Safety Monitoring and Reporting of Accidents and Failures Affecting Rail Vehicles and Equipment

Transcription

1 Issue One Date April 1994 Safety Monitoring and Reporting of Accidents and Failures Affecting Rail Vehicles and Equipment Signatures removed from electronic version Submitted by... Colin Boocock Nominated Responsible Manager Approved by... John Mitchell Chairman, Traction and Rolling Stock Subject Committee... Ken Burrage Controller, Safety Standards Synopsis This standard defines requirements for monitoring, reporting, recording, analysing and taking corrective action following safety related defects, incidents and accidents affecting rail vehicles and equipment. This document is the property of Railtrack. It shall not be reproduced in whole or in part without the written permission of the Controller, Safety Standards. Published by Safety & Standards Directorate Railtrack Railway Technical Centre LondonRoad 1994 Railtrack

2 Safety Monitoring and Reporting of Issue One Accidents and Failures Affecting Rail Date April 1994 Vehicles and Equipment page I of IS Contents Section Description Page Part A Issue record 2 Responsibilities and distribution 2 Implementation 2 Disclaimer 2 supply 2 Part B I Purpose 3 Scope 3 Definitions 3 Requirements 5 Safety performance monitoring 5 Defect reporting 5 High risk defect, incident and accident identification and reporting 7 Records 8 Appendices A Flow chart 9 B (Suggested Form I ) Safety related incident report 10 C (Suggested Form 2) Safety related incident feedback report 13 D (Suggested Form 3) Urgent safety related defect report 14 References 15 RAIL TRACK I

3 Issue One Safety Monitoring and Reporting of Date April 1994 Accidents and Failures Affecting Rail Page 2 of I 5 Vehicles and Equipment Part A [SSUerecord This standard will be updated when necessary by distribution of a complete replacement Amended or additional parts of revised pages will be marked by a vertical black line in the adjacent margin. Issue Date Comments 1 Apr 94 Original document. Supersedes GM/TTO 178, GM/lT026 I & SP-PM-094. Responsibilities and Controlled copies of this standard shall be distributed to and complied distribution with by engineering and operating personnel who are responsible for monitoring rail vehicle and equipment safety performance, or who are responsible for managing systems for reporting and analysing defects on rail vehicles and equipment that affect safety and safe interworkmg. Implementation The provisions of this are mandatory and apply from I June Disclaimer The Safety & Standards Directorate (S&SD) shall use its best endeavors to ensure that the conten~ layout and text of its standards are accurate, complete and in line with current best practice insofar as is reasonably practicable. It makes no warranties, express or implied, that compliance with all or any of its standards shall be suficient to ensure safe systems of work or operation. The S&SD will not be liable to pay compensation in respect to the content or subsequent use of its standards, except where it can be shown to have acted in bad fhith or there has been wilful defhult. Sllpply Controlled and uncontrolled copies of this standard must be obtained from the TDCC Manager, Document Services, Railway Technical Centre, London Road, Derby, DE248UP. 2 RAIL TRACK

4 Riilway Group Standard Safety Monitoring and Reporting of Issue One Accidents and Failures Affecting Rail Date April 1994 Vehicles and Equipment page 3 of IS Part B 1 Purpose To mandate that the safety performance of rail vehicles and plant and machinery equipment is monitored against targets. To ensure that all defects m rail vehicles and equipment that may affect safety or safe interworking are reported, recorded and analysed, and that necessary corrective action is taken. It also ensures that all high risk defec~, accidents and safety related incidents are formally reported. 2 Scope This Group standard applies to all rail vehicles and plant and machinery equipment that are used on the railway network. Its requirements support the provisions of GHZTO 162 and GO/0TOO04 and are additional to them. 3 Definitions Accident An unplanned event which has led to death, ill health, injury, damage or other loss. Incident An unplanned, uncontrolled event which could have led to an accident. Defect Failure of or damage to a component, system, rail vehicle or equipment that prevents or impairs its intended function. High risk defect, incident or accident (I) A safety related defec~ incident or accident that has or could have caused: (a) a fatality or statutorily reportable injury to one or more persons; (b) damage to equipment to put at risk the safety of trains; (c) damage to the environment to put at risk the safety of living systems (human and other). (2) Any incident affecting rail vehicles or equipment that is likely to result m a prosecution by the Health & Safety Executive. (3) A safety related defect that, at the decision of the engineer, gives rise to the need to undertake an urgent campaign check, component replacement or repair programme, or fleet or equipment withdrawal. BRIMS British Rail Incident Monitoring System, or other nation-wide successor system. Rail vehicle Any vehicle described as traction and rolling stock (i.e. locomotive, stock or wagon) or on-track machines. coaching RAIL TRACK 3

