The final report of the government’s Aircraft and Railway Accidents Investigation Commission on the April 25, 2005, West Japan Railway accident in Hyogo Prefecture — which killed the train driver and 106 passengers and injured 562 people — has blamed the railway company’s corporate culture for the fatal accident. It specifically mentioned JR West’s punitive re-education program for train drivers who had committed mistakes such as overruns.

It said the driver, who had overrun a train stop shortly before the accident, was so worried about being subjected to the re-education program that he was absorbed in listening to radio communications between the conductor and the control center, and failed to apply the brake in time as the train went into a sharp curve. It called on JR West to refrain from punishing employees who report incidents and instead adopt a program that teaches them in a practical way how to improve their driving skills and how to prevent accidents. This is reasonable, and JR West should follow the calls with sincerity.

The seven-car train derailed about 9:19 a.m. that day on the leg between Tsukaguchi and Amagasaki station. At Itami Station, before Tsukaguchi, the driver had overrun his stop by 72 meters but then asked the conductor to report a reduced overrun distance to the control center. Because passengers demanded an announcement of an apology for the overrun, the conductor cut intercom communications with the driver shortly after telling the driver that the overrun distance was substantial.

Fearing that the conductor was negative to his request, the driver paid close attention to radio communications between the conductor and the center. Subsequently, the driver applied the brake 16 to 22 seconds later than he should have, and the train entered the curve at 116 kph, or 46 kph above the speed limit of 70 kph, the report concluded.

Apart from improving the re-education program, the report calls for better brakes, publication of appropriate manuals to cope with accidents, and adoption of lighter train cars. The most important point is that JR West regain the safety-first spirit.

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