Pionair B463 at Brisbane on Jun 25th 2024, tail scrape on landing
Last Update: September 9, 2025 / 11:27:00 GMT/Zulu time
Incident Facts
Date of incident
Jun 25, 2024
Classification
Incident
Airline
Pionair
Flight number
QF-7295
Departure
Sydney, Australia
Destination
Brisbane, Australia
Aircraft Registration
VH-SAJ
Aircraft Type
BRITISH AEROSPACE BAe-146-300
ICAO Type Designator
B463
Airport ICAO Code
YBBN
The aircraft was unable to continue its schedule and is still on the ground in Brisbane about 42.5 hours after landing.
Australia's TSB reported:
The ATSB is investigating a ground strike involving a British Aerospace BAe 146-300, registered VH-SAJ, at Brisbane Airport, Queensland, on 25 June 2024.
On descent into Brisbane Airport, the aircraft's approach became unstable. The approach continued and the tail of the aircraft subsequently struck the runway on landing, resulting in damage to the aircraft." and stated the damage was minor.
On Sep 9th 2025 the ATSB released their final report concluding the probable causes of the serious incident were:
Contributing factors
- The first officer became disoriented after disconnecting the autopilot on short final and likely lost situation awareness. Consequently, they did not identify the increasing aircraft pitch attitude, decreasing airspeed, or low power setting and did not correct the resulting sink rate prior to touchdown.
- The captain became preoccupied with remaining fuel. This combined with an expectation of worsening visibility resulted in a sense of urgency to land off the first approach.
- Repeated communications from the captain regarding the need to land off the first approach likely increased pressure on the first officer to commit to a landing.
- ASL Airlines Australia employed and promoted pilots earlier than the prescribed minimum experience hours without additional controls in place to manage the risk of lower experienced pilots on the flight deck. (Safety issue)
- The captain’s limited command experience in a multi-crew environment likely reduced their capacity to include the first officer in the decision-making process, consider the need to assume the pilot flying role or command a go-around when the aircraft entered an undesired state during landing
Other findings
- The captain prevented further rearward input by the first officer during the flare by placing their hand on the control column. While this action is not usually completed without the required takeover procedure it likely reduced the severity of the tail strike.
The ATSB analysed:
Introduction
On 25 June 2024, a British Aerospace BAe 146-300, registered VH-SAJ, was being operated by ASL Airlines Australia on a freight flight from Sydney, New South Wales to Brisbane, Queensland. There were 2 flight crew on board. The captain was pilot monitoring (PM), and the first officer (FO) was pilot flying (PF).
While on descent to Brisbane, the meteorological conditions worsened with visibility reducing to about 1,000 m in fog. The crew conducted an instrument landing system (ILS) approach for runway 19L, using the autopilot, and visually identified the high intensity approach lighting at about 220 ft. The FO disconnected the autopilot at about 110 ft and made control inputs that resulted in an increasing aircraft pitch attitude followed by several corrections and continued decreasing airspeed. The aircraft touched down with a high pitch angle and a vertical acceleration of about 2.4 g. The tail of the aircraft struck the runway, resulting in damage to the tail strike indicator and surrounding panels.
This analysis will explore the operational considerations pertaining to flight crew experience and training, situation awareness, command decision-making and crew communication.
Loss of situation awareness
The FO was new to their position with ASL Airlines Australia, having been checked to line 28 days prior to the incident. During their line training, the FO required additional simulator and supervised line flying sectors to achieve the required standard associated with situation awareness, approach and landing. At the time of the incident, the FO had accumulated a total of 113 hours of flying on the BAe 146.
The meteorological conditions at Brisbane at the time of the approach included reduced visibility due to the formation of advected fog. At the time the crew reached the ILS decision altitude (DA) for runway 19L, the visibility was recorded as 912 m. Although this exceeded the minimum required for the approach, the FO had only experienced flying in reduced visibility during their BAe 146 simulated training, and they had not previously landed an aircraft in foggy conditions. (The FO’s experience prior to employment with the operator had predominately been flying smaller single engine aircraft in visual meteorological conditions).
