Obstructive sleep apnea (OSA) is a disorder wherein throat muscles relax intermittently, blocking the airway and causing breathing cessation during sleep. OSA is classified by the Federal Motor Carrier Administration (FMCSA) as a respiratory disorder, and is addressed in 49 CFR 391.41(b)5 — the physical qualifications for drivers.1 Certified medical examiner (CME) sleep study referrals are currently based primarily on a CME’s discretion. In 2012, FMCSA’s Motor Carrier Safety Advisory Committee (MCSAC) and Medical Review Board (MRB) released guidelines for sleep apnea screening as part of U.S. Department of Transportation (USDOT) medical examinations. These guidelines were primarily based on expert panel recommendations presented to FMCSA in 2008. Subsequently, H.R. 3095, referred to as the “Sleep Apnea Bill,” was signed into law in 2013. It requires FMCSA to go through a formal rulemaking process prior to implementing sleep disorder regulations, in particular focusing on OSA. This formal rulemaking process will ensure that driver OSA regulation benefits exceed costs, that industry stakeholder input is considered, and that specific standards for drivers, motor carriers, and CMEs are created. In March 2016, FMCSA and the Federal Railroad Administration (FRA) jointly released an Advanced Notice of Proposed Rulemaking (ANPRM) to solicit public input on OSA costs, prevalence, and safety outcomes for workers in safety-sensitive occupations. At the time of publication of this report, the comment period on the ANPRM closes June 8, 2016. At its 2016 annual meeting, the American Transportation Research Institute’s (ATRI’s) Research Advisory Committee (RAC) ranked investigating potential impacts of the proposed commercial driver sleep apnea rulemaking among the top ten research priorities. As a first task in this research, ATRI surveyed commercial drivers on a number of OSA-related issues. ATRI developed two separate surveys focusing on OSA — one for commercial motor vehicle (CMV) drivers who have had a sleep study (also known as polysomnography) and another for CMV drivers who have not had a sleep study. The surveys were initially distributed at the 2016 Mid-America Trucking Show (MATS), held March 31 — April 2, 2016 in Louisville, Kentucky. Following MATS, both surveys were available online on ATRI’s website (www.atri-online.org) from April 14, 2016 until May 9, 2016. The surveys were advertised through industry trade press and through interviews on Sirius XM Radio. In total, 822 drivers completed one of the two OSA surveys. Both surveys sought information on age, gender, employment type, and motor carrier policies relating to OSA. Reported figures in this section are stratified by whether a driver has had a sleep study (“sleep study”) or if they have not had a sleep study (“no sleep study”). Driver Demographics First, respondents were asked about their age. Respondents who have had a sleep study are more likely to be over 50 (61%) than respondents who have not had a sleep study (49%). This reflects the increased risk of OSA in older individuals, which is a potential risk factor considered by CMEs or other medical professionals when referring drivers to sleep studies. (Author/publisher)
Samenvatting