Railway Accidents Reasons and Remedies-Seminar at Bangalore- Paper submitted by Com. Parthasarathy

RAILWAY ACCIDENTS, REASONS AND REMEDIES
I take the opportunity of presenting the above subject before this august assembly where we are very fortunate to have two distinguished personalities, one Com. Basudeb Acharia MP, former chairman of parliamentary standing committee on Railways, next Mr. Prahallad Joshy MP, present member of parliamentary standing committee on Railways whose voices will be heard with rapt attention in the highest form of our democracy (i.e.) Parliament.
Even though Railway Administration is laying statistics that number of casualties in train accidents are still low compared to other transport modes, in recent days the country has witnessed more number of train accidents from our experience we come to know that we need to look beyond the proximate causes of accidents and analyse the more deep rooted factors that lead to recurring train accidents.
In Indian Railways, System Inadequacy and Human element are the two major factors which are to be probed well.
1.SYSTEM INADEQUACY
1.1 MAN POWER PLANNING
In recent years, during annual cadre review, bench mark system is used as basic principle to decide the number of staff required for train operation. In which the quality of work is totally ignored. The less number of staff utilized in one of the areas of Indian Railways will be applied to all other areas blindly without assessing the actual requirement. Result of which, even in safety categories like station masters, loco running staff etc. required leave reserve and trainee reserves are not maintained. Despite mandatory Refresher Courses, Pre Promotion Courses, Loco Running Staff like categories have to undergo training on various locomotives. Hence minimum 10% trainee reserve must be maintained apart from leave reserve. Required man power should be assessed as and when new trains are introduced. Any lapse in Man Power Planning will lead to human failure.


1.2 TECHNOLOGICAL ADVANCEMENTS
Whenever there is a train accident Railway Minister/Railway Administration disseminate technological advancements to avoid human dependence in the system. Various Railway Safety review committees recommended for technological advancement in the complicated railway system. The implementation of technological advancement should be scrutinized to ensure safety.
In recent years, some of the technological advancements taken by Indian Railway are Anti Collision Device (ACD), Train Protection and Warning System (TPWS), Train Actuated Warning Device (TAWD), Vigilance Control Device (VCD) and etc. After Js. H.R. Khanna Committee on Railway Safety Review recommended for formulating a safety plan, Corporate Safety Plan 2003-2013 was published in the year 2003.
1.2.1 Anti Collision Device (ACD
Anti-Collision Device (ACD) – A GPS-based device developed by Konkan Railway Corporation (a Public sector unit of Government of India), which is expected to sense the location of trains and stop trains which are out of normal course and thus prevent collisions. This again helps to reduce dependence on Loco drivers.
In CSP (2003-2013), in para 5.2 it is stated that
“At present provision of ACD is sanctioned on about 3500 route kilometers on Southern, South Central, South Western, North Frontier and Northern Railways.”




In the same CSP 2003-2013 a table of ‘Safety Action Plan-Signalling’ is shown as Annexure A-7

S.No. Item Details Quantiy Funds Required (Rs. in crores) Plan head and Allocation Time frame by
3.1 Items already sanctioned:
ACD works
3419 RKms