The presence of low cloud or fog can create a false visual reference which can result in a pilot orientating the aircraft to the fog layer, rather than the ground references (Federal Aviation Administration). The FO recalled that the low cloud and fog created a sight picture that they had not previously experienced in the aircraft and that following the transition to visual flying, their instrument scan pattern broke down as their attention shifted to outside the aircraft as they attempted to make sense of the landing environment.
Research by Garland et al, (1999) identified that high mental workload can negatively impact situation awareness, as only a subset of the available information can be processed and acted upon. Situation awareness can be defined as ‘the perception of the elements in the environment within a volume of time and space, the comprehension of their meaning and the projection of their status in the near future’ (Endsley, 1988) . The maintenance of a high level of situation awareness is a critical feature of a pilot’s role (Garland et al, 1999).
The combination of degraded visibility, potential visual illusion, high workload, and inexperience operating in similar meteorological conditions likely resulted in the FO losing situation awareness of the aircraft state. Consequently, the FO did not effectively manage the aircraft following the disconnection of the autopilot resulting in the aircraft initially becoming high on the approach.
A short time later, the FO likely became aware of the high profile and attempted to correct the height with several pitch attitude changes. However, the FO’s attention was outside the aircraft at this time and their instrument scan had broken down.
Consequently, they were likely not monitoring aircraft airspeed and did not command any change to the engine power settings. As a result, the airspeed reduced and the aircraft’s rate of descent increased. The FO likely identified the increased rate of descent as the aircraft neared the runway, as a large pitch attitude increase was recorded just prior to touchdown. However, these actions were not sufficient to arrest the high rate of descent and this, in combination with the high pitch attitude, resulted in the tail of the aircraft striking the runway surface.
Captain’s focus on remaining fuel
As a consequence of the unforecast reduction in visibility, with no original requirement to plan an alternative airport, the captain became increasingly concerned about the fuel state as the aircraft continued on the approach.
It was also an expectation of the captain that the visibility would deteriorate further, commenting to the FO that if they were to conduct a go-around this could potentially leave them in a worse situation. During the approach, the captain also made several remarks about committing to a landing including that if they could see the high-intensity approach lighting, then they were going to land. About 2 minutes prior to landing, the FO expressed concern regarding the autopilot usage stating that they would disconnect it should a go-around be required. In response, the captain stated ‘we don't want to go around. It’s gonna be a world of hurt’.
Prior to their descent into Brisbane, the crew had calculated the minimum fuel to divert to the Gold Coast was about 1,700 kg. The aircraft landed at Brisbane with about 2,300 kg of fuel on board, indicating there was sufficient fuel to conduct a go-around at Brisbane and safely divert the aircraft to the Gold Coast.
The captain’s preoccupation with the aircraft fuel state, combined with the expectation of worsening conditions, led to an increased desire to land the aircraft on the first approach and avoid conducting a go-around which they perceived would have resulted in an approach in conditions that would likely deteriorate further.
Continued communication regarding fuel
Brisbane air traffic control (ATC) had alerted the crew to the approaching low cloud bank about 18 minutes prior to landing. From the time of the alert until the landing, the CVR recorded continued concern from the captain.
This concern included that they had ‘no fuel’ and ‘we haven't got the fuel for this’ as well as concern with the conditions stating, ‘the weather will only get worse’ and ‘if we can see the HIAL’s,28 we’re going to land’.
About 4 minutes prior to landing, the FO asked if it was possible to calculate the fuel needed to divert to the Gold Coast, to which the captain responded ‘not now, on final, but let's try and get in’. Shortly after the FO discussed the go-around procedure in preparation for the DA, to which the captain reinforced their intention to land.
Although there was continued communication regarding the fuel state and visibility, no discussion was recorded regarding diversion plans to an alternative airport until established on the final approach. Additionally, the crew did not proactively obtain the weather conditions for alternate aerodromes, in the event that they were required to conduct a go-around without a planned diversion, limiting the crew’s options to return to conduct a second approach in Brisbane, further exacerbating the expectation of landing off the approach.
In contrast, the crew of the preceding aircraft on the approach prior to VH-SAJ, advised that there was sufficient time during descent to plan for a diversion on receipt of the weather changes. Subsequent ATC recordings indicated that this crew also advised ATC of their intention to divert to the Gold Coast, if a go-around was required.
