Sleep Apnea Screening for Overweight Commercial Truck Drivers Blocked
Douglas Bader, an Illinois State Trooper, sat in his squad car with the lights flashing when his car was struck by a tractor-trailer, causing his vehicle to burst into flames. Balder had stopped to deal with a big-rig that had stalled in the right traffic lane. Both a bright yellow tollway assistance vehicle and a tow truck also were stopped, making the scene obvious to approaching vehicles. The patrol car flashers were activated, and flares were positioned behind the vehicles. The tollway truck also was positioned behind the vehicles while flashing a large blinking arrow and amber hazard lights. Despite this obvious traffic obstacle on the side of the road, the driver of a flatbed big rig slammed into the patrol car at 63 miles per hour. The investigation conducted by the National Transportation Safety Board (NTSB) subsequently revealed that the truck driver was falling asleep. The gas truck of the patrol car exploded, and Bader suffered severe burns over a third of his body.
This tragedy reported in a recent article from the Huffington Post made national news just two months after Congress made it more difficult to adopt regulations compelling screening of truck drivers for obstructive sleep apnea. The report reviewed this failed effort along with other recent successful attempts by the trucking industry to scale back traffic safety rules. Although the U.S. has seen decades of progress toward improving roadway safety, the trucking industry has recently been successful in scaling back safety regulations. During the most recent year for which data is available, 3,451 trucking accidents claimed the lives of 3,964 people, which represents more than a seventeen percent increase in only a four year period. Efforts to defeat new trucking regulation like the attempt to force obese drivers to seek evaluation for sleep apnea have contributed to this trend.
Individuals who suffer from obstructive sleep apnea experience a repeated closing of the airway while they are sleeping. This interruption of the apnea sufferer's sleep can occur dozens of times during every hour. Because of the ongoing disruption in their sleep schedule, people who suffer from this condition frequently are exhausted and prone to fall asleep during the day. This sleep disorder can go undiagnosed in people who do not realize they are suffering from the condition for many years. However, researches have noticed a trend. Among the most common factors that suggest a person is at risk for the condition are age and weight.
The prevalence of the condition amongst commercial drivers has been estimated by the Federal Motor Carrier Safety Administration (FMCSA) to be as high as 28 percent, which amounts to nearly a third of all commercial drivers. Because truck drivers spend the vast majority of their work time engaged in sedentary activity while operating big rigs, they are prone to being overweight, which is a significant risk factor for sleep apnea. Approximately two in three truck drivers are overweight according to a recent national survey. In a study conducted by the Harvard School of Public Health, truck drivers with untreated sleep apnea are five times more likely to be involved in a tractor-trailer crash.
As early as 2008, trucking safety experts in a report to the FMCSA entitled, "Obstructive Sleep Apnea and Commercial Motor Vehicle Driver Safety" advised that truck drivers should be screened for the sleep disorder and undergo treatment in appropriate cases. While sleep apnea constitutes an issue of concern for the NTSB across all sectors of the transportation industry, the NTSB reports that the trucking industry has the most permissive rules of the primary sectors of the transportation industry.
Although the FMCSA discussed a proposal in April 2012 that would have made sleep apnea screening mandatory for overweight truck drivers, the proposal was abandoned in the wake of pushback from the commercial carriers and truck drivers. The trucking industry has since lobbied Congress to pass legislation that would force the federal agency to use the full federal rulemaking process to resurrect the proposal, creating an additional roadblock that will make it difficult to adopt regulations requiring sleep apnea screening in the future.
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