Failed or Absent Defences » LTA warning device

1Park Brake Failure - Truck Rolls Away



Brief Description of Incident/Accident & Description of Consequences/Outcomes:

An unattended partly loaded bulk explosives truck was parked with its engine running. The driver had applied the park brake before disembarking and was walking away from the truck when he noticed it moving. While the truck was rolling away he climbed back in the cab and applied the brakes. The truck travelled about 20 metres before stopping with its front wheels suspended over the edge of a 2.5m drop.

Identified Root Causes:

The park brake lever did not lock into position when the park brake was applied. When the driver closed the door as he left the cabin the vibration returned the lever to the brake release position.

Energy Type(s) Involved:

Uncontrolled movement of equipment

Equipment Type(s):

Iveco Acco 2350G Truck

Root & Contributing Cause(s):

LTA parkup

Stated or Potential Consequence(s):

Potential Fatality

Preventative/Recommended/Accepted Steps of Risk Mitigation, Points of Interest:

That truck operators ensure:

drivers of trucks with a similar park brake lever locking mechanism understand the design weakness and the significance of ensuring that the park brake is positively locked in position when parking.

the audible "brake not applied" warning alarm operates independent of the ignition position.

risk controls including parking procedures and designated parking areas adequately reduce the risk of mobile equipment rolling away.

That manufacturers and suppliers of trucks with similar park brake lever locking mechanisms review:

the locking mechanism's design to reduce the risk of similar failures.

improve the design of warning alarm activation systems to directly detect whether the lever is positively locked in position.

EMESRT Risk(s):

Park brakes not engaged

ISOLgate Checklist(s):

Download Park brakes not engaged Checklist.

Organisation:

Queensland Government Department of Employment, Economic Development and Innovation (DEEDI)


Results

Here are the results.


Information

Reference Type:

Safety Alert #150

EMESRT Risk(s):

Park brakes not engaged

Mine Type:

Any Mine Type

Energy:

Potential & Kinetic - Mechanical > Object(s) in motion - Equipment at speed

Equipment:

Published:

2006

Region:

Australia, Queensland

ISOLgate Checklist(s)

Park brakes not engaged Checklist.

ICAM Categories

Organisational Factors

• LTA design

• LTA equipment design

• LTA hardware

• LTA hardware design

• LTA parkup area

Task or Environmental Conditions

• LTA surface gradient

Individual or Team Actions

• LTA awareness

Failed or Absent Defences

• LTA safety device operation

• LTA warning device



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