235
S &T
DF
2007-08

The reply of Minister of State of Railways K.H. Muniyappa to unstarred Question No. 4299 on Lok Sabha on 19.08.2010 reveals us the current status of implementation of the above said ACD.
“The ACD developed by KRCL has been in service trials as pilot project on 1736 rkms of North East Frontier Railway…………… Further installation of ACD on Indian Railway will be planned, based on performance evaluation of equipment with improved specification on Southern, South Central and Southern Western Railways.”
For the past seven years the progress in work shows the lack of determination of Railways to improve safety. The similar is the fate of VCD also.
1.2.2 Train Protection and Warning System (TPWS)
To prevent trains passing signals at danger. Signal aspects are sensed through track balises and train speed controlled to avert a situation of trains ignoring the signal aspects. Helps to reduce the dependence on loco driver.
In case of TPWS, Annexure A-7 of CSP says the work of TPWS for 280 TKms should be completed in a time frame by 2006-07
TPWS has been introduced in between MAS –GPD section of the Southern Railway for about 50 KM only. But now also, rakes without TPWS are running in the section and when there is a failure in TPWS or when TPWS is malfunctioning ,TPWS is isolated and the same rake is allowed to run in the same condition. It nullifies the very purpose of TPWS. After TPWS is introduced, if it is isolated or failed the particular rake should not be utilized for train service until it is attended. Then only safety can be ensured.
At the same time, the CSO’s CONFERENCE held on 9th & 10th SEPTEMBER, 2010, pat on their back that as per the mid-term performance audit of the CSP most of the targets/goals set in the Plan on a pro-rata yearly basis have been achieved. It may be seen that up to 31.03.2010 (7th year of CSP) there has been 92.27% financial progress vis a vis the funds provision made in the CSP book (Rs.31,835.01 crore ). But contrarily C&AG in its audit of the CSP has mentioned that there is no Action Plan to execute the second half of CSP works.

1.3 ATTITUDE OF MANAGEMENT
It is learnt that the Railway Ministry / Railway Board has decided to review and modify the existing General Rules (Open line) 1976, taking into consideration the new Technologies and Communications, Procedures and Practices so as to enable new provisions in the proposed General Rules. They also expressed that while framing new Rules, every effort should be made to make the rules practicable, easily implementable and user friendly.
It is pertinent to point out that a rider has been added in the following lines.
“Also the Committee felt that the Rules should serve as a tool for providing Safe and Quick operation and should not in any way slow down or hamper operation in the name of Safety “(Para 2.3 of overview)
The contents and spirit of the above rider cause a certain amount of apprehension that whether economy and efficiency override the main aspect of Safety in the Train Operations, since even with out any such rider, at present in practical day-to-day working, efficiency and economy is monitored hour by hour from top to bottom but when it comes to the question of Safety it is our considered opinion that the aspect of safe train working as per Rules and Regulations is reviewed/monitored only in the event of an Accident or an Unusual Occurrence. Further the Motto of Indian Railway “Safety cannot be compromised in the name of economy and Puntucality” will get defeated by the flexibility and leniency given through the above rider.

2. HUMAN ELEMENT

The failures of railway staff cases in consequential train accidents are very high
as they are responsible for about 45% of the total consequential accidents. This need
to be curbed. If we consider “Avoidable Accidents” cases (by excluding sabotage cases and unmanned level crossing accidents etc.), the percentage share of Railway staff responsibility becomes almost 80-90%. This is a cause of concern.

2.1 NEED FOR SCIENTIFIC RESEARCH
In Indian Railways accident enquiry system ends with “Who went wrong” approach and instead it should be “What went wrong”approach. Human Failure may include absent mindedness, forgetfulness, an error of judgment, or drowsiness (due to audio-monotony of the sounds of the running train or other similar factors); at times it may be momentary mental blankness or fatigue due to inadequate rest, in yet other cases it may be mental anxiety of some kind, possibly arising from family worries or other domestic problems of stresses and tensions on the mind on account of the fast changing matrix of their living conditions.
Research Designs and Standards Organisation (RDSO)