5 Rdway Group Standard Issue One Date Am-it 1994 Page 4 of I 5 Safety Monitoring and Reporting of Accidents and Failures Affecting Rail Vehicles and Equipment Equipment [terns of plant and machinery used by a rad businesses. Does not include infrastructure related equipment (e.g. electrification, signaling, telecommunlcatlons). Environment The surroundings and conditions in which Railtrack operates, including living systems (human and other) therein. As the environmental effects of the organisation may reach all parts of the world, the environment in this context extends from within the workplace to the global system. Railway Group British Rail, Railtrack and all bodies whose activities are the subject of a railway safety case accepted by Radtrack, together with those other organisations who are considered by the Safety & Standards Directorate have the potential to make a significant contribution to safety and safe interworking as a result of their involvement. to Railway network Those lines of radway operated by Railtrack, and by other organisations that mandate s for use on their lines. Rail business Franchisee or other organisation operating trams or stations or undertakings and activities on the railway network, associated sidings, infrastructure or buildings. ROSCO British Rail-owned passenger traction and rolling stock Ieasmg company. TESCO British RatI-owned traction and rolhng stock service company. Engineer The person providing engineering support for the rail vehicles or equipment of a rad business. Local manager The person in charge of a separate engineering activity, e.g. fleet manager, depot manager. InterWorking The ability of rail vehicles or equipment to work on the railway network and with other rail vehicles and equipment, as determmed by business, operating and emergency requirements. Safety The avoidance of death, injury or poor health to customers, employees, contractors and the general public, caused by occupational accidents, 4 RAIL TRACK

6 Safety Monitoring and Reporting of Issue One Accidents and Failures Affecting Rail Date April 1994 Vehicles and Equipment page 5 of 15 incidents or hazards, also avoidance of damage to property environment. and the 4 Requirements To ensure the continued and improving safety of rail vehicles and plant and machinery equipment, rail businesses are required to monitor their safety performance. They are required to have systems in place that ensure they react urgently and positively whenever a defect occurs, or whenever an adverse trend develops that can affect the safety of the railway network. This standard therefore sets requirements in respect of: safety performance monitoring. safety related defect reporting and analysis systems. In addition this standard also sets requirements. safety related incident assessmen~. safety related incident reporting. in respect of Neither BRIMS nor the requirements of this standard displace the need for existing or proposed technical defect and incident reporting systems and documents. All systems for the statutory reporting of incidents shall remain in use. 5 Safety performance 5.1 Basic elements monitoring A rail business must ensure that a safety performance monitoring system is in place that contains the following elements:. a system for setting safety performance targets for each item of risk,. a system for collecting and analysing data generated; regular rewew of safety performance; comparison of performance with targets; corrective action. 5.2 Source data Source data from a safety performance monitoring system must include appropriate data from: a safety related defect reporting system; and be supplemented by data from (as available):. other systems for reporting safety related incidents and accidents. 5.3 Analysis The analysis and review of data for safety performance monitoring shall be as described in paragraphs 6.4 and Defect reporting 6.1 Reporting at source Defect reporting systems must be in place that ensure that any defect that occurs on rail vehicles or equipment that may affect safety and safe interworkhg is reported and acted upon as soon as possible after the defect is discovered. Facilities to report such defects shall be made avadable to all Railway Group staff who are likely to need to report defects on rail vehicles or equipment and who must be trained to operate the system. RAIL TRACK 5

