Recommendations ensuing from the rail accident in Lac-Mégantic, Quebec
The Transportation Safety Board of Canada (TSB) continues to investigate the 6 July 2013 derailment and fire involving a freight train operated by Montreal, Maine & Atlantic Railway (MMA) in Lac-Mégantic, Quebec.
Recommendations made on 23 January 2014
1. Vulnerability of Class 111 tank cars to sustain damage (R14-01)
Considering the susceptibility of Class 111 general-service tank cars to product release during accidents, the large number of general-service Class 111 cars remaining in service, and the increased movements of large volumes of flammable liquids by rail through many Canadian and American communities, the Board believes that further action is required immediately.
Given the magnitude of the risks and given that tank car standards must be set for the North American rail industry, the Board recommends that:
The Department of Transport and the Pipeline and Hazardous Materials Safety Administration require that all Class 111 tank cars used to transport flammable liquids meet enhanced protection standards that significantly reduce the risk of product loss when these cars are involved in accidents.
TSB Recommendation R14-01
See the letter from the TSB to the Honourable Lisa Raitt, P.C., M.P., Minister of Transport, and Ms. Cynthia L. Quarterman, Administrator, U.S. Pipeline and Hazardous Materials Safety Administration, dated 23 January 2014 making TSB recommendations R14-01, R14-02, and 14-03.
See the TSB's assessment of TC's response to the recommendation R14-01.
2. Route planning and analysis for trains carrying dangerous goods (R14-02)
The Lac-Mégantic derailment and other recent rail accidents demonstrate that, when accidents involving unit trains (or blocks of tank cars) transporting large volumes of flammable materials occur, there is significant risk for loss of life and damage to communities and the environment.
Route planning and analysis involves a comprehensive system-wide review of all operational changes, infrastructure modifications, traffic adjustments, and other changes affecting the safety of train movements. Additional safety benefits can be achieved when route planning and analysis is complemented by tighter operating measures. These measures can include a maximum allowable speed for trains carrying dangerous goods and a minimum level for class of track.
Safety assessments and periodic risk assessments of potential routes used for the transportation of dangerous goods will help ensure that the route selected is the one presenting the fewest overall safety risks. Therefore, the Board recommends that:
The Department of Transport set stringent criteria for the operation of trains carrying dangerous goods, and require railway companies to conduct route planning and analysis as well as perform periodic risk assessments to ensure that risk control measures work.
TSB Recommendation R14-02
See the letter from the TSB to the Honourable Lisa Raitt, P.C., M.P., Minister of Transport, and Ms. Cynthia L. Quarterman, Administrator, U.S. Pipeline and Hazardous Materials Safety Administration, dated 23 January 2014 making TSB recommendations R14-01, R14-02, and 14-03.
See the TSB's assessment of TC's response to the recommendation R14-02.
3. Requirements for emergency response assistance plans (R14-03)
An Emergency Response Assistance Plan (ERAP) is required by the Transportation of Dangerous Goods Regulations for certain goods that pose a higher-than-average risk when transported in certain quantities. When there is an accident, the handling of these dangerous goods requires special expertise, resources, supplies and equipment. Approved ERAPs would consistently ensure that first responders have access, in a timely manner, to the required resources and assistance in the event of an accident involving significant quantities of flammable liquid hydrocarbons.
Given the significant increase in the quantities of crude oil being transported by rail in Canada, and the potential for a large spill with the risks it would pose to the public and the environment, the Board recommends that, at a minimum:
The Department of Transport require emergency response assistance plans for the transportation of large volumes of liquid hydrocarbons.
TSB Recommendation R14-03
See the letter from the TSB to the Honourable Lisa Raitt, P.C., M.P., Minister of Transport, and Ms. Cynthia L. Quarterman, Administrator, U.S. Pipeline and Hazardous Materials Safety Administration, dated 23 January 2014 making TSB recommendations R14-01, R14-02, and 14-03.
See the TSB's assessment of TC's response to the recommendation R14-03.
Recommendations made on 19 August 2014
4. Prevention of runaway trains: Unattended equipment (R14-04)
The TSB has pointed out the need for robust defences to prevent runaways since 1996 (Rail Investigation R96C0172), and since then, there have been over 120 runaways in Canada that have affected main-track operations. Equipment runaways are low-probability events, but as this accident demonstrates, they can have extreme consequences, particularly if they involve dangerous goods. As demonstrated in Lac-Mégantic, the cost to human life and our communities can be incalculable.
For this reason, the Board recommends that:
The Department of Transport require Canadian railways to put in place additional physical defences to prevent runaway equipment.
TSB Recommendation R14-04
See the TSB's assessment of TC's response to the recommendation R14-04.
5. Safety management systems audits and essential follow-up (R14-05)
Until Canada's railways make the cultural shift to safety management systems (SMS), and Transport Canada makes sure that they have effectively implemented SMS, the safety benefits from SMS will not be realized.
Therefore, the Board recommends that:
The Department of Transport audit the safety management systems of railways in sufficient depth and frequency to confirm that the required processes are effective and that corrective actions are implemented to improve safety.
TSB Recommendation R14-05
See the TSB's assessment of TC's response to the recommendation R14-05.
Process
Under the Canadian Transportation Accident Investigation and Safety Board Act, federal ministers must formally respond to TSB recommendations within 90 days and explain how they have addressed or will address the safety deficiencies.