The FO had no previous experience in a multi-crew environment and had only recently been checked to line. According to Fabre (2022), when a newly appointed FO is paired with a captain that they consider as experienced, the captain’s opinion strongly influences the FO’s decision-making and significantly increases the likelihood of the crew attempting a moderate to high-risk landing scenario. The FO’s limited experience in the position and in a multi-crew environment likely meant they were more susceptible to the captain’s pressure to land and less likely to voice any concerns.
The continued verbal concern over landing off the approach compounded pressure on the FO, which likely compelled them to commit to a landing on reaching the DA.
Crew appointments
The ASL Airlines Australia operations manual outlined the minimum experience requirements for the appointment of captains and first officers. However, neither the captain nor the FO met these requirements at the time of their engagement, nor at the time of the incident.
In ‘exceptional circumstances’, the ASL Airlines Australia operations manual permitted the variance of the experience requirements with the specific approval of the director of flight operations.
There was no evidence that ASL Airlines Australia had considered the hazards associated with the appointment of pilots that did not hold the required level of experience, nor was any control put in place to manage the risks. Such controls could have included, but were not limited to, operational limitations for low experience crew.
The ATSB reviewed expositions from 6 CASR Part 121 operators and found that 5 had restrictions on FOs conducting landings in marginal meteorological conditions, including reduced visibility and low cloud.
ASL Airlines Australia did not have such a policy, and it reported that having similar limitations could lead to FOs being promoted to captain without having acted as pilot flying in adverse weather conditions. However, the FO’s limited experience in marginal meteorological conditions likely contributed to the tail strike incident. Had a similar limitation been in place, it would likely have resulted in the captain assuming control when the crew were alerted to the low visibility at Brisbane Airport.
ASL Airlines Australia had a rostering policy that prevented crew who had not accumulated 100 hours in their positions from being rostered together. However, there was no consideration made for crew who had been provided early promotion to their positions. As a result, the captain, promoted early to their position and at the time of the occurrence had not yet attained the minimum experience requirements to hold the position, was paired with an inexperienced FO. Without administrative controls in the rostering policy to prevent unsuitable pairing of crew without requisite experience, the result was a reduction in the intended experience level on the flight deck for the incident flight.
Captain’s multi-crew experience
The captain commenced with ASL Airlines Australia in November 2022, initially as a FO, before undertaking command upgrade training after 155 hours. They had held the position since February 2024 and had accrued 198 hours as a captain at the time of the incident. Prior to joining ASL Airlines Australia, the captain had not flown a jet aircraft and had mostly flown in single pilot operations. As discussed above in Crew appointments, the captain had been nominated for command upgrade training below the required 500 hours, and this reduced their opportunity:
- to gain valuable exposure operating in a multi-crew environment
- to model behaviour on experienced captains’ decision making prior to commencing in the captain role themselves.
The missed opportunity to gain valuable multi-crew experience likely impacted the captain’s capacity to include the FO in the decision-making process and limited the effectiveness of the crew during the approach. Although the captain was not the PF during the approach, the ultimate responsibility for the safety of the aircraft lay with them.
The cockpit voice recording indicated that, although it was reasonable for the captain to assume the FO was competent in flying the ILS, they did not ask the FO if they were comfortable to continue the approach after being alerted to the low cloud, fog and changing weather conditions. Likewise, while the FO did not advise the captain that they were experiencing difficulties during the approach, the captain did not recognise other cues, such as the FO’s response when requested to disconnect the autopilot at the DA, their ability to clearly see the approach lighting on short final, or their obvious discomfort with the approach.
It is likely that the captain’s limited command multi-crew experience may also have reduced their ability to establish an appropriate ‘cockpit gradient’ following advice that the meteorological conditions at Brisbane Airport were deteriorating. The term ‘cockpit gradient’ describes the level of authority that exists between the crew members, and the way this authority influences communication and decision-making. Although the pilot in command has ultimate responsibility in terms of decision-making, depending on the cockpit gradient, other crew members can be either encouraged or discouraged from influencing these decisions through their own inputs.
A ‘steep’ cockpit gradient exists when the pilot in command has an overwhelming influence in decision-making, with little input sought from other crew members. A steep gradient can ‘inhibit communication, coordination and the cross-checking of errors’ (Harris, 2011). The cockpit voice recording indicated a steep cockpit gradient existed during the approach phase, with the captain dismissing the FO’s request to recalculate diversion fuel or plans in the event of a go-around, thereby reducing the effectiveness of the decision-making process.