7 GMIRT2250 Issue One Date April 1994 Page 6 of 15 Safety Monitoring and Reporting of Accidents and Failures Affecting Rail Vehicles and Equipment A defect reporting system must enable a person to report the following data (where appropriate):. location on the railway networlq time and date; train description number;. service being worked (start time, start location, destination);. radway vehicle or equipment numbe~ c details of the defecq. control mode of the railway vehicle or equipmen~ remedial action taken on site; any operating restrictions applied; identtflcation of the nearest door or wheel, as appropriate (see GM/1-To404);. any other relevant data. A defect reporting system shall enable the person reporting the defect to be identified. A defect reporting system shall enable details of the defect and any operating restrictions to be passed on to any staff subsequently becoming responsible for the operation of the rail vehicle or equipment. 6.2 Investigation and correction of safety related defects A defect reporting system shall enable reported safety related defect data to be transmitted to the local manager (see definition in section 3) responsible for the defectwe rad vehicle or equipment, so that the local manager can arrange for the defect to be investigated and can organise corrective action. Corrective actions shall be recorded. 6.3 Collation of data from defect reports All rail businesses shall have in place systems to collate from all sources, the reports of defects on rail vehicles or equipment for which they are responsible. The collated information shall enable data to be aggregated against safety related defects; equipmenl systems and component types. 6.4 Analysis of data All rail businesses shall have in place systems for the collection and analysis of data relating to rail vehicles, equipment and component types and designs that ensure that levels and trends in safety defects are revealed. 6.5 Review of defects and defect analyses 6.5. I Immediate When a high risk defect occurs (see definition in section 3 of high risk defect, incident or accident), or when a review of the analysed data indicates that a safety critical defect is becoming high risk, the process in section 7 of this standard shall be used. 6 RAIL TRACK

8 GIWRT2250 Safety Monitoring and Reporting of issue One Accidents and Failures Affecting Rail Date April 1994 Vehicles and Equipment page 7 of Routine The engineer shall regularly review levels and trends in the occurence of safety defects. From the results of these reviews, the necessary corrective action shall be taken. 6.6 Feedback Itis recommended that a system be provided for the person who initially reported a safety related defect to be given details of the cause of the defect and subsequent action taken. 7 High risk defect, If an event occurs that meets the definition of a high risk defec~ incident incident ~d accident or accident (see definition in section 3), a common reporting procedure identification ~d must be followed, initiated by the local manager. reporting If the engineer decides that a high risk defect requires an urgent campaign check, or component replacement or repair programme, or fleet or equipment withdrawal, other interested parties. he must Immedmtely initiate an urgent advice to The procedure is shown on the flow chart (see Appendix A). Key points are detailed below. Suggestions for report forms are given in Appendices B to D. 7. I Local managers (see definition in section 3) are responsible foc. validating BRIMS entries as appropriate;. assessingsafety related defects, incidents and accidents on or concerning rail vehicles or equipment occurring or discovered in their area or reported to them, in order to determine whether any defec~ incident or accident is high risk. reporting high risk safety related defects, incidents and accidents, using a Safety Related Incident Report (suggested Form I - see Appendix B), to the engineer with the engineering responsibility for the rail vehicles or equipment. Additional sections may be added to this form if required. Existing damage reports and other forms relevant to the information required to complete the form can be attached to it as a substitute for completion of the relevant section. Urgent reports shall be supplemented by Immediate telephone or facsimile reporting to the enginee~. maintaining a local record of all high risk defects, incidents or accidents. 7.2 The engineer (see definition in section 3) is responsible for. determining the receiving and action point(s) to which the Safety Related Incident Reports (Appendix B) are to be sent and advising the local managers;. analysing the reports received from local managers and from BRIMS and analysing trends; deciding whether a high risk defect requires urgent advice to other interested parties; sending immediately this urgent advice in writing (FAX, etc.) to the control office of the local Railtrack zone control where the accidenl RAILTRACK 7

