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A Virgin Australia pilot taking off from Perth Airport mistakenly lined up the plane on the edge of a runway instead of its centre, in a move that triggered an official investigation.
The misaligned take-off incident was one of three that took place over the course of two years at the same Perth runway, the Australian Transport Safety Bureau (ATSB) said. The other two incidents involved smaller regional carriers that made similar errors.
The pilot of the Virgin Australia flight to Sydney in June 2023 began a take-off roll aligned with the left edge lights of runway 06. The pilot immediately identified the problem and corrected course, manoeuvring the 737-800 to the centreline where it took off.
Two other incidents concerned Western Sky Aviation – in August 2023 and April 2024 – and both involved conducting the take-off from the edge line.
The view from Perth’s runway 06, showing lights on the edges but not in the centre. Credit: ATSB
“In each incident, as the pilots believed they had correctly aligned the aircraft with the runway centreline, they commenced the take-off,” the safety bureau report said.
In an August 2023 Western Sky Aviation departure, the pilot of a Cessna Conquest 441 detected his plane impacting runway edge lights and returned to Perth immediately, where he found no aircraft damage.
During the third flight, in April 2024, which involved the same Western Sky Aviation plane, a different pilot “heard an unusual noise but believed it originated from inside the cabin” and continued the departure. Minor damage to the right engine propeller of the aircraft was subsequently identified.
“In all three incidents, when entering [the runway] from [the taxiway], the pilots taxied past the turn onto the centreline and lined the aircraft up along the runway edge lighting on the far side of the runway to where they entered,” the safety bureau said.
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Runways sometimes have centreline lighting as well as edge lighting, depending on their size and the volume of traffic they handle. For example, Perth’s runway 03 has centreline lighting.
The 2023 and 2024 incidents have prompted special reminders for pilots and a request from the airport to highlight the higher-risk nature of the spot.
The safety bureau pointed to “several factors known to increase the risk of a misaligned take-off”: they happened in pre-dawn darkness, and the runway had an “unmarked extended pavement area on each side”, which made it appear wider than it was.
Taxiway lighting located in the ground continued across the runway, making it harder to see where the centreline of runway 06 was, the bureau said, noting that the “recessed edge lights at the start of runway 06 could be mistaken for centreline lighting”.
Perth’s runway 03 with centreline lighting.Credit: ATSB
The “required runway markings were reported by two of the incident pilots to be difficult to see at night”, the bureau noted, while taxi lighting on one of the Cessna Conquest 441 flights was reported by one pilot as being of limited benefit.
The report on Perth airport comes two weeks after the safety bureau said that a failure to fully understand take-off conditions almost led to two major accidents at Melbourne Airport in which miscalculations in take-off speeds nearly resulted in two jets hitting crews at work on the runway.
In Perth, another factor specific to the Virgin flight crew was how their attention “was diverted to completing pre-take-off tasks and their take-off clearance while lining up on the runway”, the safety bureau said.
“This divided their attention between the flight deck and the monitoring of the external environment.”
Virgin Australia Airlines has since added caution notes to its Perth Airport supplementary port information regarding centreline misidentification on runway 06.
The airline has also “revised the before take-off procedure to reduce flight crew workload during line‑up” – and has incorporated the 2023 event into non-technical skills training.
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Perth Airport requested a change to information that Airservices Australia linked to the runway, highlighting that runway 06 has a “misaligned take-off risk”. In April 2024, Perth airport added markings on the extra pavement next to runway 06 to help prevent future misalignment.
As Qantas ramps up flights from Perth to Europe, the West Australian airport has made plans for a new terminal. It will include the expansion of its existing International terminal, and the construction of a new Domestic terminal for Qantas. Perth Airport now has a Qantas Domestic Business Lounge, Qantas Club and Qantas Perth International Lounge.
Virgin Australia and Perth Airport were approached for comment.
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