The U.S. Department of Transportation has published an Advance Notice of Proposed Rulemaking (ANPR) on the Evaluation of Safety Sensitive Personnel for Moderate-to-Severe Obstructive Sleep Apnea, 47 Fed. Reg. 12642 (March 10, 2016).
The ANPR is directed at individuals occupying "safety sensitive positions" in highway and rail transportation, and on its potential consequences for the safety of rail and highway transportation. The DOT's agencies, the Federal Motor Carrier Safety Administration (FMCSA) and the Federal Railroad Administration (FRA), through this rulemaking, are requesting data and information from employers and the public concerning the prevalence of moderate-to-severe obstructive sleep apnea (OSA) among those employees in those positions.
The DOT is defining obstructive sleep apnea as a "respiratory disorder characterized by a reduction or cessation of breathing during sleep. OSA is characterized by repeated episodes of upper airway collapse in the region of the upper throat (pharynx) that results in intermittent periods of partial airflow obstruction (hypopneas), complete airflow obstruction (apneas), and respiratory effort-related arousals from sleep (RERAs) in which affected individuals awaken partially and may experience gasping and choking as they struggle to breathe."
The ANPR states that risk factors for developing OSA include: obesity, male gender, advancing age, family history of OSA, large neck size, and an anatomically small oropharynx (throat). Additionally, OSA is associated with increased risk for other adverse health conditions such as: "hypertension (high blood pressure), diabetes, obesity, cardiac dysrhythmias (irregular heartbeat), myocardial infarction (heart attack), stroke, and sudden cardiac death.
Specifically, the agencies are requesting comment on the costs and benefits of requiring motor carrier and rail transportation workers in safety sensitive positions "who exhibit multiple risk factors for OSA to undergo evaluation and treatment by a healthcare professional with expertise in sleep disorders. For instance, the DOT points out that the Federal Aviation Administration:
Has always considered OSA a disqualifying condition, but has used its special issuance process to certificate airman if the hazard of OSA was satisfactorily treated or mitigated. In November 2013, FAA proposed guidance that would have required pilots with a body mass index (BMI) of 40 or more to be evaluated for OSA.
As this rulemaking presents perhaps considerable efforts and costs on impacted employers, review and comments on the ANPR may be worthwhile. Comments on the ANPR, under Docket numbers FMCSA–2015–0419 and FRA–2015–0111, are due by June 8, 2016.
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