The question is: are these bad rules that have been rightfully put on hold, or is there a real risk that the public is being put at risk as a result of these changes.
When the Federal Motor Carrier Safety Administration (FMCSA) proposed rules for screening truck drivers for sleep apnea last year, truckers protested. Part of the problem was that the new rules were not being issued as “rules” per se, but as “guidance” for medical inspectors. This caused concern that the standards would be less clear than an actual rule. However, the main protest was that the policy, which would require screening of all truck drivers with a body mass index (BMI) of 35+ be screened for sleep apnea, would not undergo a cost-benefit analysis, nor would it be available for change based on industry input.
After objections by truckers, the FMCSA decided to put the guidance on hold and go through the standard rulemaking procedure, something that was made official when Congress passed a law enforcing the decision. Perhaps the biggest irony of this is that the industry had previously used a recommendation for sleep apnea screening to protest changes in rules about how long truck drivers could be on the road. And the industry’s own experience predicts that a sleep apnea screening program could save trucking companies significant money in reduced trucking accidents and healthcare costs.
Similar to the trucking industry’s protest was the response of pilots’ organizations to the FAA’s proposal that all pilots with a BMI of 40+ should be screened for sleep apnea. The president of the trade organization for aviation medical examiners sent a letter to the FAA saying, “no scientific body or evidence has demonstrated that undiagnosed obesity or OSA (obstructive sleep apnea) has compromised aviation safety.”
The FAA backed off after the House of Representatives introduced a bill similar to the one used to stop the FMCSA’s process.
Or Bad Influence?
It’s hard to know how to feel about these actions by special interest groups that are eager to rewrite the rules in their favor. It’s hard to know why they even feel the need to make such protests, particularly in the case of the trucking industry, where one company that introduced a sleep apnea screening program saw a 73% reduction in preventable accidents among treated drivers, and an overall crash reduction of 30%. The company saw a reduction in crash-related costs by 48% and healthcare savings of $539 per driver per month. It seems hard to believe that such savings could possibly be overwhelmed by any screening process, no matter how bureaucratic or onerous.
Without a detailed analysis, it’s hard to know whether these rules have rightly been put on hold. It is possible that some good will come from the reconsideration of the rules, such as the permission for truck drivers to use oral appliance therapy, which was missing from the previous rules.
If you would like to learn more about oral appliance therapy as an option for sleep apnea treatment, please contact the Advanced Dental Sleep Treatment Center in Omaha today.