What Happened
What Happened
On February 13, 2024, about 1:38 p.m. local time, a CSX Transportation (CSX) maintenance-of-way (MOW) employee was killed when a ballast regulator reversed direction and struck the employee in the gage of the track in Roanoke Rapids, North Carolina. The struck employee was the foreman of a CSX crosstie replacement team that was using the ballast regulator and other equipment to perform track resurfacing and crosstie replacement near milepost 81.61 on a CSX North End Subdivision industry spur track. Visibility conditions at the time of the accident were clear, and the temperature was 51°F.
[1] (a) All times in this report are local times unless otherwise noted. (b) A ballast regulator is a piece of MOW equipment that evenly distributes ballast, or crushed stone, along a railroad track bed. (c) Gage is the distance between the heads of rails. Standard gage in the United States and Canada is 4 feet 8.5 inches, measured at a point 0.625 inches below the top of the rail.
[2] The crosstie replacement team consisted of a foreman and 53 roadway workers and equipment operators.
What We Found
What We Found
We determined that the probable cause of the CSX Transportation maintenance-of-way employee (foreman) fatality was the ballast regulator operator’s lack of awareness that the foreman was standing in the gage of the track before the ballast regulator operator initiated an unannounced reverse movement and the foreman’s lack of awareness of the ballast regulator moving toward him. Contributing to the accident were incomplete communications regarding the movement of the ballast regulator at the 10th Street highway–rail grade crossing. Further contributing to the accident was a nonoperational change-of-direction alarm that did not sound, and the lack of sound from the horn, when the machine reversed direction.
What We Recommended
After the accident, on February 15, 2024, the Fatality Analysis of Maintenance-of-Way Employees and Signalmen Committee issued an alert regarding the preliminary details of the accident to raise awareness and the importance of maintaining vigilance while working on or about tracks and around roadway maintenance machines.[3]
After the accident, CSX issued a safety alert describing the accident and emphasizing the importance of being aware of one’s surroundings and of conducting “what if” scenario assessments to identify risks associated with the planned work. CSX also made changes to several of their rules, including increasing the red zone distance around roadway maintenance machines from 15 feet to 25 feet.[4] CSX also now requires employees to conduct additional job briefings midway through shifts, to alert employees to changes in work plans, and instructs MOW machine operators to sound the machine’s horns if the CDA becomes inoperative.
In January 2025, NTSB investigators attended CSX’s demonstration of a new collision avoidance system that incorporates object and employee detection technology and automatic antilock braking. The system uses advanced proprietary technology to maintain separation between MOW machines and employees. The system produces in cab audible coaching for the machine’s operator and, if an operator does not initiate a response, stops the machine short of an employee or object. CSX reported that its goal is to install the collision avoidance system in about 300 machines in 2025.
[3] The ad-hoc, voluntary, consensus-based committee was formed by the Federal Railroad Administration along with railroad labor and management representatives to analyze fatalities and other incidents, focusing on identifying risks, trends, and factors affecting roadway worker safety. [4] The
red zone is an area where a person working on or near the track could be struck by moving equipment.
