relate to the rail mode.  You can use the filter tool to refine the results and to search for keywords within the text of each recommendation.

Urgent safety recommendations

Urgent safety recommendations released publicly in advance of a final report are available here until release of a final report at which time they are incorporated into the database.

 

Keywords: Recipient: Mode: Status:

Safety Recommendation 018/16
Issued To NZTA on 25 Aug 16
On 25 August 2016 the Commission recommended to the Chief Executive of the NZ Transport Agency that he liaise with KiwiRail and relevant road controlling authorities to assess and confirm which provincial level crossings have significant safety issues that do not align with the NZ Transport Agency's Traffic Control Devices Manual - Part 9 - Level Crossings, then work with the authorities to ensure that safety improvements are prioritised and implemented.
Implementation Status: Open
Reply: The Transport Agency, in its capacity as rail safety regulator, will formally write to the appropriate entities, including KiwiRail and advise them of the recommendation 018/16 and request that they advise the Agency of how they plan to:
1. Review the level crossings in their areas to establish if there are safety issues that need addressing - in alignment with the NZ Transport Agency?s Traffic control devices manual - Part 9 - Level Crossings
2. Ensure safety improvements are prioritised and implemented.
We will ensure the Commission is kept informed of the progress made relating to this recommendation.

Safety Recommendation 012/16
Issued To NZTA on 27 May 16
A survey of the Te Onetea Road level crossing was carried out to the ALCAM standards on 20 March 2012. The sighting distances in both directions did not allow sufficient time for long vehicles to drive safely over the level crossing without being struck by a train. Therefore, a fully road-compliant long vehicle could not use the level crossing with the recommended margins for safety.

No action had been taken between the 2012 survey and the date of the accident, 27 February 2014, to mitigate the risk to road users and train vehicles. The Commission recommends that the Chief Executive of the NZ Transport Agency work with KiwiRail and Waikato District Council to address this safety issue.
Implementation Status: Open
Reply: In relation to Recommendation 012/16, the Agency intends to refer the sighting distance issue directly to the Waikato District Council and KiwiRail Holdings Ltd.

We will do this at the earliest opportunity and will report progress back to the Commission.

Safety Recommendation 013/16
Issued To NZTA on 27 May 16
It is possible that the Te Onetea Road level crossing is one that has been affected by changes in the allowable dimensions of long, low road vehicles. Unless the profiles of all level crossings are assessed against the current allowable dimensions for long, low vehicles, the potential risk of this type of accident occurring will remain high.

The ALCAM survey measures the gradient of the road leading up to the level crossing, but does not measure the rate of change in gradient in order to record the profile or vertical alignment of the road for the purposes of ensuring that road-legal vehicles can use the level crossing safely without becoming stuck.

It is important that rail level crossings are compatible with road vehicles, and that road users are made aware of limitations on the use of at-risk level crossings, in much the same way that drivers of high vehicles are warned of low bridges and tunnels.

The Commission recommends that the Chief Executive of the NZ Transport Agency work with KiwiRail and all road controlling authorities to ensure that rail level crossing assessments include a measure of the road profile and compatibility with the allowable dimensions for long and low road vehicles.
Implementation Status: Open
Reply: In relation to Recommendation 013/16, the Transport Agency is currently exploring options of how to best find a solution to addrss this safety recommendation.

We will inform the Commission once the Transport Agency has both determind and can detail the scope of what is required.

Safety Recommendation 001/16
Issued To KiwiRail on 25 Feb 16
The Commission recommends that the chief executive of KiwiRail closely monitor the replacement of brake blocks on individual wagons to provide another predictive tool for preventing premature wheel-bearing failures.
Implementation Status: Open
Reply: We accept this safety recommendation and we are in the process of implementing changes within the business to allow the completion of the required actions. In due course we will provide evidence to demonstrate that the recommended actions have been implemented.

Safety Recommendation 011/15
Issued To KiwiRail on 26 Aug 15
Rail workers are not required to give permission for rail medical officers to access medical records held by their private practitioners, which means the rail medical officers would not necessarily have access to all relevant medical information in order to determine their fitness for safety-critical duties.


The Commission recommends that the Chief Executive of KiwiRail introduce a system whereby KiwiRail medical professionals are automatically granted access to employees' medical records held by private medical practitioners as necessary to ensure employees who perform safety-critical roles are not impaired by prescription or over-counter medications.
Implementation Status: Open
Reply: The new recommendation is considered to be in-line with the other recommendations made in the report, and KiwiRail therefore accepts in principle this recommendation.

In order to achieve the new recommendation, it should be appreciated that other authorities will need to implement changes in order to provide the jurisdiction for allowing the disclosure of medical records held by private medical practitioners to be passed over to KiwiRail medical professionals.

