It’s hard to manage what you can’t measure, or so goes an early lecture in Business 101. And measuring driver health and health-related safety performance is a tricky business indeed.
Coinciding with the Department of Transportation’s notice seeking public input on the impacts of sleep apnea on truck drivers, the National Academies of Sciences, Engineering, and Medicine on Thursday issued a new report that points to significant gaps in the current research.
Indeed, insufficient sleep can decrease a commercial vehicle driver’s level of alertness, which may increase the risk of a crash. Yet little is known about effective ways to minimize that risk, says the analysis, requested by the Federal Motor Carrier Safety Administration (FMCSA) in light of various driver health- and fatigue-related responsibilities and rulemakings. An FMCSA spokesman said the agency would not comment on the report at this time.
Approximately 4,000 fatalities due to truck and bus crashes occur each year, 10 percent to 20 percent of which are estimated to involve fatigued drivers, the study begins.
But current research on the connection among hours of service, fatigue, and accident frequency for truck operators is complicated by the difficulty of measuring driver fatigue objectively, the invasive nature of measuring the amount and quality of drivers’ sleep, and many factors contributing to crashes that are unrelated to lack of sleep.
But here’s the catch, according to the report: The stresses associated with work as a truck driver—including irregular schedules and economic pressures—place these drivers at substantial risk for insufficient sleep, and that in turn leads to the chronic health issues pervasive in the industry, including sleep apnea, hypertension, cardiovascular disease, adult-onset diabetes, and other conditions commonly associated with obesity.
And the most common remedy to drowsiness, drinking coffee and other caffeinated products, can provide only temporary relief from drowsiness. That’s a patch, not a repair—as are rumble strips and any of the tricks and technologies used to help a driver stay alert. Simply, there is no biological substitute for sufficient sleep: The only way to alleviate driver fatigue is to obtain an adequate quality and quantity of sleep, the study says.
The committee that conducted the study also found that substantial data gaps limit understanding of the factors that affect the health and wellness of truck drivers. Although considerable data are collected on drivers who work for large carriers, much less information is available on those who work for small carriers, especially independent owner-operators, the report notes.
The American Trucking Assns. continues to call for comprehensive research to support any regulatory initiative.
"ATA has long held that a singular focus on hours of service rules as a “silver bullet” countermeasure to address fatigue is ineffective," said Rob Abbott, vice president of safety policy, responding to the report. "It is appropriate for the National Academies to study the many factors that can impact such crashes, such as how drivers choose to spend off-duty time that should be used to rest. The focus, however, should not be on crashes where fatigue is merely present, but on those resulting from fatigue."
As a result of the analysis, the committee recommended several improvements in data and research methods by FMCSA to support a more comprehensive understanding of the relationships between truck driver fatigue and highway safety, and between fatigue and long-term health.
These include a call for a federally conducted, ongoing survey that will allow comparisons of truck drivers to track changes in their health status over time and the factors likely to be associated with those changes—and ideally to connect the collected data with relevant electronic health records.
To increase the availability of relevant data for researchers, FMCSA should also incentivize those who capture driver performance data—large fleets, independent trucking associations, and insurance companies. Such efforts should ensure that data confidentiality is maintained, through restricted access arrangements or use of statistical techniques for disclosure protection.
The committee also recommended statistical design and analysis methods to account for factors that confound comparisons between control and treatment groups in crash studies.
In terms of dealing directly with driver issues, the report recommends FMCSA should carry out a research program on fatigue management and training. The research program should include:
- evaluating the effectiveness of the North American Fatigue Management Program (NAFMP) for educating truck and bus drivers in how to modify their behavior to remedy various potential sources of fatigue;
- determining how effective the NAFMP training modules are in meeting the needs of drivers’ employers, including fleet managers, safety and risk managers, dispatchers, driver trainers and other corporate officials (e.g., those conducting carrier-sponsored employee health and wellness programs);
- evaluating any new education programs regarding sleep apnea that FMCSA has or plans to develop; and
- examining possibilities for the development and evaluation of incentive-based programs for improving health and fitness, including regular coaching, assessment, and support.
The report additionally looked into the use of various on-board technologies for detecting driver fatigue in near real time. But despite almost three decades of research on technological innovations—such as lane deviation and eyelid tracking systems, collision alerting and warning systems, and varying levels of automation—“operational strategies” for their use are still in the early phases of understanding and application, the committee concluded.