a heavy commercial truck

Fatigue Study Well-Timed for Hours Rule Foes

Public Citizen, the Teamsters, Advocates for Highway and Auto Safety, and the Truck Safety Coalition went back to the U.S. Court of Appeals for the District of Columbia Circuit on Monday asking it to review the hours of service rule being enforced by the Federal Motor Carrier Safety Administration. The same four opponents of the rule have twice before sued and blocked the hours rule in the same court, and they may be aided by a new study out yesterday that recommends mandatory obstructive sleep apnea screenings for truckers who are confirmed to be obese.

"Truck drivers with sleep apnea are much more likely to fall asleep at the wheel, and the condition is increasingly common as Americans become more obese,” said Dr. Stefanos N. Kales, M.D., MHP, the study's senior author and medical director of Employee and Industrial Medicine at Cambridge Health Alliance, a Harvard Medical School teaching affiliate. "Additionally, we found that drivers who suffer from obstructive sleep apnea frequently underreport symptoms and diagnoses and often do not follow through with sleep study referrals and sleep apnea treatment," Kales added.

The 15-month study examined 456 commercial drivers from more than 50 employers. Seventy-eight (17 percent) of them met the screening criteria for suspect OSA. These drivers were older, more obese, and had a higher average blood pressure. Of the 53 drivers who were referred for sleep studies, 33 did not comply with the referral and were lost to follow-up, CHA said. The other 20 were confirmed to have OSA, but, after diagnosis, only one of these complied with treatment recommendations. "It is very likely that most of the drivers who did not comply with sleep studies or sleep apnea treatment sought medical certification from examiners who do not screen for sleep apnea and are driving with untreated or inadequately treated sleep apnea," Kales said.

The study, "Screening for Obstructive Sleep Apnea During Commercial Driver Medical Examinations," was published yesterday by the Journal of Occupational and Environmental Medicine. The authors noted FMCSA is considering recommendations to require sleep apnea screening for all obese drivers based on body mass index. The rule opponents sent a letter on March 9 to DOT Secretary Raymond LaHood, asking him to direct FMCSA to begin a new hours rulemaking.

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