FMCSA Publishes Trucking Sleep Apnea Rules for Public Comment
The problems posed by obstructive sleep apnea in relation to commercial driving and commercial transportation has long been known. The problem affects millions of Americans but presents the largest problems for individuals in safety-sensitive occupations such as driving a commercial truck. Under 49 U.S.C.31136(a) and 31502(b)—delegated to Federal Motor Carrier Safety Administration (FMCSA) by 49 CFR 1.87(f) and (i), the agency has the authority to set forth minimum medical and physical standards for the operation of a commercial motor vehicle (CMV).
In a long-awaited announcement, FMCSA has revealed and published proposed rules regarding the safety problems presented by sleep apnea. These rules have been expected since, perhaps, sometime after 2005 when Congress authorized the establishment of a Medical Review Board. But perhaps more recently since the MRB and MCASC were tasked with finding solutions to the problem in 20011. Working alongside the Federal Railroad Administration (FRA), FMCSA is seeking public comment on rules designed to address the problems presented by this conditions.
What is Obstructive Sleep Apnea?
Obstructive Sleep Apnea (OSA)is a type of respiratory disorder that affects millions of Americans. The condition occurs during sleep and is expressed by a repeated collapse of the upper airways in the pharynx causing partial airflow obstruction and complete airway obstruction. These obstructions can cause the person to partially or fully awake from their sleep. Many people with OSA are often unaware of their interrupted sleep and thus, the condition remains undiagnosed in some individuals for long durations or indefinitely. However, many report a general feeling of malaise or tiredness that they struggle to get rid of regardless of how long they may sleep.
How Does it Affect Commercial Drivers and What Accidents have been Attributed to the Condition?
The condition of OSA often results in a less refreshing and productive sleep. Sleep is a biological necessity. In the short-run OAS can result in a feeling of tiredness, malaise, fatigue, or exhaustion. In the long-run OAS can lead to unintended episodes of sleep due to severe exhaustion. In other words, people affected by the condition can fall asleep without meaning to or realizing it. Other effects of the condition can include cognitive deficits. OAS can lead to reduced concentration, attention, situational awareness, and memory. In short, the condition reduces a commercial driver’s ability to function at his or her job including the ability to respond to hazards and dangers.
The report recounts a number of train accidents attributed to OAS perhaps due to the often spectacularly catastrophic nature of train collisions and derailments. However, the report also discusses a work zone collision attributed to OAS in Jackson, Tennessee. The accident occurred in July of 2000 on I-40. A tractor trailer traveling on the highway collided with a Tennessee Highway Patrol car that was escorting several construction vehicles. The collision with the police vehicle sent the tractor-trailer across the median where it collided with an oncoming SUV. The police officer in the patrol vehicle was killed and the SUV driver was seriously injured. The driver of the tractor-trailer was diagnosed with OAS and undergone surgery for the condition but failed to disclose his conditions when seeking medical certification.
How Would FMCSA Rules Address the Problem of Moderate to Severe Sleep Apnea in Truckers?
FMCSA previously issued advisory criteria in 2000. However, outside of situations where the medical examiner has experience with the condition and the condition is disclosed by the operator, the criteria has produced only limited success. Thus, FMCSA is proposing additional standards and guiding factors to assist medical examiners to identify and address the condition.
A starting point for the shape the regulations could take begin with the 2011 MCSAC and MRB letter that identified a body mass index (BMI) of 35 or greater as requiring a sleep study to determine whether the CMV operator has OAS. A BMI of 35 was selected because 80 percent of individuals at that level have OAS.
However, the rules are still being developed and FMCSA is seeking public input regarding the prevalence and extent of the problem presented by OAS in relation to commercial driving. Furthermore, the agency is seeking comment regarding the cost-benefit analysis of imposing new rules, regulations and restrictions to detect OAS. The agency is also seeking guidance on effective diagnostic and screening procedures that could be implemented in addition to AASM FAA standards. Questions include how frequently transportation workers should be screened for OAS and the safety performance history of workers with the condition. Furthermore, the agency is seeking comment on effective treatments and criteria to evaluate the effectiveness of treatments to address the condition.
Interested parties are encouraged to contact FMCSA regarding the proposed regulations. OAS is a medical condition that significantly affects the health and safety of not only commercial motor vehicle drivers in safety sensitive positions but also the safety of all motorist who share the roadways with these commercial drivers.
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