BURLINGTON, ON, June 11, 2013 /CNW/ - The Transportation Safety Board of
Canada (TSB) is calling for fundamental changes aimed at improving the
country's rail network—beginning with an automatic, fail-safe way to
slow or stop trains when a signal is missed. This is one of three
recommendations emerging from a TSB investigation report (R12T0038), released today, into a fatal 2012 VIA Rail derailment near
On 26 February 2012, three locomotive engineers were killed and dozens
of passengers were injured when VIA 92 derailed at a crossover en route
from Niagara Falls to Toronto. Investigators determined within days
that the train had been travelling at more than four times the
allowable speed, and that the locomotive crew had not properly
responded to signals requiring a slowdown to 15 mph.
The frequency of misperceived signals—approximately one per month in
Canada—is a driving force behind the Board's recommendation. "Every
day, hundreds of passenger and freight trains encounter thousands of
signals all over Canada," said Wendy Tadros, Chair of the TSB. "Missed
signals are a real risk, and we need to drive that risk down. That's
why we're calling for an automatic, fail-safe way to stop trains."
The TSB investigation concluded that the signals were misperceived by
the crew and that several factors could have been responsible,
including the unexpected presence of a work crew on the tracks. The
report adds that the accident occurred at a point in the route where,
99% of the time, the crew would go straight ahead at track speed, and
that such an expectation may have strongly influenced their actions.
The Board is making two further recommendations, including the
installation of in-cab video cameras in all lead locomotives in
mainline operations. To prevent these kinds of accidents, the TSB needs
to better understand why they happen, and recordings are the key to
that understanding. Finally, the Board recommends improving crew
survivability by applying crashworthiness standards for new locomotives
to rebuilt passenger and freight locomotives.
"We think Canadians deserve safer railways," added Tadros. "And that is
why the TSB is recommending fundamental changes. We want railways where
trains will automatically slow down and stop when they are supposed to,
where what happens in the locomotive cab gets recorded, and where crews
are given a better chance of surviving an accident."
The TSB is an independent agency that investigates marine, pipeline,
railway and aviation transportation occurrences. Its sole aim is the
advancement of transportation safety. It is not the function of the
Board to assign fault or determine civil or criminal liability.
RECOMMENDATIONS for VIA RAIL 92 CRASH (R12T0038)
NEAR BURLINGTON, ONTARIO in FEBRUARY 2012
On 26 February 2012, VIA Rail passenger train 92, en route from Niagara
Falls to Toronto, Ontario proceeding eastward entered a crossover near
Burlington, Ontario, and derailed the locomotive and 5 coaches. The
locomotive struck a building after it derailed and the locomotive cab
was destroyed. Many passengers were injured, and the 3 crew members in
the cab of the locomotive were fatally injured.
1) The Department of Transport require major Canadian passenger and
freight railways to implement physical fail-safe train controls,
beginning with Canada's high speed rail corridors.
Currently, Canada's major passenger and freight railways rely solely on
administrative defences (rules, procedures) to prevent this kind of
accident. These defences alone are inadequate for situations where the
train crew misperceives, misinterprets or does not follow a signal
indication. The Board is calling for physical defences so that if a
signal is missed, the train will be stopped automatically.
2) The Department of Transport require that all controlling locomotives in
main line operation be equipped with in-cab video cameras.
The absence of valuable information from in-cab voice and video
recorders means there will always be unanswered questions, and
represents a lost opportunity. Understanding the environment and
interaction between the crew is vital. In order to prevent accidents
in the future, we need to understand why the accidents happen.
3) The Department of Transport require that crashworthiness standards for
new locomotives also apply to rebuilt passenger and freight
Currently, there is no requirement for rebuilt locomotives to meet
standards for crashworthiness—only new locomotives. Many locomotives
may be susceptible to cab structural, fuel tank and other failures
during derailments. This includes over 90% of freight and passenger
locomotives in Canada.
Under the Canadian Transportation Accident Investigation and Safety Board Act , federal ministers must formally respond to TSB recommendations and
explain how they have addressed or will address the safety
deficiencies. As of 11 June 2013, the Minister of Transport has 90 days to respond to recommendations put forth in investigation R12T0038.
Using an Assessment Rating Guide (which includes definitions for the status of recommendations), the Board evaluates the responses and their overall effectiveness.
Each response is assessed as Fully Satisfactory, Satisfactory Intent,
Satisfactory in Part or Unsatisfactory. Progress made to address TSB
recommendations is assessed by the Board on an ongoing basis.
SOURCE: Transportation Safety Board of Canada
For further information:
View the animation of the accident
Read the backgrounder
TSB Media Relations
The TSB is online at www.tsb.gc.ca. Keep up to date through RSS, Twitter @TSBCanada, YouTube, Flickr and our blog.