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The Fatigue Insider Blog

Should truck drivers be tested for sleep apnea?

Jan 15, 2020 ISS Comments (0)

 

The results of a 2018 survey found that half of commercial truck drivers suffer from breathing disorders that could make them more susceptible to falling asleep at the wheel. This startling insight, gained through a survey of over 900 Italian truck drivers, has prompted many to call for routine testing of breathing disorders, particularly obstructive sleep apnoea.
 
Luca Roberti, in response to this survey, made an appeal to European haulage companies in a presentation at the European Respiratory Society international congress, “considering that drivers are in charge of transport vehicles weighing several tons, companies have a great moral and civic responsibility to ensure their employees are safe to drive and are not at risk of suddenly falling asleep at the wheel.”
 
Similar statistics have been recorded in an Australian context, with a study in Sleep found that 41% of truck drivers suffer from OSA. Some of the contributing factors to this are the demography of Australian truck drivers, who are overwhelmingly male, overweight or obese, and 40+, all of which a risk factors for the development of OSA.
 
Research has shown that a driver who is deprived of sleep due to OSA may be up to 12 times more likely to be involved in a driving accident.
 
The good news is that routine screenings followed by appropriate treatment can be a highly effective way to address this issue. A 2016 study in the Journal of Sleep Medicine showed that truck drivers with OSA who receive treatment for two years may be able to reduce their crash-risk to that of truck drivers without OSA.
 
You can access the article “Assessing sleepiness and sleep disorders in Australian long-distance commercial vehicle drivers: self-report versus an “at home” monitoring device” in Sleep here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3296788/
 
You can access the article “Screening, diagnosis, and management of obstructive sleep apnea in dangerous-goods truck drivers: to be aware or not?” in the Journal of Sleep Medicine here: https://doi.org/10.1016/j.sleep.2016.05.015

 

 

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Developing a blood test for drowsy driving

Dec 04, 2019 ISS Comments (0)


Some experts have said that drowsy driving can be as dangerous as drunk driving, and as such we should devote as much attention to tired and fatigued drivers as we do to speeding and inebriated ones. Victoria’s Transport Accident Commission (TAC) says that fatigue is a contributing factor in 16-20% of the state’s road crashes. But until recently, without a tool like a breathalyser, it has been near impossible to identify fatigued drivers.
 
Now, because of breakthrough research led by Professor Derk-Jan Dijk, there may be a blood test that will tell us whether a driver is sleep deprived on the horizon. A unique study conducted at the University of Surrey’s Sleep Research Centre used machine learning to a blood-based generic risk profile using mRNA sequences to help identify persons who were acutely sleep deprived. A machine learning algorithm identified a subset of 68 genes and with 92% accuracy could detect whether a sample was from a sleep-deprived or well-rested individual. For the study, 36 participants had their blood sampled after 40 hours of sleep deprivation to evaluate changes in the expression of thousands of specific genes reflecting acute inflammation.
 
Developing a simple test for sleep deprivation that could be used to keep drowsy drivers off the road may be a while off, Professor Derk-Jan Dijk says "This is a test for acute total sleep loss; the next step is to identify biomarkers for chronic insufficient sleep, which we know to be associated with adverse health outcomes." At the moment, this breakthrough may have more immediate use within the field of clinical sleep medicine, as it may assist doctors in the diagnosis of sleep conditions.
 
Nevertheless, sleep deprivation is a huge public health problem, and any step towards understanding and combatting it is one in the right direction. Hopefully this ground-breaking research can be applied to the fatigue management of those in transport professions like pilots, train operators, truck drivers, and bus drivers, who place the public at risk when they have had insufficient sleep; and eventually, contribute to a solution for enforcing against drowsy drivers.
 
Check out the study here, in the journal of Sleep.

 

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London’s Buses commit to combatting fatigue

Nov 27, 2019 ISS Comments (0)

 

 
Transport for London (TFL) recently announced a range of measures to address fatigue among bus drivers, which has been reported as a factor in several incidents involving London’s buses.
 
In the five years from January 2014, almost 5,000 people were injured by crashes involving a TFL contracted bus and 49 were killed.
 
