Pacific National's fatigue management procedures required train drivers to not work if they felt fatigued. This requirement primarily relied on drivers self-reporting if they felt fatigued, and there was no proactive assurance that drivers had obtained adequate sleep, including for higher fatigue risk situations. Self-reporting mechanisms were very seldom utilised and Pacific National had not conducted surveys or used other audit mechanisms or processes to identify any perceived or actual barriers to drivers self-identifying fatigue.
The ATSB is satisfied that the actions advised by Pacific National will reduce the risk of this safety issue.
Pacific National has engaged in an enforceable voluntary undertaking (EVU) with the Office of the National Rail Safety Regulator (ONRSR), accepted by ONRSR in May 2023 (see ONRSR website). Pacific National advised the ATSB that the commitments in the EVU underpin the actions that Pacific National has committed to that align to the findings made by the ATSB. In relation to fatigue management, the commitments included:
In November 2023, Pacific National advised the ATSB that it ensures rosters allow for appropriate rest opportunity and also acknowledges that although rosters allow for rest, individual circumstances may result in workers not able to take rest or not gain quality rest. It also advised that it had committed to conducting an extensive review of fatigue risk management, that will involve consultation and engagement with the workforce to understand barriers to fatigue identification and reporting.
Pacific National further advised that it conducted a workplace trial of a tablet application to test an individual’s psychomotor vigilance before a shift. The trial aimed to review the application’s suitability and appropriateness. Pacific National reported that, although the trial provided important feedback, the application was not deemed adequately reliable as a risk control for broader implementation for its operations.
