162 Obstructive sleep apnea screening for commercial motor vehicle drivers

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IntroductionIn the United States in 2015, there were 4 15 000 accidents involving large trucks resulting in 3589 fatalities. The majority of fatal crashes occurred between 12 pm and 3 pm and fatigue was the number one cause of fatal crashes that involved driver impairment-related factors. Obstructive Sleep Apnea (OSA) affects 3 to 7 percent of the male population and sleepiness in drivers is dangerous leading to decreased alertness, judgment and slower reaction times resulting in an increase of motor vehicle accidents (MVA). Screening for OSA in commercial motor vehicle drivers was inconsistent among the seven providers certified to provide Department of Transportation (DOT) physicals in four different offices of Rochester Regional Health.MethodsImplementation of the Joint Task Force (JTF) Guidelines developed by the American College of Occupational and Environmental Medicine, the American College of Chest Physicians and the National Sleep Foundation followed education sessions for certified examiners and resources for OSA referrals if necessary. The JTF guidelines consist of measureable biometric screenings including body mass index and measurement of neck circumference; use of the Epworth Sleepiness Scale; subject evaluation of sleep symptoms; and screening for hypertension to provide an evaluation measure to screen for OSA and three criteria for driver certification based on the outcome.ResultsOver an 8 week period, 102 drivers were screened using the JTF guidelines resulting in 100% compliance and appropriate referrals for OSA testing or documentation of continued positive airway pressure (CPAP) compliance in drivers with a history of OSA.DiscussionUsing a consistent screening tool to evaluate for OSA in drivers improves the practice of occupational medicine while ensuring personal and public safety by reducing the risk of motor vehicle accidents.

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