TFL said that it would make £500,000 in new funding available for London Bus operators to trial new technology and introduce innovative solutions that change the safety culture within bus garages and increase the focus on driver health and wellbeing.
 
This includes rigorous fatigue risk management systems for any company operating London buses and fatigue training for all managers. These systems are intended to assess the tiredness of drivers and provide processes for managing and reporting it when it occurs.
 
A TFL commissioned report on the subject of driver fatigue discovered that more than one-third of drivers had what they described as “a close call” when driving a bus because of their weariness.
 
This is absolutely a step in the right direction and will likely benefit drivers, operators, and the general public.

 

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Developments in trucking laws: Fatigue risk management

Oct 30, 2019 ISS Comments (0)


 

The National Heavy Vehicle Regulator (NVHR) is calling for more flexibility in fatigue rules in its submission to the Heavy Vehicle National Law (HVNL) review being conducted by the National Transport Commission.

The implementation of the submission would allow operators with demonstrably robust fatigue management systems more flexibility to manage fatigue risks. This could mean a change in framework and culture surrounding fatigue management, allowing it to expand from basic prescriptive work and rest hours.
 
Dr Adam Fletcher said, “Fatigue management is about much more than work hours and sleep. It also relates to workload, individual factors including health and sleep timing preferences, and the ability for drivers to be flexible when they feel it is safer...This development reflects a closer alignment with the point I have made publicly and with regulators for many years.”
 
NHVR CEO, Sal Petroccitto said, “the NHVR believes that prescriptive work and rest hours should still play a role in providing a minimum ‘safe harbour’ for drivers, but that a multi-tiered approach to fatigue risk management would allow flexibility for operators who take up additional, new or innovative safety practices.”
 
Current laws reduced fatigue-related crashes between 2003 and 2009, but "the rate of heavy vehicle crashes caused by driver fatigue" has been stable since then. An expansion in the scope of fatigue management to include factors like workload, health, and driver autonomy could bring the rate of fatigue-related crashes down further.

 

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Can Fatigue Monitoring Technology Boost Heavy Vehicle Safety?

Jul 31, 2019 ISS Comments (0)

Driver fatigue and distraction are still significant factors in heavy vehicle crashes. Recent industry data suggests that one in ten heavy vehicle crashes results from heavy vehicle driver fatigue.
 
Recognising that innovative solutions are necessary to combat this problem, The National Heavy Vehicle Regulator (NHVR) is undertaking a trial of fatigue safety-related technologies to gain a greater understanding of how they work and are used.
 
The preliminary review of Fatigue/Distraction Detection Technology, released this month, has shown that the technology has the potential to boost heavy vehicle safety, but should be used as part of a Fatigue Risk Management System and not in isolation. Technologies used included fitness for duty tests, continuous operator monitoring, performance-based monitoring, and vehicle-related technologies.

The summary of preliminary report is available here, and we look forward to their final conclusions in June 2020!

 

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Fatigue Risk Management in EMS

Oct 31, 2018 ISS Comments (0)

Fatigue continues to be a widespread problem for Emergency Medical Services (EMS) personnel. Both mental and physical fatigue can affect EMS personnel, due to the intensity of the job and working shifts, which we know disrupts normal patterns of sleep and circadian rhythms. Studies have found significantly higher levels of fatigue and mental health issues amongst paramedics, as well as significantly poorer sleep quality compared to other industries.

Near misses and accidents involving EMS personnel, where fatigue was a contributing factor, continue to occur. Earlier this year, an Emergency Medical Technician in the USA was killed when the technician driving the ambulance fell asleep at the wheel, colliding into another vehicle.

Evidence-based Guidelines for Fatigue Risk Management in EMS were recently published in the Prehospital Emergency Care journal recommend:

  • The use of fatigue surveys to measure and monitor fatigue in EMS personnel
  • Shifts to be shorter than 24 hours in duration
  • Access to caffeine as a fatigue countermeasure
  • The opportunity to nap while on duty in order to mitigate fatigue
  • Education and training on fatigue-related risks
 
The guidelines also remind us that fatigue management is a shared responsibility between EMS personnel and employers.

For more information on fatigue risk management in EMS, contact us via Facebook , LinkedIn , Twitter or comment below.


 
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