9 Issue One Safety Monitoring and Reporting of Date April 1994 Accidents and Failures Affecting Rail Page 8 of 15 Vehicles and Equipment incident or defect happened or was discovered, for onward transmission to the Railtrack National Incident Room;. mmating any corrective action considered necessary to reduce the potential risks to the safety of persons and the railway and the well-being of the environmen~ validating BRIMS as necessa~,. advising the report sender of actions taken. 7.3 The Rah-ack National Incident Room is responsible for recording each urgent advice of a high risk defect and for distributing this advice immediately to all rail businesses, TESCOS and ROSCOS, and the BR Director, Safety. 7.4 The rail businesses, TECSOS and ROSCOS and the BR Director, Safety are responsible for:. notifying the Railtrack National Incident Room of a 24-hour single contact to receive urgent advices of high risk defects;. acknowledging receipt of urgent advice reports within 24 hours. 7.5 The rail businesses, TECSOS and ROSCOS are responsible for: advising other owners of any rail vehicles or equipment revolved in an urgent advice situation; accepting full responsibdity for initiating essential action for similar rail vehicles, equipment or components under their control. 8 Records Safety Related Incident Report (suggested Form I - Appendix B) All records to be retained by the local manager and the engineer after the completion of any action taken. Safety Related Incident Feedback Report (suggested Form 2- Appendix C) To be retained by the local manager with the relevant Safety Related Incident Report (Form I). Copy to be retained by the originator after the completion taken. of any action Records shall be retained of all recorded defects. Urgent Safety Related Defect Report (suggested Form 3- Appendix D) Records of urgent defect reports to be retained by the Radtrack National Incident Room and the engineer. NB: All documentation retention periods must be in accordance with GM/_lTOl RAIL TRACK

10 Railwav Grouts Standard GMIRT2250 Safety Monitoring and Reporting of issue One Accidents and Failures Affecting Rail Date April 1994 Vehicles and Equipment page 9 of 15 Appendix A FIOW chart (Outlines process described in section 7: High risk defe~ incident and accident identification and reporting.) voefect, INCIOENT ACCIOENT OCCURS OR URGENT ADVICE PROCEOURE I ENGINEER ADVISES RAIL TRACK ZONE CONTROL OF OEFECT 1- t I 5!Z2!Y I RAIL ETC. t t BUSINESSES. ACKNOWLEDGE RECEIPT t I nlocal MANAGER [OENTIFIES RISK LEVEL ANO INVESTIGATES t YES { mm L! \ / F1 ENGINEER REcEI VES FORIA I YES ENGINEER ANALYSES ANO OECIDES ON CORRECTIVE ACTION t rl ENGINEER t , SENOS OETAILS OF CAUSE AND ACTION TO BE TAKEN TO INTER- ESTED PARTIES -=XQ--I cpa t oother ENGINEERS INITIATE CORRECTIVE ACTION t ENGINEER COMPLETES FORM Z ANO FORWARDS TO ~ LOCAL MANAGER F$LE - GMRT22S0 RAIL TRACK 9

11 GWRT2250 Issue One Safety Monitoring and Reporting of Date April 1994 Accidents and Failures Affecting Rail Page 100f15 Vehicles and Appendix B (Suggested Form [) Safety Related in section 3. The process is described in section 7.) Incident Report (Tobe used for high risk defects, incidents and accidents as defined GMmT2250/FoRM I SAFETY RELATED INCIDENT REPORT RAIL VEHICLES AND PLANT & MACHINERY TO: FROM: Copy to BRIMS input point incident Reference No BRIMS Reference No Repom Author Date Local Manager Date ALL APPROPRIATE SECTIONS OF THIS FORM MUST BE COMPLETED I PIACE OF INCIDENT (Where necessary include signal numbers, OLE structure numbers and/or other identification features). 2 DATE OF INCIDENT TIME OF INCIDENT WEATHER CONDITIONS VEHICLE AND UNIT NUMBERS FULL DESCRIPTION OF OCCURRENCE , (continued) 10 RAIL TRACK