The principle organisation responsible for research into safety and technological improvements in India is the Research Designs and Standards Organisation (RDSO) which was established in 1957 under the Ministry of Railways in Lucknow. They also have a Psycho-Technical department concerned with the drivers and other staff operating within the railways system where assessment of cognitive abilities takes place (psychometrics), alongside biofeedback tests. But it seems they are not sufficient to solve the problem.
The investigation of Railway Safety and Human Factors by use of a system perspective is the focus of TRAIN Project, a research project funded and managed by the Swedish National Rail Administration and carried by independent researches. Such researches on human factor are also continuously carried out in UK Rail System, US, Northern European and Japanese Railways. In spite of advance technologies such as ATP (Automatic Train Protection), ETCS (European Train Control System) is used in above countries, they continue research on human factors for the past twenty years.
Therefore a thorough understanding of the social processes which compel one to render erratic performances or commit blunders is thus an essential part of the psychological research programme on Indian Railways.
2.2 NON-FILLING UP OF VACCANCIES IN SAFETY CATEGORIES
The Railway Board itself had forced to commit that the Indian Railways are pulling on with a shortage of 18% of sanctioned posts. It is a fact that the sanctioning of additional posts for increasing traffic is being let down by the pre condition of matching surrender of posts and hence the 5% yearly growth in traffic achieved by the Railways in the last 10 years had not reflected in sanctioned strength. So the factual position is still worse. The little effort taken by the RRB to fill up the posts of Assistant Loco Pilots is also stalled by some corrupt Railway officials who leaked the question papers on payment of 3.5 lakhs of rupees. The inertness of the Railway Board in this grave situation is quite alarming. Starred Q.No. 102 raised by Tapan Kumar Sen, MP and Mohammed Amin on 10.07.2009.Reply by Railway Minister in the Rajya Sabha
Sl. No. Category Sanctioned Strength Actual Strength Vacancies
1. Group ‘A’ & ‘B’ 17,680 16,131 1,549
2. Group ‘C’ 10,20,076 9,07,510 1,12,566
3. Group ‘D’ 5,29,208 4,70,879 58,329
TOTAL 15,66,964 13,94,520 1,72,444

(i) Every year 3% of employees retire.
(ii) As per the Railway Board vacancies as on 31.03.2010
3% of 13,94,520 = 41835
3% of 13,52,685 =40560
Total Vacancies =82415 + 172444 = 254859
As per reply by Kumari Mamata Banarjee, Minister of Railways to Q.No. 293 in Rajya Sabha on 13.08.2010
The details of the number of vacancies on the Zonal Railways as on 01.04.2009 is as under: -