The captain provided control input instructions to the FO during the final stages of the approach. Likely due to their limited experience in the captain role, they did not recognise that the approach would have been better handled by a more experienced crew member who had previously encountered comparable conditions. Consequently, no authoritative decision was made by the captain to assume the PF role or to command a go-around when the aircraft entered an undesired state after autopilot disconnection.
Captain’s control input
The captain reported that as the high sink rate developed, they anticipated the FO’s reaction and placed their hand on the control column to prevent any further increase in the aircraft’s pitch during the landing. This likely reduced the severity of airframe damage caused by the tail strike.
ASL Airlines Australia procedures stated that any control handover must be conducted in a positive manner to minimise confusion and operational risk. The FO recalled feeling the captain’s pressure on the control column preventing further rearward input, but the captain did not verbalise their actions at the time. While the control column input from the captain may have prevented further damage to the aircraft, it also risked confusion about who was in control of the aircraft during a critical stage of flight.
Metars:
YBBN 242130Z 20007KT 9999 FEW005 SCT030 BKN040 14/14 Q1022 RF00.0/003.4 DIST BR/FG TO SW=
YBBN 242100Z 20007KT 8000 VCFG FEW002 BKN036 BKN045 14/14 Q1022=
YBBN 242053Z 21007KT 8000 VCFG FEW002 BKN036 BKN046 14/14 Q1022=
YBBN 242048Z 21007KT 5000 VCFG FEW001 BKN036 BKN043 14/14 Q1021=
YBBN 242030Z 21007KT 3600 BR BCFG SCT001 BKN035 14/14 Q1021=
YBBN 242030Z 21007KT 3600 BR BCFG SCT001 BKN035 14/14 Q1021=
YBBN 242016Z 20006KT 1800 BR VCFG OVC001 14/14 Q1021 RF00.0/003.4=
YBBN 242000Z 20007KT 0900 R19L/1400U R19R/P2000N FG OVC001 14/14 Q1021=
YBBN 242000Z 20007KT 0900 R19L/1400U R19R/P2000N FG OVC001 14/14 Q1021=
YBBN 241959Z 20007KT 0900 R19L/1400U R19R/P2000N FG OVC001 14/14 Q1021=
YBBN 241934Z 20008KT 0400 R19L/P2000N R19R/P2000N FG SCT001 BKN035 14/14 Q1021=
YBBN 241930Z 19007KT 0800 R19L/P2000N R19R/P2000N FG FEW002 SCT035 14/14 Q1021=
YBBN 241900Z 20008KT 9999 FEW002 13/13 Q1020=
YBBN 241830Z 21007KT 9999 FEW025 13/13 Q1020=
YBBN 241800Z 20008KT 9999 FEW035 SCT065 15/15 Q1020 RF00.0/003.4=
YBBN 241730Z 20006KT 9999 VCSH FEW010 SCT037 BKN054 15/15 Q1020=
YBBN 241700Z 21007KT 9999 -SHRA FEW008 SCT035 BKN050 15/15 Q1020 RESHRA=
YBBN 241700Z 21007KT 9999 -SHRA FEW008 SCT035 BKN050 15/15 Q1020 RESHRA=
YBBN 241630Z 24006KT 2400 +SHRA FEW008 BKN019 BKN030 15/15 Q1020=
YBBN 241630Z 24006KT 2400 +SHRA FEW008 BKN019 BKN030 15/15 Q1020=
YBBN 241621Z 26007KT 6000 -SHRA FEW008 SCT015 BKN020 15/15 Q1020=
YBBN 241600Z 26007KT 9999 -SHRA FEW012 BKN050 15/15 Q1020 RF00.0/000.2=
Incident Facts
Date of incident
Jun 25, 2024
Classification
Incident
Airline
Pionair
Flight number
QF-7295
Departure
Sydney, Australia
Destination
Brisbane, Australia
Aircraft Registration
VH-SAJ
Aircraft Type
BRITISH AEROSPACE BAe-146-300
ICAO Type Designator
B463
Airport ICAO Code
YBBN
This article is published under license from Avherald.com. © of text by Avherald.com.
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