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Tragedies Lead to Change In Apnea Screening Policies

The release of the National Transportation Safety Board’s findings into the cause of the fatal Metro-North train derailment in the Bronx last year was highlighted by word that an undiagnosed case of sleep apnea was behind the tragedy. Sleep apnea afflicts an estimated 18 million Americans, and is a serious disorder that has not only been linked to a much increased potential for fatal errors in operating vehicles and heavy machinery, but has also been associated with a number of chronic and life threatening health conditions.

Metro-North already has been working with its unions on a plan to institute screenings of their employees, and plans to request approval to hire a screening company from the Metropolitan Transportation Authority. Similar actions have already been taken by the Federal Railroad Administration (FRA). That agency has indicated that they are establishing new rules specifically addressing fatigue and sleep disorders in train engineers and in other employees. According to FRA spokesman Michael England, “Our goal is to reduce the likelihood of accidents, injuries and fatalities caused by fatigue.”

Sleep disorder screening is already provided by many other transportation agencies, including New Jersey Transit. It is unknown whether Amtrak offers them, but it is likely that if they do not that it will be under serious discussion as the topic is becoming more and more important to the public, and as the risks become more clear.

DWD = Driving While Drowsy

Sleep apnea is a condition in which a person’s airway becomes blocked when they are sleeping. It is often associated with obesity, and though it can appear in both men and women it is more frequently diagnosed in older men. There are a number of notable warning signs of the disorder, including obesity, snoring, and large neck size. Sleep apnea not only puts its victims at risk for falling asleep at the wheel – it also increases their risk of high blood pressure, diabetes, stroke and cardiovascular problems, as well as mood disorders such as depression.

The issue of introducing sleep apnea screening is not quite as clear cut for those who are in charge of the nation’s truck drivers, and particularly not for their union, which has fought strenuously against any ruling that mandates sleep apnea tests for their operators. Websites exist that refer to efforts to have truck drivers with higher Body Mass Indexes as “witch hunts” and indicate that the Federal Motor Carrier Safety Advisory Committee and the Medical Review Board have “declared war” on truck drivers. The executive vice president of the Owner-Operator Independent Drivers Association, Todd Spencer, calls studies about sleep apnea “junk science.” He says “We’ve not seen the impact in safety and health of sleep apnea that the NTSB talks about. Generally when somebody’s saying, ‘This is – we’re killing people, we’re killing people’ they have an economic interest in pursuing this … either they’re making money from treatment, they make money from diagnosis, they make money maybe through lawsuits.”

The National Transportation Safety Board’s Mark Rosekind says that the disorder is a national problem in all areas of transportation. “We have accidents in rail, commercial trucking, commercial aviation, marine, pretty much every mode of transportation.”

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