When All is Quiet on Capital Hill, Obama Slips in Sleep Apnea Billby Jana Ritter - Published: 10/16/2013
President Barack Obama Tuesday quietly signed into law legislation to ensure any federal standards governing screening, testing, or treatment of individuals operating commercial motor vehicles for sleep disorders would be through a rulemaking instead of guidance, which has previously been the case.
The legislation, highly applauded by trucking stakeholders was somewhat moot because the Federal Motor Carrier Safety Administration had already announced it was following the wishes of the trucking industry and would deal with the sleep disorders issue through the rulemaking process rather than regulatory guidance.
The American Trucking Associations and the Owner-Operator Independent Drivers Association quickly applauded Reps. Bucshon and Lipinski for introducing the bill.
The ATA said the legislation would “ensure that if the federal government sets standards for sleep apnea screening and testing of professional truck and bus drivers, those standards are established through an informed rulemaking process.”
OOIDA said that a rulemaking “would include requiring that a full cost-benefit and regulatory impact analysis be used should the FMCSA decide to set policy regarding screening, testing and treatment for sleep apnea as opposed to guidance, which is not subject to this critical analysis.”
Truckers and medical professionals have long complained that fuzziness in federal guidance on obstructive sleep apnea (OSA) testing and treatment has resulted in pendulum swings from one extreme to the other.
One extreme mentioned by drivers is that an examiner may see a trucker's stomach sticking out over his belt and immediately order sleep apnea testing. From an examiner's point of view, it's not worth staking one's medical career on, so better to be safe than sorry and test pretty much everyone. On the other hand, there are horror stories about truckers finding a practitioner who will turn a blind eye to excessive daytime sleepiness or other obvious signs of OSA.
Over a year ago, the Board of Directors of American Trucking Associations, meeting in Las Vegas, passed a new policy urging that any government decisions on sleep disorder screening for commercial drivers be made following a regular, science-based process.
“Fatigue and driver health are two serious issues facing the trucking industry,” ATA President and CEO Bill Graves said. “However, as important as it is to address those issues, it is equally important for the federal government to use the regulatory process – with its emphasis on science-based outcomes and cost-benefit analyses.”
The ATA policy approved in Las Vegas reads in part that any effort to address sleep disorders, like obstructive sleep apnea, should be done “through rulemaking and not through the publication of regulatory guidance;” and that those rules focus on “conditions that pose a substantially elevated crash risk based on sound data and analysis, be cost beneficial and promote effective treatments that minimize the impact to motor carriers.”
“This is not an insignificant step,” Graves said. “There are more than 3 million professional truck drivers and the cost of screening, diagnosis and treatment for sleep apnea could easily exceed $1 billion annually. Taking a step as potentially costly as that shouldn’t be undertaken lightly and outside of the normal processes.”