Medical groups denounce transportation agencies’ withdrawal of sleep apnea rulemaking

Darien, IL – Three medical professional groups have expressed disapproval over the Federal Motor Carrier Safety Administration’s and the Federal Railroad Administration’s Aug. 4 decision to withdraw a proposed rule on obstructive sleep apnea.

The American Academy of Sleep Medicine, the American College of Occupational and Environmental Medicine, and the American Thoracic Society issued statements after the Aug. 4 withdrawal, asking the agencies to “take alternative steps to improve sleep apnea screening among individuals occupying safety-sensitive positions in highway and rail transportation.”

FMCSA and FRA released their joint advance notice of proposed rulemaking in March 2016 in response to truck and train incidents investigated by the National Transportation Safety Board in which OSA was a factor. The agencies sought to gather information and look at the costs and benefits of any regulations, such as requiring operators with multiple OSA risk factors to undergo evaluation/treatment by a sleep disorders expert.

A recent study from the University of California, San Francisco concluded that 41 percent of commercial motor vehicles drivers could have OSA, which occurs when the airway is blocked and normal breathing is interrupted. One of the results is increased drowsiness that can cause operators to become less alert and reactive.

A March 2016 study from the University of Minnesota, Morris determined that drivers who do not follow their prescribed treatment for OSA are five times more likely to be involved in a crash than drivers without OSA.

“By withdrawing this rule, under the guise of reducing regulatory burdens, our nation’s highways and rail systems are less safe and less reliable for us all,” Dr. David Gozal, former president of the American Thoracic Society and a sleep research expert, said in a statement released Aug. 10. “We strongly urge the administration to reconsider its decision and to move forward with the rulemaking process.”

Sleep apnea affects an estimated 22 million people in the United States, and 80 percent of moderate to severe OSA goes undiagnosed, according to the American Sleep Apnea Association.

“As [ACOEM] noted last year in our comments to the ANPRM, the literature clearly shows that drivers with untreated OSA are at an increased risk of motor vehicle crash, but as there is no agreement on how to best identify these at-risk workers, it is essential that a starting point be identified – we had hoped this rulemaking would fulfill that purpose,” American College of Occupational and Environmental Medicine President Dr. Charles Yarborough said in an Aug. 21 statement.

FRA’s Rail Safety Improvement Act of 2008 requires railroads to institute fatigue management programs. FMCSA stated that it plans to continue endorsing the voluntary North American Fatigue Management Program to CMV drivers and employers.