Board officials made the observation during a news conference Tuesday in Quebec City, while releasing a report into a crash in February 2010 that injured seven people in St-Charles-de-Bellechasse.
The report cited a variety of factors behind that crash, including: poor visibility because of snow; poor technology that leaves open the possibility of human error; and improper sharing of medical data that could reveal things like sleep disorders.
It said all those things contributed to the 2010 accident where the Via passenger train burst into a siding track at excessive speed.
Almost two years later to the day, there were related factors behind the Via derailment that killed three crew members in Burlington, Ont., on Feb. 26, 2012, board members said.
"The scenario is similar," TSB official Ed Belkaloul told reporters.
"There's obviously room for improvement. It's clear: when it comes to high-speed trains and passenger trains, the measures are insufficient, as this accident illustrates."
The TSB says the Canadian rail system relies too heavily on human activity and has been too slow to adopt automated systems, like in the United States.
It says it's been pushing for changes in one accident report after another, but believes the industry and federal regulators have been too slow to adopt them.
The report on the 2010 accident found that:
— The derailment occurred when the train entered the siding track while travelling at excessive speed, at 103 km/h instead of the allowable speed of 24 km/h.
— Communication problems contributed to a misunderstanding about where the train was and what it needed to do.
— Snow on railway signs and overall reduced visibility prevented the crew from seeing key signals.
— The crew's planning and reaction was likely degraded by fatigue. One locomotive engineer, who previously worked at CN, had been found to be at risk of obstructive sleep apnea and his previous employer had asked that he undergo a sleep study. But there was no process to transfer that medical data when he went to work at Via.
"In this occurrence, the OSA (sleep apnea) health concern was not effectively communicated between companies and the condition was not acted upon by the new employer," the report said.
The report also lamented the absence of recording equipment on the train, which it said would have simplified the investigation.
Via reacted later Tuesday through spokesman Marc Beaulieu.
He said the modenization of security systems, along the lines being proposed, would require a "massive investment" and he said there was no consensus within the industry to spend such sums. Beaulieu pointed to upcoming upgrades in the United States that he said are projected to cost $15 billion over the next few years.
"We're still at the discussion stage," he added.
As for voice recordings, he said that was an issue that needed the approval of the employees' union and other partners. Beaulieu said the company was ready to move ahead, if it were to receive such support.
— With files from Alexander Panetta in Montreal