Sleep Apnea in Trucking is a Serious Safety Concern
At the first ever Sleep Apnea & Trucking Conference, held in Baltimore, MD, a sold out crowd of trucking industry leaders, sleep medicine professionals, regulators and vendors gathered to discuss solutions for the serious problem of sleep apnea in trucking. The two-day event was hosted by the American Sleep Apnea Association (ASAA) and co-sponsored by the American Trucking Associations (ATA) and the FMCSA.
Obstructive Sleep Apnea (OSA), the most common category of sleep-disordered breathing, is a condition where airways become obstructed while sleeping, typically resulting in "hypoxia" or low blood oxygen levels at night. The obstruction leads to interruptions in breathing lasting several seconds at a time, loud snoring, and non-restful sleep. OSA has been demonstrated to significantly increase safety and health risks, leading to extreme daytime sleepiness.
Medical research has shown that OSA is a significant cause of motor vehicle crashes (resulting in a two- to seven-fold increased risk). Studies also suggest that commercial motor vehicle (CMV) operators have a higher prevalence of OSA than the general population. According to FMCSA research, around 30 percent of drivers suffer from mild to severe sleep apnea.
The National Transportation Safety Board (NTSB) renewed its campaign to broaden the use of sleep disorder screening across all modes of transportation - air, rail, marine, and trucking - as part of a long-term effort to significantly reduce the negative effects of fatigue. According to NTSB Vice Chairman Christopher Hart, fatigue and sleep apnea are major problems of the trucking industry and regulators need better awareness and better treatments to address the problem properly.
Hart proposed that the FMCSA incorporate new sleep disorder suggestions in an online medical examiner book. He also said he believes FMCSA will complete a revised examination report form by September to include the assessment of sleep disorders and publish a best practices guide for examiners.
Currently, there are few rules in transportation addressing OSA. In trucking, FMCSA asks about sleep disorders, OSA, daytime sleepiness, and snoring on the questionnaire completed by commercial truck drivers undergoing examination for medical certification. Further, the FMCSA Medical Review Board in 2008 recommended that the adminstration require OSA screening for all drivers with a body mass index (BMI) over 30, but the FMCSA has yet to act on that recommendation.
Regulators say that sleep disorders are big problems of the trucking industry. FMCSA Administrator Anne Ferro, who spoke at the Conference, said that fatigue-related crashes need to be reduced in the trucking industry, and that more research, programs, events, and targeted outreach and intervention will reduce drowsy driving accidents. "We consider fatigue to be a high risk behavior, something we're addressing as part of our core mission to reduce severe and fatal crashes involving commercial motor vehicles," said Ferro. "We know sleep apnea contributes to fatigue, that it interferes with safe driving. Thus sleep apnea is a threat to safety."
Over twenty speakers spoke at the two-day conference. Among them was R. Clay Porter, partner, Dennis, Corry, Porter & Smith, LLP. Mr. Porter examined the potential legal ramifications of drivers with sleep apnea on the road. While sleep apnea has not become a major player in the realm of truck litigation, it is "going to be part of this legal landscape sooner rather than later." Recommendations have already been made placing drivers, employers, and physicians on notice about this problem, along with proposed specific steps that should be taken to reduce preventable accidents attributed to OSA. In addition, existing case law exists to frame an argument for punitive damages for employers, and criminal convictions for employees and employers if OSA problems are ignored or hidden. The word to the wise is "deficio gero vestrum periclitatus", which roughly translates to "fail to act at your peril."
Those unable to attend the sold-out conference can purchase the Resource Toolkit, a comprehensive manual with materials on sleep apnea and trucking, which will be available after the conference at http://www.satc2010.org/. You can also click here for a variety of sleep apnea treatment options from the ASAA.
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