The Role of Sleepiness, Sleep Disorders, and the Work Environment on Heavy-Vehicle Crashes in 2 Australian States

Abstract

Heavy-vehicle driving involves a challenging work environment and a high crash rate. We investigated the associations of sleepiness, sleep disorders, and work environment (including truck characteristics) with the risk of crashing between 2008 and 2011 in the Australian states of New South Wales and Western Australia. We conducted a case-control study of 530 heavy-vehicle drivers who had recently crashed and 517 heavy-vehicle drivers who had not. Drivers' crash histories, truck details, driving schedules, payment rates, sleep patterns, and measures of health were collected. Subjects wore a nasal flow monitor for 1 night to assess for obstructive sleep apnea. Driving schedules that included the period between midnight and 5:59 am were associated with increased likelihood of crashing (odds ratio = 3.42, 95% confidence interval: 2.04, 5.74), as were having an empty load (odds ratio = 2.61, 95% confidence interval: 1.72, 3.97) and being a less experienced driver (odds ratio = 3.25, 95% confidence interval: 2.37, 4.46). Not taking regular breaks and the lack of vehicle safety devices were also associated with increased crash risk. Despite the high prevalence of obstructive sleep apnea, it was not associated with the risk of a heavy-vehicle nonfatal, nonsevere crash. Scheduling of driving to avoid midnight-to-dawn driving and the use of more frequent rest breaks are likely to reduce the risk of heavy-vehicle nonfatal, nonsevere crashes by 2-3 times.

Obstructive Sleep Apnea, Health-Related Factors, and Long Distance Heavy Vehicle Crashes in Western Australia: A Case Control Study

“…Interestingly however, the pooled analysis of data from the NSW and WA portions of the current study found that OSA was not associated with the risk of a crash. 11 While reasons for this difference require further investigation, it is possible that OSA has a greater impact on crash risk for WA drivers due to the vast distances they travel, isolation, monotonous scenery, and harsh climate of WA-all factors which exacerbate the effects of fatigue.…”

“…[8][9][10][11] However, WA has a unique road environment with vast distances between locations, extreme temperatures and weather conditions, and monotonous scenery. 12 WA is also governed by different fatigue regulations from the rest of Australia and faces specifi c challenges for heavy vehicle safety.…”

Level of fatigue and daytime sleepiness among heavy vehicle drivers in Sri Lanka

“…Being a less experience driver increase the likelihood of crashing. 31 The mean workday length of this sample of drivers was 9.37 hours (SD=2.25). This was lower than the average workday length of 11.89 hours (SD=1.683) reported in a study among 600 New Zealand truck drivers.…”

Obstructive sleep apnea and driving risk: The current Turkish legislation, controversies, and future perspectives

“…A Turkish study by Firat and colleagues [32] suggesting that portable sleep monitoring is reliable in detecting OSA with AHI>15/h in highway bus drivers is important in this context. Given the controversies regarding the relationship between OSA severity and MVA risk in clinical cohorts versus the lack of an association between AHI and MVA risk in commercial drivers [30,33], there is also a need for development of screening tools for objective evaluation of EDS in such individuals. The Oxford Sleep Resistance (OSLER) Test [34] as well as a recently developed neurocognitive test, Gothenburg Sleep Resistant (GOSLING) Test seem to be less time-consuming and reliable tools to detect attention deficits in OSA patients with high MVA risk [35].…”