DOT requests comments on sleep apnea screening

DOT requests comments on sleep apnea screening

The US Department of Transportation’s Federal Motor Carrier Safety Administration (FMCSA) and Federal Railroad Administration (FRA) are seeking public input during the next 90 days on the impacts of screening, evaluating, and treating commercial motor vehicle (CMV) drivers and rail workers for obstructive sleep apnea (OSA).

The National Transportation Safety Board (NTSB) recommended that DOT take action to address OSA screening and treatment for transportation workers.

This joint advance notice of proposed rulemaking (ANPRM) is the first step as both agencies consider whether to propose requirements specifically for OSA. They will host three public listening sessions to gather input on OSA in Washington DC, Chicago IL, and Los Angeles CA.

An estimated 22 million men and women could be suffering from undiagnosed OSA, a respiratory disorder characterized by a reduction or cessation of breathing during sleep.  Undiagnosed or inadequately treated moderate to severe OSA can cause unintended sleep episodes and deficits in attention, concentration, situational awareness, memory, and the capacity to respond safely to hazards when performing safety-sensitive service.

For individuals with OSA, eight hours of sleep can be less refreshing than four hours of ordinary, uninterrupted sleep, according to a study by the American Academy of Sleep Medicine. The size and scope of the potential problem means that OSA presents a critical safety issue for all modes and operations in the transportation industry.

“The collection and analysis of sound data on the impact of OSA must be our immediate first step,” said FMCSA Acting Administrator Scott Darling. “We call upon the public to help us better understand the prevalence of OSA among commercial truck and bus drivers, as well as the safety and economic impacts on the truck and bus industries.”

In a March 9 article by Kevin Jones of Fleet Owner  magazine, a tragic instance of OSA-related effects was cited:

The pre-publication copy of the DOT proposal cites several sleep apnea-related incidents investigated by NTSB, including a July 2000 work zone accident in which a tractor-trailer driver collided with a Tennessee Highway Patrol vehicle trailing construction vehicles, killing the state trooper inside. The tractor-trailer driver was 5 feet 11 inches tall, weighed 358 pounds, and had been diagnosed with and undergone surgery for OSA, but had not indicated either the diagnosis or the surgery on examinations for medical certification, according to the investigation report.

For any CMV drivers shown to have a respiratory dysfunction such as OSA, FMCSA currently recommends that medical examiners refer them for further evaluation and therapy. In January 2015, the agency issued a bulletin to remind healthcare professionals on the National Registry of Certified Medical Examiners of the current physical qualifications standard and advisory criteria concerning the respiratory system; specifically, how the requirements apply to drivers that may have obstructive sleep apnea.

To read the ANPRM and provide comments, click here.

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