Friday, April 20, 2018

OOIDA Foundation says FMCSA's own figures don't support need for new sleep apnea rule

Tuesday, January 31, 2017
by LYNDON FINNEY/The Trucker Staff

GRAIN VALLEY, Mo. — Pointing out that obstructive sleep apnea is a medical condition that’s been common for many years, the Federal Motor Carrier Safety Administration’s own statistics don’t support the “sudden” need for increased scrutiny in the form of a new federal regulation.

So says the Owner-Operator Independent Drivers Association Foundation in a white paper, “The Truth About Obstructive Sleep Apnea.”

The OOIDA Foundation was organized to fund and sponsor research concerning economic and safety issues affecting the motor carrier industry.

The white paper was issued some 10 months after FMCSA and the Federal Railroad Administration published an Advance Notice of Proposed Rulemaking and Request for Comment on data and information concerning the prevalence of moderate-to-severe

obstructive sleep apnea among individuals occupying safety-sensitive positions in highway and rail transportation, and on its potential consequences for the safety of rail and highway transportation.

OOIDA itself has expressed opposition to any such regulation, primarily because the association says OSA is not the crash risk factor some have portrayed it to be and because of its costs to independent contractors, many of whom have insurance that does not cover sleep apnea testing and treatment, or have no insurance at all.

In 2008, FMCSA’s Medical Review Board (MRB) “found that obstructive sleep apnea causes daytime sleepiness, making drivers more likely to have accidents.”

Then last year, the MRB recommended required sleep studies for drivers who either have BMIs of 40 or above, or have BMIs of 33 or above plus three additional risk factors.

“Both FMCSA and proponents of OSA screening fail to recognize that sleep apnea is not a new

disorder, but a condition that has affected millions of people over several decades and yet there has not been the carnage and devastation on our roadways that FMCSA would have us believe is inevitable without stricter mandatory OSA screening regulations,” the white paper said. “FMCSA’s own studies in particular have found that there is ‘no link’ between the severity of sleep apnea and traffic crashes. Moreover, while FMCSA and various organizations have attempted to correlate OSA with fatigue, it is critical to understand that OSA is not necessarily related to fatigue as there are many factors which can cause and influence fatigue. The concept or the definition of fatigue is frequently misunderstood and it should be noted that there is no current consensus about what fatigue is or how it should be measured.”

The foundation said data from the FMCSA’s Large Truck and Bus Crash Facts in 2013 and 2014 supported its claim.

The data showed that in 2011 only 1.8 percent of fatal crashes were attributed to impairment-related factors. In 2012, the figure was 1.7 percent, in 2013 it was 1.4 percent and in 2014 it was 1.8 percent.

“Irrespective of the facts, FMCSA, as well as others, continue to disseminate misperceptions and falsehoods concern sleep apnea and its safety impacts in the trucking industry,” the foundation said.

OOIDA also cited a 2004 crash risk study that said patients with sleep apnea had no greater probability of having a crash than patients without sleep apnea, either before or after their diagnoses.

The white paper also questioned the effectiveness of using CPAP machines to treat all sleep apnea patients, noting that some users of CPAP machines had reported a decrease in sleep.

The white paper said a sleep apnea rulemaking could cost the trucking industry billions of dollars.

It noted that a University of Minnesota study claiming that there are approximately 290,000 to 1.1 million truck drivers expected to have OSA in the United States.

“If a conservative 26 percent of all truck drivers had a body mass index of 33, along with three other factors … that required them to undergo a sleep study, it would cost the trucking industry between $624 million and $7.3 million just for testing,” the white paper said.

According the foundation, low-end estimates for a sleep study range from $624 to $7,300, and treatment from $116 to $1,500 on the low side and $440 to $5,500 on the high side.

“A proposal to screen drivers for OSA, especially when FMCSA’s own research and data demonstrate that there is no valid or reliable evidence which shows that sleep apnea is the cause for commercial motor vehicle crashes, is not an effective effort to improve highway safety,” the white paper concluded. “Instead it is an effort propelled by special-interest groups who already profit at the expense of drivers due to the currently flawed National Registry of Certified Medical Examiners program. A potential sleep apnea rulemaking would be the most expensive rule ever proposed by FMCSA, and yet without any demonstrable relationship with safety.”

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