Estimated cost of crashes in commercial drivers supports screening and treatment of obstructive sleep apnea
Open accessAbstract
Sleep apnea among commercial drivers may increase the risk of fall-asleep crashes, which incur large expenses. Drivers of passenger cars whose apnea is treated experience lower crash risk. Among community-based holders of commercial driver's licenses, we considered three methods for identifying sleep apnea syndrome: (1) in-lab polysomnography; (2) selective in-lab polysomnography for high-risk drivers, where high risk is first identified by body mass index, age and gender, followed by oximetry in a subset of drivers; (3) not screening. The costs for each of these three programs equaled the sum of the costs of testing, treatment of identified cases, and crashes. Assuming that treatment prevents apnea-related crashes, polysomnography is not cost-effective, because it was more expensive than the cost of crashes when no screening is done. Screening with BMI, age and gender, however, with confirmatory in-lab polysomnography only on high-risk drivers was cost-effective, as long as a high proportion (73.8%) of screened drivers accepts treatment. These findings indicate that strategies that reduce reliance on in-laboratory polysomnography may be more cost-effective than not screening, and that treatment acceptance may need to be a condition of employment for affected drivers.
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Workplace programs to increase screening and treatment of sleep apnea may have financial benefits for companies.
“Accordingly, workplace programs to increase screening and treatment of sleep apnea may have financial benefits for companies.184”
From Sleep, Health, and Society (2017) · cites this paper as [184]
Sleep apnea impairs commercial drivers' ability to drive safely.
“For example, sleep apnea occurs at high rates among commercial drivers184–186 and impairs their ability to drive safely.”
From Sleep, Health, and Society (2017) · cites this paper as [184]
Sleep apnea occurs at high rates among commercial drivers.
“For example, sleep apnea occurs at high rates among commercial drivers184–186 and impairs their ability to drive safely.”
From Sleep, Health, and Society (2017) · cites this paper as [184]
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- Authors
- Gurubhagavatula, I., Nkwuo, J. E., Maislin, G., & Pack, A. I.
- Affiliations
- Philadelphia VA Medical Center (US)
- University of Pennsylvania (US)
- Corresponding author
- Gurubhagavatula, Indira
- Venue
- Accident Analysis & Prevention
- Publisher
- Elsevier BV
- Published
- 2008-01
- Volume
- 40
- Issue
- 1
- Pages
- 104-115
- ISSN
- 0001-4575 (ISSN-L)
- PMC
- PMC3506009
- OpenAlex
- W2160888874
- Cited by
- 51
- References
- 49
- Citations by year
- 2026: 1 · 2025: 1 · 2023: 1 · 2022: 2 · 2021: 2 · 2020: 2 · 2019: 4 · 2018: 3 · 2017: 3 · 2016: 3 · 2015: 3 · 2014: 3 · 2013: 3 · 2012: 4
- FWCI
- 2.89
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Accident Analysis & Prevention (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- Federal Highway Administration
- National Heart, Lung, and Blood Institute (P50HL060287, P01-HL60287)
- National Center for Research Resources (K23-RR16068-03, 3-M01-RR00040-39S2, M01RR000040, K23RR016068)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Physical Sciences › Engineering › Safety, Risk, Reliability and Quality › Traffic and Road Safety
- Keywords
- obstructive sleep apnea, commercial drivers, accident costs, sleep apnea screening, polysomnography, cost-effectiveness, body mass index, oximetry, treatment acceptance
- MeSH terms
- Accidents, Occupational, Accidents, Traffic, Adult, Cost-Benefit Analysis, Female, Humans, Male, Middle Aged, Oximetry, Predictive Value of Tests, Risk Factors, Transportation, Odds Ratio, Polysomnography, Sleep Apnea, Obstructive, Continuous Positive Airway Pressure
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