I read the decision and found it thoroughly disturbing. What is the answer in a culture like that where even if there is no explicit threats but there is plenty of "discouragement" and pressure especially in an environment with few jobs and plenty waiting in the wings?
I particularly found the meetings about icing to be absurd "just get up there and see what it is like". Even worse by the report CASA had been in there trying to improve the place yet no action was taken by management. Its unfortunate it took 3 deaths for that to come to a halt.