(i) Loco Running Categories 13102

(ii) Other Safety Categories 75922

(iii) Other than Safety Categories 79085
2.3 SIGNAL PASSING AT DANGER (SPAD)
In recent accidents, SPADs are the major causes for collisions. Whenever there is SPAD cases Railway Administration widely spreads
“the drivers were well within their stipulated duty hours and had proper rest before they commenced duty. On Indian Railways, all trains other than the suburban services (diesel or electrical multiple units) are provided with a driver and an assistant, which greatly reduces the chances of the driver passing a signal at danger due to carelessness or lapse of concentration.”
But there have been cases where the drivers under stress or other compulsions have committed serious errors. In the case of the train crew, one wonders what is that makes the drivers pass a signal at danger. As it is quiet obvious that locomotive crew very well know that they may themselves be the first victim of their own mistakes and there cannot be a greater deterrent than the fear of losing one’s own life, they figure in a quite few accidents. It stands to a reason therefore that a driver would not consciously pass a signal at danger and one is lead to conclude that there must be some other factors beyond his control when he does so.
In recent days, the crew links of mail and express trains are tightened in the name of optimum utilization of crews and thereby extended run increased the work load. The reduction of rest period in between two spells of duties, less availability in the head quarters/home causes accumulated fatigue among the drivers causes micro sleep. Lack of sleep due to continuous night duties lead to cumulative sleep deficit. To overcome the effect of these night shifts require at least two days rest and should avoid an early shift on their return to work.
Research paper on ‘Human Factors in Railway Systems: Implication for Safety’ prepared by B. Hockey and N.Carrigan University of Leeds says,
“Research on fatigue, within the railways as elsewhere, fails to distinguish the general behavioural outcome (tiredness) and the possible causes of the state. In particular fatigue is often ascribed to sleepiness brought about by sleep deprivation or poor management of shift cycles, and the problem for performance typically identified with increased risk of eye closure or actual sleep. It is important to recognize that metal fatigue can result entirely from over work, in the form of sustained cognitive operations even with normal sleep and well adjusted shift cycles. Taking a nap of up to one hour has been shown to reduce fatigue on night shift.”
2.3.1 ERGONOMICS AND RUNNING ROOM
A Driver needs higher degree of alertness and concentration throughout the journey as he is running a train in higher speeds on track where sudden obstruction is very much a possibility and the train has no chance to stop suddenly like road vehicles. Inadequately maintained and designed driving cabs with louder noise, uncomfortable seating arrangement, non-functional safety equipments like speedometer, wiper, insufficient focusing of head light etc., are a sufficient distraction. Mainly absence of toilet in locomotive (not even Urinal) make the crew to control natures call for longer time and this will result in distraction of Driver is anybody’s imagination.
The uniformity of driving equipments like A9, SA9, Throttle and Speedometers and the side of driving control stand develops a reflex among the Loco Pilots and if disturbed the reflex action is also disturbed. A Loco Pilot regularly driving right hand side has an assessment of distance of sighting the signals first but when driving from left occasionally the first sighting point and distance is lost and the reflex action also is delayed which is a safety hazard.
Both horns are to be located above the headlight at extreme ends of the loco to avoid noise pollution in the driving cab and rebound echo sound with coaches. The seats with back rests should be fitted in position such as the A9, SA9 are reachable for operation from driving seat like a car. The long hood working of WDP4 locos should be avoided as there is no visibility. This safety hazard was purchased by the Railway Board while ordering the originally designed double cab WDP4 as single cab.
Further an aspect which is of great importance in ensuring a driver’s well being and alertness on duty is the condition of Running Room. Though various high power committees had stressed on this matter, the improvement in Running Room has been inadequate.
2.3.2 WORKING HOURS
Hours of Employment Regulation is part and parcel of the Indian Railway Act. All railway employees are guided by these Rules in the subject of their hours of duty and rest. Under the pretext of the exceptional of work, employees especially field staff in whose hands are reposed the safety of the trains are forced to work even beyond 12/16 hours mainly due to short of hands. Drivers, Guards, Station Masters, Cabin men, etc are some of the categories to whom working even beyond 12/16 hours is nothing unusual. Various Committees were formed to go into the Railway Accidents whenever major rail accident occurs and these committees have laid due and adequate emphasis that a limit must and should be laid in regard to maximum limit of working hours to Loco Running Staff.
The Railway Laboaur Tribunal 1969 headed by Js.N.M.Miabhoy observed in para 6.187, “Though running duty is not of an intensive character, it is duty which demands continued attention, alertness and exertion in its performance. Any over-exaction from such staff has important and far-reaching repercussions on safety of public, persons and property. Such staff has to work under conditions which may set in fatigue earlier that it may occur in cases of staff working indoors or at stations and depots.” Further recommended that the over all duty hours at a stretch from signing-on to signing-off does not exceed 14 hours provided further that the total maximum hours will be progressively reduced by half an hour every two years from the date of this Report till the target of 12 hours is reached, i.e. at the end of eight years from the date of this Report the total maximum of duty at a stretch from signing-on to signing-off shall not exceed 12 hours.
Thus it is clear that the Miabhoy Tribunal 1969 also gave its recommendation for limiting the maximum limit of working hours to Loco Running Staff which recommendation was accepted in Toto by Government of India (Ministry of Railways). Then it was agreed in 1973 at the floor of parliament that the duty hours of Running staff will be reduced from 14 hours to 10 hours. But again in 1981, Railways extended the duty hours of Running Staff unlimited through interpretation. Further, the Honorable CAT/Ernakulam has struck down this order as inhuman and instructed the Railways to prescribe the maximum limit of working hours in 1992. Even after this overall duty hours of Running staff is still beyond 12 hours and at times unlimited through deliberate, ambiguous orders of Railways. In spite of all the above recommendations and instructions the unfortunate situation in Railways as on date is the Running staff are compelled to work without limit to working hours. In our humble opinion it is not enough that no staff should be allowed to work beyond a certain limit and it will do well to Railways and to its image if a limit to the working hours of Loco Running Staff is enforced without much delay.
The Railway Board themselves states that why Safety related Voluntary Retirement Scheme introduced to Running Staff. The reasons quoted reads as under-
“The scheme will to safety categories viz, Drivers (excluding Shunters) and gangmen whose working has a critical bearing on safety of train operations and track maintenance. The scheme has been framed on the consideration that with advancing age, the physical fitness and reflexes of staff of these categories deteriorate, thereby causing a safety hazard.
The Driver category is directly responsible for the running of trains. Running duties demand continued attention and alertness. The element of stress combined with uncertain hours of work entailed in the performance of running duties over long periods of time tend to have a deleterious psychosomatic effect of their health. There is a slowing down of reflexes with the passage of time making them vulnerable to operational lapses.
The Parliamentary Standing Committee – 2004, recommended 8 hours duty for Loco Running Staff
A Judicial Review on hours of work and period of rest for Safety categories was agreed by Govt on 15/02/2006 and yet to be implemented.
2.3.3 Psychometric testing for Indian train drivers: The
relationship between experience, age and performance
Joseph Knowles 2008
Project report submitted in part-fulfilment of the requirements
for the postgraduate degree in Ergonomics (Human Factors)
© Loughborough University

