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NTSB asks FMCSA to identify drivers at risk for sleep apnea

WASHINGTON — The National Transportation Safety Board (NTSB) has recommended to the Federal Motor Carrier Safety Administration that the agency implement a program to identify commercial drivers who are at high risk of having obstructive sleep apnea or OSA and to withhold medical certification unless these workers can prove they’ve been diagnosed and treated effectively for the disorder.

Further, in a safety recommendation issued today the NTSB said it wants FMCSA to “develop and disseminate guidance for commercial drivers, employers and physicians” for identifying high-risk drivers.

Although NTSB’s recommendation specifically mentioned “commercial drivers,” the agency’s complete letter to FMCSA Assistant Administrator Rose A. McMurray about the safety recommendation mentioned only one incident of a tractor-trailer driver with diagnosed OSA. He had collided with a Tennessee Highway Patrol vehicle, killing the trooper. The trucker had had surgery for OSA but hadn’t reported his condition when examined for his medical certification.

Other NTSB investigations mentioned included two commercial airline pilots who fell asleep (one of whom was at risk for OSA) and missed their intended destination airport in Hilo, Hawaii, and a train engineer who had been diagnosed with OSA who went through a stop and struck another train.

In its letter to McMurray, the NTSB said the prevalence of OSA is more than 50 percent in patients with an average body mass index of 40.0. It also mentioned a 2006 consensus statement from the Joint Task Force of the American College of Chest Physicians, the American College of Occupational and Environmental Medicine and the National Sleep Foundation recommending that commercial drivers with a body mass index of 35 or higher and hypertension that can’t be controlled on less than two medications not be certified for longer than three months pending a formal OSA evaluation.

NTSB noted an FMCSA-commissioned study which found that 17.6 of commercial drivers studied had mild OSA; 5.8 percent had moderate OSA and 4.7 percent had a severe condition.

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