Drowsy Driving as a Concern in the Transportation Industry

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Federal regulations in the near future will mandate employees in safety sensitive positions be tested for sleep disorders to decrease crash rates and fatalities

Those in safety sensitive positions such as commercial truck drivers, railroad workers, and other modes of the transportation industry should be tested for common sleep disorders

Obstructive Sleep Apnea is a common disorder that is a major cause of Excessive Daytime Sleepiness (EDS) that leads to people falling asleep while sitting, reading, and even driving. According to yearly statistics, more than 1,300 fatalities and 70,000 injuries are directly caused by drowsy driving. 53% of Americans report driving drowsy, and 19% also report nodding off behind the wheel. 23% of American drivers claim to personally know someone who has crashed due to drowsy driving. And those with sleep apnea, a common sleep disorder, are 7 times more likely to get into an accident. A person's obesity, measured by their Body Mass Index (BMI), is a major predisposing factor.

The Federal Motor Carrier Safety Administration (FMCSA) has taken action. The government organization has established its own Medical Expert Panel on sleep apnea to determine the prevalence and effect of sleep apnea on commercial truck drivers. The Panel recommended the FMCSA incorporate a method to determine excessive daytime sleepiness in the CMV Medical Report Form and use BMI as an objective method to establish the need for a sleep study. The FMCSA is currently reviewing the data to determine the appropriate recertification process to be launched in the next 24 - 36 months. As an example, if the FMCSA chooses a BMI ≥ 33, roughly 24% of the CMV population will need to be tested for a sleep study. If a BMI ≥ 30 is used almost half (42%) of the population will be tested.

In the railroad industry, the Federal Railroad Administration (FRA) issued a safety advisory in 2004 regarding sleep apnea from a report addressing the collision of two trains in 2001 due to the engineer and conductor's insufficiently treated obstructive sleep apnea.

In conjunction with a railroad regulated by the FRA, University Services Sleep Diagnostic & Treatment Centers developed a program that will easily screen, confirm, diagnose, and treat sleep disorders cost effectively. The model was based on the company's own research conducted with a Class 1 Railroad company to determine the prevalence of EDS in the population and established that a study could be performed successfully through joint cooperation between the employer and the workers. The study, currently under peer review for publication, screened for the prevalence of OSA using a Health Risk Assessment (HRA) and confirmed using an ambulatory device that does not require an overnight stay in a Sleep Disorders Center.

The results of the study found the risk of OSA among participants to be 40%, higher than the general population (2-4%), and from those found to be at risk, 80% confirmed positive to have OSA by the study's criteria. Each participant followed the model exactly, with no failures.

"Those in safety sensitive positions such as commercial truck drivers, railroad workers, and other modes of the transportation industry should be tested for common sleep disorders," commented Dr. Benjamin Gerson, Medical Director of University Services Sleep Diagnostic & Treatment Centers who will present these study findings on Sleep Apnea & Transportation Workers at the National Safety Council's annual Congress & Expo in Anaheim, California on September 22.

If a company with personnel in safety sensitive positions in the transportation industry fails to recognize the need for a sleep study among their employees, the federal government may make that decision for them. Like the government mandated employee drug testing of the 1980's, employers will need to adjust their business model to include the upcoming regulations from the FMCSA and other modals of the DOT. It is important to have a sleep disorder testing model already in place to make this transition an easy one.

About University Services:
University Services, a multi-specialty medical services organization, provides sleep diagnostic and treatment in seven sleep centers located throughout southeastern Pennsylvania, southern New Jersey, and northern Delaware. Each offer state-of-the-art overnight testing facilities with private bedrooms, bathrooms, and the comforts of home. Convenient at home testing options are also available.

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Crystal Parsons
University Services
215-637-6800
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