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Runway change leads to two ‘terrifying’ near misses

Source: ATSB

Two international flights carrying hundreds of people narrowly avoided disaster when they overshot a runway and took off just metres above airport workers.

Both planes flew so close to an active Melbourne airport site that jet blast affected the area, a report says, resulting in a stress-related injury to a worker.

Their flight crews were unaware the runway had been shortened by more than 1.5 kilometres for night resurfacing work, resulting in two near misses within a fortnight.

A Malaysia Airlines Airbus A330-300 first overran the runway that had been reduced to about two kilometres on September 7, 2023, when it took off. It passed seven metres above the airport worksite.

Eleven days later, a Bamboo Airways Boeing 787-9 overshot the same strip and took off less than five metres above the night works’ vehicles and personnel.

Each plane was carrying more than 200 people at the time.

No one was injured but a worker reported that the first near-miss made their vehicle shake violently.

The second incident resulted in one stress-related injury, the Australian Transport Safety Bureau report says.

“These were serious incidents,” Chief Commissioner Angus Mitchell said on Tuesday.

“In both cases we had a fully loaded and fuelled aircraft with over 200 personnel on board coming within metres of fixed equipment on the ground and with works equipment.

“It was by luck in this case that we didn’t have an impact.”

All crews had been notified about the reduced runway through flight notices and the airport’s information service radio broadcasts.

However, crews on the two international flights involved in the near misses had not identified the information due to “expectations, workload and time pressures”.

They consequently used standard take-off performance calculations, with reduced engine thrust causing them to overshoot.

The flight crews also failed to confirm the shortened runway with air traffic control, which in turn failed to challenge them.

Dispatchers, who brief flight crews, had noted the reduced runway but did not emphasise it because it affected the take-off thrust required, which is the pilot’s responsibility.

“To those workers on the ground it was a terrifying experience,” Mitchell said.

“That’s why we’ve been so detailed in the investigation, but also in our safety recommendations to ensure that this type of thing does not occur, particularly in Australia, again.”

Both airlines have updated their procedures to ensure that changes to runway distances are directly communicated to flight crews.

Airservices Australia – in consultation with the Civil Aviation Safety Authority – is reviewing its air traffic control procedures as a result of the near misses.

The bureau has recommended the International Civil Aviation Organisation review air traffic control communication procedures to crews on “safety critical” aerodrome conditions.

The international body has already committed to introducing additional highly visible signage to alert crews of runway changes.

-AAP

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