12 Safety Monitoring and Reporting of Issue One Accidents and Failures Affecting Rail Date April 1994 Vehicles and Equipment page I I of 15 Appendix B (Suggested Form I) Safety Related Incident Report (continued) /FORM I page 2 7 Required only for incidents on the hne. Tram Reporting No Time From To Vehicle and Unit No ,... Tram Load tons/tonnes No of vehicles No fitted Brake Force tonsltonnes Type of brake in use Posmon of passenger/goods switch (a) DETAILS OF DAMAGE Copy of any exmmg damage report forms can be attached (b) DETAILS OF INJURIES (c) DAMAGE TO ENVIRONMENT (continued) RAIL TRACK II

13 FWway Grou~ Standard. Issue One Safety Monitoring and Reporting of Date April 1994 Accidents and Failures Affecting Rail Page 120f15 Vehicles and Equipment Appendix B (Suggested Form I) Safety Related Incident Report (continued) GIWRT22501FORM I page 3 9 CAUSE AND/OR REMARKS LOCAL ACTION TAKEN Validated BRIMS cause code Technical defect code Note Addnlonal sheets, sketches and photographs can be used to supplement secuons 6,8 and 9. END 12 RAIL TRACK

14 Safety Monitoring and Reporting of Issue One Accidents and Failures Affecting Rail Date April 1994 Vehicles and Equipment page 13 of 15 Appendix C (Suggested Form 2) (To be used for-high risk defects, incidents and accidents as defined Safety Related Incident in section 3. The process is described in section 7.) Feedback Report GMIRT22501FORM 2 SAFETY RELATED INCIDENT FEEDBACK REPORT RAIL VEHICLES AND PLANT & MACHINERY FOR ENGINEER S USE ONLY TO FROM , I Date report received Sender s reference Date of mcldent Incident reference Reportactioned by Summary of ActIon Taken (to include any proposed reports and/or tests) , BRIMS entry correct? P/easecrde YES NO If NO. BRIMS cause code amended to Technical defect code amended to File Reference of follow up detads Signature Date A COPY OF THIS FORM MUST BE SENT TO THE REPORT ORIGINATOR, AND WHEN NECESSARY TO THE BRIMS INPUT POINT END RAIL TRACK 13.

15 Railway GrouD Standard GMIRT2250 Issue One Safety Monitoring and Reporting of Date April 1994 Accidents and Failures Affecting Rail Page 140f15 Vehicles and Equipment Appendix D (Suggested Form 3) (To be used by the Engineer for urgent reporting of defectsto urgent Safety Related Railtrack local zone control oftlce as described in section 7.) Defect Report GMRT22501FORM 3 URGENT SAFETY RELATED DEFECT REPORT RAIL VEHICLES AND PIANT & MACHINERY FOR ENGINEER S USE ONLY TO Radtrack control office ,.... FROM PLEASE DISTRIBUTE THIS MESSAGE IMMEDIATELY Incident Reference No Report Author Date ALL APPROPRIATE SECTIONS OF THIS FORM MUST BE COMPLETED I PLACE OF INCIDENT DATE OF INCIDENT TIME OF INCIDENT WEATHER CONDITIONS (If relevant to defect) VEHICLE AND UNIT NUMBERS FULL DESCRIPTION OF DEFECT OTHER RAIL VEHICLES, PLANT OR MACHINERY LIKELY TO BE AFFECTED BY THIS DEFECT (IF KNOWN) END 14 RAIL TRACK.

16 Gm/RT2250 Safety Monitoring and Reporting of Issue One Accidents and Failures Affecting Rail Date April 1994 Vehicles and Equipment page 15 of 15 References Mandatory references (to bere-issuedasgm/rt2213) GM/TTO I IO Traction and Rolling Stock Records GH/ZTO 162 Reportingof SafetyRelatedInformationto Railtrack Other references GO/0TOO04 AccidentManagementand Investigation BRIMS User/Reference Manual GM/TT0404 (to bere-issuedasgm/rt2212) Datato be Displayedon RailVehicles RAIL TRACK 15