Experience is something gained over a period of time and can often lead to improvement of skills and expertise in any given area. Those who have experience with a certain type of task (such as driving a train) will have learnt about the intricacies involved and will have established rules and routines, as well as further developing skills in that task.
The arguments on driving performance and experience seem to suggest that experience can improve performance of drivers.
Conclusion of study
In regards to age, further investigation is needed as to why older people performed significantly worse on the testing in this study. Some ideas regarding concentration have been mooted and the next logical step is to discover why performance dips after 46, when research suggests that for most people dips in performance do not occur until older, retirement age. Research involving attitudes to work in India and performance may reveal areas which can be improved upon. A systematic, organized review of equipment, both used for testing and that used in the cabs, should be ergonomically reviewed to ensure the designs are as inclusive as possible. This will eradicate or support the possibility that older users are being designed out and thus not performing as well. Consideration of older drivers needs in regards to sleeping should be considered as well as any reduction is physical ability.
Ethical Approval
This project has been approved by the Loughborough University Ethical Advisory
Committee. Approval was also given from RDSO.
3. REMEDIES
3.1 ACCOUNTABILITY
The important factor of accountability in many accidents ends in lower level only. This is also a reason for recurrences and hence this should go to top level for every accident to ensure safety, efficiency and better image of the Railways.
3.2 MAN POWER
Proper trainee reserve should be planned in all safety categories. Required man power should be assessed as and when new trains are introduced.
3.3 TECHNOLOGICAL ADVANCEMENTS
Automatic Train Protection System (ATP) like modernization, ACD and etc should implemented with fixed time frame sincerely to reduce human dependence.
3.4 ATTITUDE OF MANAGEMENT
Attitudinal change to ensure our Motto of Indian Railway “Safety cannot be compromised in the name of economy and punctuality” is must.
3.5 INDEPENDENT RESEARCHES
Independent researches on railway safety and human factors continuously should be carried out.
3.6 FILLING UP OF VACCANCIES
Filling up of vacancies should be done immediately and ban on recruitment like policies should be done away with.
3.7 DESIGN OF LOCOMOTIVES
Ergonomically designed cab with at least urinal facility should be done without further delay. The condition of Running Room and working spot of all safety categories should be properly maintained.
3.8 HOURS OF WORK AND REST
The working hours at a stretch of Running Staff should be limited to 8 hrs and the same should not go beyond 6 hrs. in passenger/express services. Calender day rest every week to all Running Staff be made statutory. Consecutive night duty be limited to two and crew should be relived between 1.00hr. to 3.00hr. splitting the full night to two spell.

All the members of this Association reaffirm their commitment to railway safety and resolve to do their best to avoid train accidents.