666 Challenges for the better screening of sleep apnea syndrome in a railway company in japan

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IntroductionSAS is known to cause drowsiness and lack of concentration at work and poses a serious job-fitness risk as a train driver. E company launched the initial screening program in 2003 using Epworth Sleepiness Scale (ESS) and induced pulse oximetry in 2007, and examin all train drivers every three years.MethodsAsed on ESS and pulse oximetry the detailed examination using sleeping polysomnography (PSG). Crews who need medical treatment such as continuous positive airway pressure (CPAP) were subject to work restrictions until the improvement was confirmed.ResultsAccording to the statistics for 9 years until October 2016, 5500 crews examined 151 crews were subject to work restrictions.After treatment, more than 90% of the cases have recovered their AHI to less than 30% of previous level, and all drivers successfully returned to their original jobs in about 2 weeks.DiscussionsArger proportion of SAS patients (2.7%) than average Japanese population (1.7%, Guidelines for Diagnosis and Treatment of Sleep Disordered Breathing in Cardiovascular Disease), company is still experiencing false negative cases improve the drivenvironment to prevent daytime drowsiness and educations for crew members.

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