Obesity linked to sleep apnea in drivers

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Updated Jan 13, 2010

Study suggests screenings could reduce crash risk

A new study has confirmed previous research that obesity-driven testing identifies commercial truck drivers with a high likelihood of obstructive sleep apnea and suggests that requiring OSA screenings could reduce the risk of truck crashes resulting from driver fatigue and sleepiness. “Truck drivers with sleep apnea have up to a sevenfold increased risk of being involved in a motor vehicle crash,” said Dr. Philip Parks, medical director of employee health and occupational services at healthcare provider Lifespan and the study’s lead author. The study results were published April 2 in the Journal of Occupational and Environmental Medicine.

OSA is a syndrome characterized by sleep-disordered breathing, resulting in excessive daytime sleepiness, sleep attacks, psychomotor deficits and disrupted nighttime sleep. About 2.4 million to 3.9 million licensed commercial drivers in the United States are believed to have OSA. In addition to being unrecognized or unreported by drivers, OSA often remains undiagnosed by many primary care clinicians despite the fact that OSA increases the risks of hypertension, diabetes and heart disease.

Over the 15-month study period, 456 commercial drivers were examined from more than 50 different employers; 78, or 17 percent, met the screening criteria for suspected OSA. These drivers were older and more obese, and had a higher average blood pressure. Of the 53 drivers who were referred for sleep studies, 33 did not comply with the referral and were lost to follow-up. The remaining 20 all were confirmed to have OSA, but after diagnosis, only one of these 20 drivers with confirmed OSA complied with treatment recommendations.

“Although it is not surprising, it is concerning that we found that drivers with sleep apnea frequently minimize or underreport symptoms such as snoring and daytime sleepiness,” Parks said. “As a result, it is possible that many of the 14 million truck drivers on American roads have undiagnosed or untreated sleep apnea.”

Dr. Stefanos N. Kales, medical director of employee and industrial medicine at Cambridge Health Alliance, which assisted with the study, said it is “very likely that most of the drivers who did not comply with sleep studies or sleep apnea treatment sought medical certification from examiners who do not screen for sleep apnea and are driving with untreated or inadequately treated sleep apnea.”

The Federal Motor Carrier Safety Administration is considering recommendations to require sleep apnea screening for all obese drivers based on body mass index or BMI, which is calculated based on height and weight. FMCSA requires medical certification of licensed commercial drivers at least every two years. “OSA screenings of truck drivers will be ineffective unless they are federally mandated or required by employers,” Kales said.

Lifespan is Rhode Island’s largest healthcare system, and Cambridge Health Alliance is a healthcare system with three hospitals based in Somerville, Mass.

Preventable or not
Wet curve gets on Doe’s nerves

Light rain pattered gently against the cab as John Doe drove his tractor-trailer northward along a stretch of rural two-lane highway. The speed limit was posted at 55 mph. At high noon, while cruising at 50 mph in sparse traffic, something caught Doe’s eye: a compact car was starting to enter the southbound lane. At that instant, a fast-moving southbound pickup truck came around a curve, about 100 yards behind the car.

Suddenly aware that a nearly stationary automobile was blocking his lane, the pickup’s driver attempted a panic stop. That attempt was dramatically unsuccessful, resulting in the pickup totally losing traction on the wet asphalt. Out of control, the pickup suddenly swapped lanes and slid helplessly – directly into the path of Doe’s tractor!!!

According to a witness, there was nothing further Doe could have done to avoid striking the pickup. Specifically, the witness said Doe immediately applied his brakes and spun the steering wheel full right. But, alas, Doe’s tractor-trailer also began to slide and was smashed – to the tune of an estimated $6,000 in front-end damages.

While Doe’s local review board judged him guiltless, the corporate safety director was not convinced. So the matter was sent to the National Safety Council’s Accident Review Committee for a final ruling. After considering the statement of the witness, NSC ruled the incident nonpreventable.

In Brief
Safety & Loss Prevention Management Council and the Security Council of the American Trucking Associations reorganized to form the Supply Chain Security & Loss Prevention Council (SCS&LPC) and the Safety Management Council (SMC). ATA says the reorganization recognizes the operational synergy between freight claims, loss prevention and security, as well as the singular, paramount focus of trucking’s safety professionals.

Transportation Security Administration’s Highway Information Sharing and Analysis Center on March 27 issued an alert for trucking companies and drivers engaged in cross-border operations within Mexico or whose deliveries take them close to the Mexican border. ISAC outlined threats faced by trucking companies involved in deliveries or pickups across the Mexican border and provided guidance to help ensure the safety and security of truck drivers and their loads. For more information, go to www.tssi-inc.com.

U.S. Secretary of Transportation Ray LaHood joined China’s Minister of Transport Li Shenglin on March 27 in Washington, D.C., to sign an agreement to cooperate on the safe transportation of hazardous materials.

Penske Truck Leasing teamed up with Smith System, a provider of driver safety training, to provide Penske customers online access to Smith System’s E Learning truck driver safety training courses and related training materials, including online and in-person training, and a wide selection of instructional safety-related DVDs, books, posters and related materials through MyFleetAtPenske, Penske’s customer website.