In The News
University of Minnesota study: Crashes 5 times more likely for OSA drivers refusing treatment
Truck drivers diagnosed with obstructive sleep apnea (OSA) who refuse treatment have a fivefold increase in the risk of serious, preventable crashes, according to a new study led by University of Minnesota Morris and drawn from data supplied by Schneider and its OSA services provider, Precision Pulmonary Diagnostics (PPD).
Schneider helped with funding, and funding also was tied to a regional university transportation center of the U.S. Department of Transportation.
Conducted by faculty, staff and student researchers and supported by the Roadway Safety Institute (a DOT university center) at the University of Minnesota Twin Cities, "This is the largest study of sleep apnea and crash risk among commercial motor vehicle drivers to date," stated a university news release on the study titled "Non-adherence with Employer-Mandated Sleep Apnea Treatment and Increased Risk of Serious Crashes."
According to the release, the study compared more than 1,600 truck drivers diagnosed with OSA to an equal number of drivers screened as unlikely to have OSA. Drivers with the condition were given an auto-adjusting positive airway pressure (PAP) machine, and its use was electronically monitored. Treatment carried no out-of-pocket costs under the study firm's employee medical insurance plan, the release noted.
The rates of preventable serious truck crashes per 100,000 miles driven were compared across the study groups.
"To put our findings in context, if we look at 1,000 truck drivers each working for a year, the drivers with obstructive sleep apnea who refuse mandated treatment would have 70 preventable serious truck crashes, compared to 14 crashes experienced by both a control group and by drivers with sleep apnea who adhered to treatment," said Stephen Burks, lead author of the study, and professor of economics and management at Morris.
An early FMCSA sleep apnea crash risk technical report found no correlation between untreated sleep apnea and crash risk but some stakeholders have said truckers who took the test were hoping to get a free sleep study. The Federal Motor Carrier Safety Administration's recent Advanced Notice of Proposed Rulemaking on testing and treatment for sleep apnea is looking for specific data on crash risk related to OSA although in its ANPRM, FMCSA didn't explicitly say that. The agency asked: "Is there information available for estimating the future consequences resulting from individuals with OSA occupying safety sensitive transportation positions in the absence of new restrictions?" It also stated that it was seeking information from interested parties to decide on "whether to take regulatory action and ... how to craft the most effective regulations to address the potential safety risks associated with OSA."
And although the ANPRM is a fact-finding endeavor, it is only the first step in the rulemaking process which could take up to four years. A lot of the first stage depends on comments FMCSA receives.
Stakeholders have told The Trucker that although they fully support drivers with sleep apnea getting treatment, any final rule should not only be based on sound science and improve safety, but shouldn't be overly restrictive to carriers and drivers and be cost-effective. Some drivers have reported being told by medical examiners that their sleep test results showing negative for OSA wouldn't be accepted and they would have to be re-tested and others say the cost for in-lab sleep studies added to the time it takes them off the road are cost-prohibitive.
Jon Anderson, professor of statistics at Morris, said, "I expect our sleep apnea findings will be carefully considered in the rulemaking process on sleep apnea standards for truck drivers and train operators just launched on March 8 by the U.S. Department of Transportation."
Burks said, "The paper's results suggest putting obstructive sleep apnea screening standards in the medical exam commercial truck drivers take every two years. I am very pleased that Morris students have helped add to the scientific evidence that will be used in this important public policy-making process."
Study co-author Dr. Charles A. Czeisler, chief of the Division of Sleep and Circadian Disorders at Brigham and Women's Hospital, and Baldino Professor of Sleep Medicine at Harvard Medical School in Boston, said, "Given that the risk of heart disease, cancer, diabetes, dementia and premature death are similarly increased in people with untreated obstructive sleep apnea, regulatory agencies worldwide owe it to truck drivers and to the motorists who share the road with them to require objective screening, diagnostic testing, and treatment adherence monitoring for all commercial drivers."
Schneider "respectfully declined" to comment on the findings.
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