Unexpected Movement of Unsecured Equipment on Railroad Track
The problem
Safety Alert Section 2 Title - Railroad employees face significant risk of serious injury or death when they enter the gauge of the track without first ensuring that all equipment on the track is stationary and properly secured against movement.[1] A track is fouled when an individual or equipment is in the gauge of the track or within 4 feet of the nearest rail of the track and can be struck by a moving train or on-track equipment. (See figure 1.)
- The National Transportation Safety Board investigated five accidents between July 2024 and July 2025 in which railroad employees were seriously injured or killed when they fouled the track and were then struck by unsecured equipment.
- Unsecured equipment on the track can appear stationary but may start to roll unexpectedly when the brakes are released accidentally or applied incorrectly, or when an inadequate number of hand brakes are applied.
- Railcars coupled with locomotives may start to roll when the locomotive controls are not properly secured or an engineer accidentally manipulates the throttle, reverser, or brakes.
- Freight railcars, including tank cars, may experience unexpected movement when the material in the railcars move, or the liquid in the tank cars slosh, and create a shift in load.
- Slack action can lead to sudden and unexpected movement of railcars. Slack action is the amount of free movement between connected railcars before one railcar transmits its motion to the next. This movement is a result of the couplers and draft systems used in freight trains, which are designed to connect railcars securely, manage forces during train operations, and allow limited motion between railcars to absorb shocks and reduce stress on railcar components.
- Moving equipment may strike or otherwise come in contact with stationary equipment positioned on the track and set the stationary equipment in motion.
- When unsecured equipment moves on uneven or sloped track, the movement can be unexpected or intensified if the track slopes downhill.
- The
gauge of the track is the area between the two rails of the track.
Figure 1. Ensuring equipment is stationary and secured against movement.
Related investigations
Safety Alert Section Content 3 Five recent accident investigations into injuries and deaths involving unexpected railcar movement highlight the danger posed by fouling the track near unsecured or inadequately secured equipment.
Safety Alert Section Content 5 On April 9, 2025, a Norfolk Southern Railway conductor was seriously injured during switching operations in Sheffield Yard in Muscle Shoals, Alabama. After the engineer had stopped a consist of 55 railcars, the conductor fouled the track and went between two railcars to apply the hand brake on one of the railcars. As the conductor was applying the hand brake located at the rear of the railcar, the railcar began to roll backward on a descending grade and struck the conductor. The hand brake was partially applied when the accident occurred. (RRD25FR010)
Safety Alert Accordion Header Title On April 4, 2025, an American Auto Works ConGlobal-3 conductor was killed during switching operations at the BNSF Railway Automotive Distribution Facility, located in Richmond, California. The conductor was on the ground directing a shoving movement when he fouled the track and went between two railcars to align the mismatched couplers. The conductor had not communicated with the engineer that he was fouling the track and was subsequently found dead between the two railcars he was attempting to couple. (RRD25FR009)
Safety Alert Accordion Title 1 On March 11, 2025, a Hulcher Services Inc. employee was seriously injured during a railcar rerailing operation at the Port of Stockton in Stockton, California. The employee fouled the track and went between the loader, which was being used to rerail the railcars, and the railcar that was being rerailed. The employee released the hand brake of the railcar to connect the railcar with the loader. When the hand brake was released, the railcar began rolling toward the loader and struck the employee. (RRD25FR008)
Safety Alert Accordion Title 2 On July 19, 2024, a Norfolk Southern Railway conductor was seriously injured while switching coal cars at Lambert’s Point Yard in Norfolk, Virginia. The conductor and a brakeman were releasing the brakes and uncoupling loaded coal cars one at a time to allow them to roll down a descending grade for unloading. The accident happened when the conductor fouled the track and went between the coal cars to apply the hand brake on the rear coal car, and the brakeman released the hand brake on the coal car in front. As the coal car in front rolled downhill, the coal car in the rear unexpectedly rolled and struck the conductor. (RRD24FR014)
Safety Alert Accordion Title 3 On August 27, 2024, a Norfolk Southern Railway conductor was seriously injured while coupling railcars at Lambert’s Point Yard in Norfolk, Virginia. The conductor made multiple attempts to couple two railcars by directing the engineer in the lead locomotive to reverse short distances to bump the couplers together. During the last of these attempts, one of the railcars rolled up grade. The conductor then fouled the track and went between the railcars to manually adjust the coupler on this railcar to facilitate the coupling process and was struck when the uncoupled railcar rolled back down grade toward him unexpectedly. (RRD24FR015)
RRD25FR010
On April 9, 2025, a Norfolk Southern Railway conductor was seriously injured during switching operations in Sheffield Yard in Muscle Shoals, Alabama. After the engineer had stopped a consist of 55 railcars, the conductor fouled the track and went between two railcars to apply the hand brake on one of the railcars. As the conductor was applying the hand brake located at the rear of the railcar, the railcar began to roll backward on a descending grade and struck the conductor. The hand brake was partially applied when the accident occurred. (RRD25FR010)
