What is the problem?
Undiagnosed and untreated obstructive sleep apnea (OSA)—and the
fatigue that results from it— continues to be deadly on our highways.
Commercial drivers must be medically fit to operate their vehicles
safely, yet many suffer from OSA.
OSA is a treatable chronic disease in which patients experience
episodes of airway obstruction while sleeping, resulting in
fragmented sleep and subsequent daytime sleepiness and fatigue.
Because many commercial drivers are older, obese males, they
tend to have higher incidences of OSA than the general population.
OSA often goes undiagnosed in the
transportation environment, which
increases the risk that drivers will
suffer from fatigue and perform their
duties in an unsafe manner.
Too many commercial drivers with
inadequately treated OSA operate
on our roadways due to a lack of
strong federal regulations addressing
screening, diagnosing, and ensuring
adequate OSA treatment; inadequate
Federal Motor Carrier Safety
Administration (FMCSA) guidance for
certified medical examiners; and weak
company policies and procedures
regarding driver health.
What can be done?
In February 2019, NTSB determined the following:
Commercial drivers operating on our roadways are generally
conscientious and well-trained; however, some employers and
federal regulators don’t pay enough attention to their drivers’
health and well-being. Many commercial drivers are at risk
of developing OSA, which puts the public at risk for a crash.
Highway personnel in safety-sensitive positions need to be
screened for OSA and treated if necessary. When treated, OSA
is not a medically disqualifying condition for transportation
operators in safety-sensitive positions.
To address the problem of medical fitness, the following actions should be taken:
Operators/Companies
- Develop a formal sleep apnea program that includes screening,
diagnosis, treatment, and follow-up for commercial drivers.
Regulatory Agencies (FMCSA)
- Provide drivers and certified medical examiners easy access
to more specific, clearer guidance on OSA.
Commercial Drivers
- Work with qualified health care providers to ensure they are
evaluated and adequately treated for OSA.
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