Learn from the train tragedy

JR福知山線事故に学べ

    On April 28, 106 people were confirmed dead. The death toll topped 100 after rescuers gained access to a crumpled portion of the first car and found the bodies of seven more people, including the driver. Government investigators, the police and JR engineers are working together to pinpoint the cause of the accident.

    It is premature to conclude that the accident was caused entirely by error on the part of the driver and other operating personnel. All possible factors must be examined, including train operation, control mechanisms, the structure of the train cars, maintenance and geography.

    One discovery mentioned earlier as a possible clue to the derailment was rail marks from what might have been stones crushed by the passing train. West Japan Railway Co. (JR West) believes, however, that the marks were made by pebbles disturbed by the train's speeding wheels. One fact is clear, though: The train was behind schedule — a fact that raises suspicion that speed may have played a role in the accident. This theory is supported by an analysis of records registered by a speed monitoring device. Those records show that the train was traveling at more than 100 kph. The maximum speed limit at the sharp curve is 70 kph.

    The train had overshot the stop line at the previous station, causing it to fall about 90 seconds behind schedule by the time it backed up and opened its doors. Punctuality is a hallmark of Japanese trains. Some passengers have stated the seven-car train was running much faster than usual just before the accident, as if to make up for the delay. Possibly the driver was under heavy pressure to stay on schedule, putting service before safety. A review of in-house education at JR West seems in order.

    Even if the driver is found guilty of professional negligence the company cannot escape blame, as ensuring the safety of passengers is the foremost duty of mass transit systems. Human errors, even if proven, do not reduce the need to redouble efforts to prevent accidents.

    One way to prevent a derailment would be to upgrade the automatic braking system. Such a system was installed near the accident site, but it was said to be so antiquated that it did not work even when a train passed by at excessive speed.

    Another problem seems to be the structure of the train cars, which are made of lightweight stainless steel. While lighter trains can travel faster, they are more vulnerable to physical shocks, provide less impact protection and make rescue work more difficult.

    Yet another problem is the absence of guardrails designed to prevent derailments. Obviously the lesson of the March 2000 Tokyo subway collision, also caused by derailment, has not been learned. The need for guardrails was voiced following the Shinkansen derailment in October during the Chuetsu earthquake in Niigata Prefecture.

    A review of maintenance policy is warranted, considering that JR management has reduced the number of personnel in charge of rail repairs and inspection through outsourcing and other cost-cutting measures. JR companies say they have tried to improve safety through mechanization and automation, yet investment for maintenance and inspection should not be curtailed in the name of shoring up business foundations.

    Geography was a factor in the tragedy. The apartment building the train smashed into was 6 meters from the tracks. The question is: What can be done to prevent the construction of buildings near railways? That won't be easy in this crowded country, but halting the construction of apartments near sharp railway curves in urban areas might be a good start.

    The Ministry of Land, Infrastructure and Transport has its work cut out in investigating the cause of the accident, as does the Hyogo Prefectural Police department, which is probing the criminality of those involved. The driver and other on-site operators are suspected of professional negligence resulting in death and injury.

    In the past, top executives of railway companies have been rarely held criminally responsible for accidents. To prevent recurrences once and for all, however, it will be necessary to conduct a full investigation of all involved, including executives at the highest levels of management.

The Japan Times Weekly
May 7, 2005
(C) All rights reserved

      事故原因については、死亡した電車運転士を含む現場の問題ばかりでなく、列車運行・制御、車両構造、整備、線路の地形など、あらゆる要素を考慮せねばならない。

      問題のカーブでは時速70キロの制限があったが、搭載されていた記録装置によれば、事故車の速度は100キロを超えていた。

      電車は事故直前の駅で、ホームをオーバーランし、バックしたため90秒出発が遅れた。乗客によれば、事故直前に電車は通常よりもずっと速く走行していたという。運転士は定時運転確保に必死だったのではないか。

      運転士の責任とは別に、JR西日本は安全運行確保の責任を免れない。

      現場近くに設置されていた自動列車停止装置（ATS）は旧式で、電車が速度超過をしても対応しないタイプだった。

      問題の列車の車両は、衝撃に弱い軽量ステンレス製だった。

      また、現場には脱線防止のガードレールが設置されていなかった。00年3月に起きた東京の地下鉄脱線事故、04年10月の新潟中越地震で起きた新幹線脱線事故の教訓は生かされていなかった。

      経費節減のため線路保守作業を軽視する傾向も問題だ。

      電車が衝突したマンションは線路から6メートルの所にあった。都市部の鉄道の急カーブ近くのマンション建設は制限すべきだ。

      これまでの重大事故では、鉄道会社のトップが刑事責任を追及されたことはほとんどなかった。今回の事故では、運転士などの現場担当者ばかりでなく、経営陣の責任を追及することが必要になる。