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CTA should focus on fatigue after O'Hare Blue Line crash crash, NTSB says

The National Transportation Safety Board wants the CTA to take fatigue seriously when it schedules workers' hours and install an automatic braking system on trains to prevent crashes like one on the Blue Line at the O'Hare stop last spring.

The CTA operator dozed off, causing the train to hit a bumper and catapult onto an escalator, injuring passengers on March 24, 2014.

The NTSB recommended better training about fatigue hazards for CTA employees in general and for the people who schedule train operators. Board members also advised transit agencies nationwide to implement automatic braking systems on rail.

"Any mass transit accident has the potential to be a mass casualty event," NTSB Chairman Christopher Hart said Tuesday at a hearing in Washington, D.C.

"There is no place in mass transit for an operator to fall asleep at the controls of a train."

The train operator was so tired she was impaired on March 24, National Transportation Safety Board members concluded. They blamed the challenges of shift work and the operator's failure to manage her off-duty time to get enough rest,

They also charged the Chicago Transit Authority did not properly manage the employee's work schedule to mitigate fatigue and allowed an insufficient stopping distance and inadequate speed restrictions at the O'Hare stop.

"The CTA is committed to maintaining one of the strongest safety records of any major U.S. transit agency," CTA spokesman Brian Steele said. Immediately after the accident, the CTA "took a number of steps to further improve safety, including lowering the speed limit of trains entering the station and moving the fixed trip stops, which stop a train manually when needed, further back." Train operator Brittney Haywood, who was fired after the crash, admitted she was tired when she started her shift.

The CTA train was traveling at 26 mph before it hit a bumper at the end of the track.

"If the CTA had transmission-based train control, would this have been prevented?" board member Robert Sumwalt asked.

NTSB officials said yes.

Steele said the CTA will review the braking system request but it was too early to know how it would be incorporated into the track and signal system.

Board members blamed the design of the center track as inadequate to prevent a train striking the bumping post and called the CTA's hazard-management program insufficient.

The collision, which occurred about 2:50 a.m., sent 34 people to the hospital and caused an estimated $9 million in damage to equipment and the station. Prior to the crash, Haywood had worked the proceeding Thursday, Friday, Saturday and Sunday. This included a day shift Thursday, an overnight shift Friday, an overnight shift Saturday and then the fateful overnight shift that started Sunday at 8:40 p.m.

Haywood told investigators she slept soon after arriving home at 4 a.m. Sunday until 2 or 3 p.m. but records show she used her phone during that time, authorities said. It was the second time Haywood had dozed off while driving a train. Haywood was hired in April 2013 and worked as a flagger. She qualified to run trains in January 2014. Officials with the Amalgamated Transit Union Local 308 said a culture of overtime at the agency put Haywood in a difficult position and that her call-in status had caused her to work abnormal hours. CTA administrators said there was nothing about the operator's work schedule that suggests fatigue should have been a factor and that she worked 55.7 hours in the prior seven days. The CTA did revise its scheduling rules for train operators, including increasing the minimum rest time between shifts from eight to 10 hours and requiring employees to take at least one day off in any seven-day period.

"Is it fair to say junior employees were more at risk for over-scheduling and fatigue than senior employees?" board member T. Bella Dinh-Zarr asked. NTSB staff agreed.

Specifically, board members suggested the CTA should: use "fatigue science" and avoid risks when assigning shifts and setting hours; provide predictable schedules to have better-rested employees; and train schedulers to set hours that won't lead to exhaustion.

The CTA is already using Federal Transit Administration fatigue-management tools to improve scheduling, Steele said. "The O'Hare station handles more than 300 train trips daily and more than 2,400 trips weekly, and has been doing so for 30 years. Since this station was built in 1984, millions of trains have pulled into the station."

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