DOT Agency to Issue Sleep Apnea Rules for Examiners This Year, Official Says

This story appears in the May 17 print edition of Transport Topics.

LINTHICUM, Md. — The Federal Motor Carrier Safety Administration expects to issue new rules for medical examiners to address sleep apnea and other health conditions later this year, agency officials said.

“Sleep apnea is an important cause of fatigue,” Mary Gunnels, head of FMCSA’s Office of Medical Programs, said at the Sleep Apnea & Trucking Conference here on May 12. “It is an important problem that has to be addressed. We know this is a public health issue.”

The one-day conference was sponsored by American Trucking Associations, FMCSA and the American Sleep Apnea Association.

Gunnels did not specify exactly what the proposed rules will say about sleep apnea, a condition that affects an estimated 28% of truckers. But she did tell carriers, doctors and government officials in attendance to expect “more emphasis” on apnea as the agency formulates new standards medical examiners can use to perform physical examinations on commercial drivers.

Drivers who are fatigued are involved in at least twice as many accidents as those who are not, according to recent studies.

Truckers currently must undergo tests every two years or more frequently, if necessary, because of health conditions. However, the exam does not specifically disqualify drivers diagnosed with sleep apnea as it does if a driver’s vision does not meet a specific standard.

Instead, it is up to the examiner to determine whether a driver with sleep apnea can be sidelined. FMCSA now considers the condition as one of several severe cardiopulmonary conditions that can idle a driver.

Fatigue has been specified as the cause of at least 15% of fatal single-truck crashes, in which drivers typically run off the road and hit a fixed object such as a tree, Gunnels said. Most often, crashes occur between 1 a.m. and 7 a.m. on rural roads, according to FMCSA.

Apnea symptoms include poor sleep quality, falling asleep during the day and headaches.

Driver fatigue also can be triggered by other disorders such as sleep deprivation, alcohol impairment and drug interactions. Those drivers with sleep apnea serious enough for them to be disqualified can remain on duty or go back to work if they receive treatment such as from machines that prevent them from snoring and gasping for breath while asleep.

FMCSA Administrator Anne Ferro, speaking at the conference, stressed the importance of improving driver health and the importance of removing fatigued drivers, including those with untreated sleep apnea, from the road.

Sleep apnea risk factors are greater for males and people who are obese and increasing age, said Dr. Lawrence Epstein of Harvard Medical School. An estimated 50% of truckers are obese, and another 38% are in a group that can be considered overweight.

FMCSA also is commissioning a study of 3,000 drivers with sleep apnea later this year to provide more details on crash likelihood when compared with drivers who don’t have the condition, said Martin Walker, chief of FMCSA’s research division.

In addition, the agency is preparing a driver health campaign that includes brochures, posters, compact discs and a self-assessment tool for drivers to test their sleep quality.

In another fatigue-related step, the American Transportation Research Institute is requesting proposals for a new study.

The group said last week it wants proposals by July 16 to develop guidelines and materials that carriers can use to implement a program to mitigate fatigue.

Also during the conference, the Truck Safety Coalition presented an award to Schneider National Inc.’s senior vice president, Donald Osterberg, for his ongoing effort to promote truck safety.

“Through collaboration, we can work towards the goal of zero fatalities and serious injuries,” said Osterberg, who describes himself as a public safety advocate.

“Don doesn’t just talk about truck safety — he pursues it with a vengeance, and follows up with persistent reassessment and improvement, with the ultimate goal of saving lives,” said Jeff Burns, an attorney and board member of two truck safety groups.