RRD25FR009
On April 4, 2025, an American Auto Works ConGlobal-3 conductor was killed during switching operations at the BNSF Railway Automotive Distribution Facility, located in Richmond, California. The conductor was on the ground directing a shoving movement when he fouled the track and went between two railcars to align the mismatched couplers. The conductor had not communicated with the engineer that he was fouling the track and was subsequently found dead between the two railcars he was attempting to couple. (RRD25FR009)
RRD25FR008
On March 11, 2025, a Hulcher Services Inc. employee was seriously injured during a railcar rerailing operation at the Port of Stockton in Stockton, California. The employee fouled the track and went between the loader, which was being used to rerail the railcars, and the railcar that was being rerailed. The employee released the hand brake of the railcar to connect the railcar with the loader. When the hand brake was released, the railcar began rolling toward the loader and struck the employee. (RRD25FR008)
RRD24FR014
On July 19, 2024, a Norfolk Southern Railway conductor was seriously injured while switching coal cars at Lambert’s Point Yard in Norfolk, Virginia. The conductor and a brakeman were releasing the brakes and uncoupling loaded coal cars one at a time to allow them to roll down a descending grade for unloading. The accident happened when the conductor fouled the track and went between the coal cars to apply the hand brake on the rear coal car, and the brakeman released the hand brake on the coal car in front. As the coal car in front rolled downhill, the coal car in the rear unexpectedly rolled and struck the conductor. (RRD24FR014)
RRD24FR015
On August 27, 2024, a Norfolk Southern Railway conductor was seriously injured while coupling railcars at Lambert’s Point Yard in Norfolk, Virginia. The conductor made multiple attempts to couple two railcars by directing the engineer in the lead locomotive to reverse short distances to bump the couplers together. During the last of these attempts, one of the railcars rolled up grade. The conductor then fouled the track and went between the railcars to manually adjust the coupler on this railcar to facilitate the coupling process and was struck when the uncoupled railcar rolled back down grade toward him unexpectedly. (RRD24FR015)
What can railroad employees do?
Safety Alert Section Title 5 - Stay vigilant and expect equipment to move on any track, at any time, from any direction.
- Foul the track only when necessary and after confirming that it is safe to do so.
- Follow the railroad operating rules when you foul the track.
- Inspect railcars that are not attached to locomotives to ensure that they are fully stopped and properly secured.
- Use ladders or end platforms on railcars when applying hand brakes to avoid entering the gauge of the track before the equipment is secured.
- Use brake sticks that can be fully extended from a position outside the gauge of the track; do not use brake sticks over couplers or draft gear to avoid inadvertently fouling the track.
- Before fouling a track to perform work, ensure that any other cut of railcars on the same track is separated by no less than 50 feet.
- Confirm that locomotives connected to railcars have completely stopped and that the engineer has secured all locomotive controls before fouling the track or going between railcars.
- Establish and maintain clear communication with the crew during switching operations, especially if you need to foul the track.
- Conduct a job briefing before you start work, when working conditions change, or when communication between the crew becomes unclear.
- Stop work if conditions are unsafe or communication is unclear.
- Participate in safety briefings and follow all securement procedures.
- Be aware of railcar design and slack action behavior, such as end-of-railcar cushioning devices that expand or contract slowly or sloshing fluids in tank cars that cause delayed and unexpected movement.
- Be aware that uneven or sloped track may cause railcars to move unexpectedly and watch for movement after releasing the handbrakes.
- Mentor less-experienced employees to reinforce safe practices.
What can railroads do?
Safety Alert_Section Title 6 - Review and revise operating rules related to locomotive and railcar securement to ensure that these instructions are easy to understand.
- Direct front-line managers to routinely check proper securement of equipment and provide corrections to crew when proper securement procedures are not followed.
- Revisit safety procedures whenever a close call or incident happens to identify any gaps in the procedures.
- Train employees to foul the track only when necessary and emphasize that employees need to ensure a spacing of 50 feet or more between themselves and unsecured equipment on the track.
- Require front-line supervisors to confirm that employees are properly briefed on and following safe procedures when they are required to do work within the foul of a track.
- Direct front line managers to routinely observe switching crews to ensure that employees are only fouling track and equipment safely, and only when the work requires them to do so.
- Reinforce that employees are empowered to take a safe course of action when working around railcars, including stopping work if necessary.
Interested in more information?
Safety Alert Section Content 1 Federal Railroad Administration –
Switching Operations Fatality Analysis (SOFA) Working Group –
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