Safety Recommendation 010/15
Issued To NZTA on 30 Jul 15
On 30 July 20152 the Commission recommends that the Chief Executive of the NZ Transport Agency liaise with the relevant road control authorities in Auckland and Wellington, and KiwiRail, to review all pedestrian rail crossings and ensure that they address the safety issue whereby they have a level of protection commensurate with the level of risk currently and in the immediate future.
Implementation Status: Closed acceptable
Reply:
KiwiRail and Auckland Transport are working on a solution to address the identified safety issues at the pedestrian level crossings at Morningside Station in West Auckland. The Transport Agency is actively monitoring this situation to ensure the resolution is implemented in an effective and timely manner.

We cannot yet provide a definitive timeframe for when these changes will be completed but give an undertaking to update the Commission once the next stages of this work have been determined by KiwiRail and Auckland Transport.

Safety Recommendation 012/15
Issued To NZTA on 30 Jul 15
On 30 July 2015 the Commission recommends to the Chief Executive of the NZ Transport Agency that from a regulatory perspective he take the necessary steps to ensure that the relevant Safety Case(s) and resultant safety system(s) (including any lease or access agreements made under those systems) expressly articulate which party or parties is responsible for controlling and protecting pedestrians as they cross the boundaries between railway stations and the rail corridor.
Implementation Status: Open
Reply: While the Transport Agency gives the Commission an undertaking to implement this recommendation, we must first consider the statutory and regulatory options in which to do this. This will involve engaging with a number of relevant parties - a process that will take time. We will advise the Commission of our progress in due course.

Safety Recommendation 013/15
Issued To NZTA on 30 Jul 15
On 30 July 2015 the Commission recommends that the Chief Executive of the NZ Transport Agency liaise with the relevant road control authorities in Auckland and Wellington, and KiwiRail, to review all pedestrian rail crossings and ensure that they address the safety issue whereby they have a level of protection commensurate with the level of risk currently and in the immediate future.
Implementation Status: Open
Reply: Throughout New Zealand, a wide range of level crossing-related activities and work is being undertaken by a variety of rail participants and agencies. This work encompasses level crossing infrastructure, planning, funding, risk review and risk mitigation.

Consequently, the Agency is commencing a ?stock-take? of this work and the parties responsible for it to give us a greater knowledge base about the solutions being developed and by whom. When this work is completed and the Transport Agency has a comprehensive picture of the scope of activities underway, it will be in a clearer position to provide the Commission with information about this recommendation.

Safety Recommendation 008/15
Issued To MoT on 28 May 15
There is no requirement for health professionals who provide primary health care to transport industry personnel employed in safety-critical roles to inform appropriate authorities when there are concerns regarding the fitness of duty of such personnel under their care. In this instance the driver had been prescribed a collection of medications that singularly or collectively had the potential to adversely affect his performance, yet he continued to drive freight and passenger trains.


The Commission recommends that the Secretary for Transport address this safety issue.
Implementation Status: Open
Reply: The Ministry of Transport will consider the implications and options. It will work with the NZTA and the rail industry in looking at options for addressing the intent of this recommendation.

Safety Recommendation 009/15
Issued To NZTA on 28 May 15
Safety-critical rail workers are not required to declare prescribed medications they are taking when presenting for triggered health assessments. The driver had been prescribed a combination of medication that was known to cause performance impairment and behavioural changes, anxiety, agitated delirium and disorientation in more severe cases. The medicines also came with a warning to patients to not drive or operate heavy machinery until the effects became known. In this case, although the driver had presented for triggered health assessments, the extent of his medication was not known by a KiwiRail health professional and he continued to drive freight and passenger trains.


Additionally, rail workers are not required to give permission for rail medical officers to access medical records held by their private practitioners, which means the rail medical officers would not necessarily have access to all relevant medical information in order to determine their fitness for safety-critical duties.


The Commission recommends that the Chief Executive of the NZ Transport Agency works with the National Rail System Standards Executive to ensure that all rail workers performing safety-critical work, such as drivers, are required to complete the self-assessment questionnaire when presenting for any pre-placement, change- of- risk, periodic or triggered health assessment.
Implementation Status: Closed acceptable
Reply: The Transport Agency confirms it will implement this final recommendation.

The guidance for rail licence holders around the conduct of the different health assessments categories is currently outlined in National Rail System Standard 3 (NRSS).

NRSS 3 is to be withdrawn later this year and replaced with the National Transport Commission (Australia) document ? National Standard for Health Assessment of Safety Workers (2012). It is anticipated this will be in September 2015.

The Transport Agency has confirmed with the National Transport Commission (Australia) that the intent of the National Standard for Health Assessment of Safety Workers (2012) is that the self-assessment questionnaire be completed by the rail worker when undergoing any type of health assessment.

The Transport Agency gives an undertaking to ensure the NRSS Executive is aware of this intent and that it is clearly conveyed in the Standard.

The time frame for implementation will be communicated to the Transport Accident Investigation Commission as soon as it has been established.

Current Page: 1 of 52
Results: 1 to 10 of 517
  Print