Recommendations ensuing from the rail accident in Lac-Mégantic, Quebec
The Transportation Safety Board of Canada (TSB) continues to investigate the 6 July 2013 derailment and fire involving a freight train operated by Montreal, Maine & Atlantic Railway (MMA) in Lac-Mégantic, Quebec.
Recommendations made on 23 January 2014
1. Vulnerability of Class 111 tank cars to sustain damage (R14-01)
Considering the susceptibility of Class 111 general-service tank cars to product release during accidents, the large number of general-service Class 111 cars remaining in service, and the increased movements of large volumes of flammable liquids by rail through many Canadian and American communities, the Board believes that further action is required immediately.
Given the magnitude of the risks and given that tank car standards must be set for the North American rail industry, the Board recommends that:
The Department of Transport and the Pipeline and Hazardous Materials Safety Administration require that all Class 111 tank cars used to transport flammable liquids meet enhanced protection standards that significantly reduce the risk of product loss when these cars are involved in accidents.
TSB Recommendation R14-01
See the letter from the TSB to the Honourable Lisa Raitt, P.C., M.P., Minister of Transport, and Ms. Cynthia L. Quarterman, Administrator, U.S. Pipeline and Hazardous Materials Safety Administration, dated 23 January 2014 making TSB recommendations R14-01, R14-02, and 14-03.
See the TSB's assessment of TC's response to the recommendation R14-01.
2. Route planning and analysis for trains carrying dangerous goods (R14-02)
The Lac-Mégantic derailment and other recent rail accidents demonstrate that, when accidents involving unit trains (or blocks of tank cars) transporting large volumes of flammable materials occur, there is significant risk for loss of life and damage to communities and the environment.
Route planning and analysis involves a comprehensive system-wide review of all operational changes, infrastructure modifications, traffic adjustments, and other changes affecting the safety of train movements. Additional safety benefits can be achieved when route planning and analysis is complemented by tighter operating measures. These measures can include a maximum allowable speed for trains carrying dangerous goods and a minimum level for class of track.
Safety assessments and periodic risk assessments of potential routes used for the transportation of dangerous goods will help ensure that the route selected is the one presenting the fewest overall safety risks. Therefore, the Board recommends that:
The Department of Transport set stringent criteria for the operation of trains carrying dangerous goods, and require railway companies to conduct route planning and analysis as well as perform periodic risk assessments to ensure that risk control measures work.
TSB Recommendation R14-02
See the letter from the TSB to the Honourable Lisa Raitt, P.C., M.P., Minister of Transport, and Ms. Cynthia L. Quarterman, Administrator, U.S. Pipeline and Hazardous Materials Safety Administration, dated 23 January 2014 making TSB recommendations R14-01, R14-02, and 14-03.
See the TSB's assessment of TC's response to the recommendation R14-02.
3. Requirements for emergency response assistance plans (R14-03)
An Emergency Response Assistance Plan (ERAP) is required by the Transportation of Dangerous Goods Regulations for certain goods that pose a higher-than-average risk when transported in certain quantities. When there is an accident, the handling of these dangerous goods requires special expertise, resources, supplies and equipment. Approved ERAPs would consistently ensure that first responders have access, in a timely manner, to the required resources and assistance in the event of an accident involving significant quantities of flammable liquid hydrocarbons.
Given the significant increase in the quantities of crude oil being transported by rail in Canada, and the potential for a large spill with the risks it would pose to the public and the environment, the Board recommends that, at a minimum:
The Department of Transport require emergency response assistance plans for the transportation of large volumes of liquid hydrocarbons.
TSB Recommendation R14-03
See the letter from the TSB to the Honourable Lisa Raitt, P.C., M.P., Minister of Transport, and Ms. Cynthia L. Quarterman, Administrator, U.S. Pipeline and Hazardous Materials Safety Administration, dated 23 January 2014 making TSB recommendations R14-01, R14-02, and 14-03.
See the TSB's assessment of TC's response to the recommendation R14-03.
Recommendations made on 19 August 2014
4. Prevention of runaway trains: Unattended equipment (R14-04)
The TSB has pointed out the need for robust defences to prevent runaways since 1996 (Rail Investigation R96C0172), and since then, there have been over 120 runaways in Canada that have affected main-track operations. Equipment runaways are low-probability events, but as this accident demonstrates, they can have extreme consequences, particularly if they involve dangerous goods. As demonstrated in Lac-Mégantic, the cost to human life and our communities can be incalculable.
For this reason, the Board recommends that:
The Department of Transport require Canadian railways to put in place additional physical defences to prevent runaway equipment.
TSB Recommendation R14-04
See the TSB's assessment of TC's response to the recommendation R14-04.
5. Safety management systems audits and essential follow-up (R14-05)
Until Canada's railways make the cultural shift to safety management systems (SMS), and Transport Canada makes sure that they have effectively implemented SMS, the safety benefits from SMS will not be realized.
Therefore, the Board recommends that:
The Department of Transport audit the safety management systems of railways in sufficient depth and frequency to confirm that the required processes are effective and that corrective actions are implemented to improve safety.
TSB Recommendation R14-05
See the TSB's assessment of TC's response to the recommendation R14-05.
Process
Under the Canadian Transportation Accident Investigation and Safety Board Act, federal ministers must formally respond to TSB recommendations within 90 days and explain how they have addressed or will address the safety deficiencies.