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11 Research Directions for Studying the Impact of Fatigue on Commercial Motor Vehicle Drivers' Health and Wellness
Pages 203-216

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From page 203...
... to drivers' health over the longer term." The need to study the relationship between fatigue and various health problems is supported in Chapter 8, where Czeisler (2015) is quoted: "Persons experiencing sleep insufficiency are more likely to have chronic diseases such as cardio­ ascular disease, diabetes, depression, or obesity." Chapter 8 v summarizes what is currently known about the relationship between commercial motor vehicle (CMV)
From page 204...
... A FRAMEWORK FOR ASSESSING FACTORS RELATED TO DRIVER HEALTH AND WELLNESS Chapter 10 stresses the importance of collecting information on a wide variety of factors with a potentially important, causal role in crashes involving commercial motor vehicles, as well as on the various outcomes of interest, such as crash rate. Such information gathering is relevant here as well, to help understand the extent to which various fatigue-related risks and other causal factors impact driver health and wellness.
From page 205...
... • Frequency of conversion to type II • Medications used diabetes • Frequency of acute and/or chronic • Frequency of cardiovascular disease fatigue (average hours driving per week, average hours on the job per week, average hours of sleep per night) • Medicine and drug use • Medical conditions • Years driving (cumulative exposure to vibration, diesel exhaust, etc.)
From page 206...
... If this problem became widespread, it might be necessary to conduct a medical examination for a subset of the respondents as a means of calibrating the responses. One important objective would be to identify career drivers who do and do not develop various health conditions to determine what factors may have contributed to either a negative change in a driver's health status or maintenance of the status quo.
From page 207...
... relied on a repeated cross-sectional data set to quantify the prevalence and trends over time of multiple medical conditions in CMV drivers. The data set was drawn from the Road Ready database of CMV driver medical examinations for 2005 to 2012.
From page 208...
... Department of Transportation should fund, design, and conduct an ongoing survey that will allow longitudinal comparisons of commercial motor vehicle drivers to enable tracking of changes in their health status, and the factors likely to be associated with those changes, over time. In addition, it would be highly desirable for the survey data thus collected to include sufficient information to enable linking of the data to relevant electronic health records, with a particular focus on condi tions that may threaten drivers' health and safety.
From page 209...
... The Medical Examiner Handbook contains some, although minimal, guidance on evaluation of drivers with OSA. As discussed in Chapter 8, the FMCSA Medical Review Board and a Medical Expert Panel on Obstructive Sleep Apnea and Commercial Motor Vehicle Driver Safety presented recommendations to the agency concerning screening, diagnosis, treatment, and monitoring of CMV drivers for OSA in 2008 and 2012.
From page 210...
... influences crash risk; (2) whether OSA influences crash severity for commercial motor vehicles (fatal, injury, property damage only)
From page 211...
... above a specified value, enlarged neck circumference, or obstructed posterior throat, or certain medical conditions such as hypertension. As noted above, however, while there are various potential screening criteria for OSA, FMCSA has not indicated which of these should be used in certifying medical exams, and as a result, medical examiners do not apply consistent criteria with respect to OSA.
From page 212...
... and commercial motor vehicle drivers throughout all the research stages, from the drafting of requests for proposals through analysis of data. The supported research should be focused on a better understanding of the incidence of OSA in commercial motor vehicle drivers; its impact on driver fatigue, safety, and health; and the benefits of treatments.
From page 213...
... . Research is scant on the link between drug use and impairment among CMV drivers as both ethical and practical difficulties are entailed in learning about drug impairment from actual motor vehicle accidents.3 3  Presentationby Ronald Farkas, FDA, at National Transportation Safety Board (NTSB)
From page 214...
... This program -- a trainthe-trainer program entitled Mastering Alertness and Managing Driver Fatigue -- covered such topics as the importance of obtaining adequate rest and sleep, body and sleep physiology, circadian rhythm effects, shiftlag influences from rotating work schedules, sleep disorders, the influences of chemical substances, a list of drowsy driver warning signals, and a set of fatigue countermeasures (Krueger et al., 2007)
From page 215...
... Additionally, FMCSA needs to find a way of identifying when NAFMP training modules are downloaded from the website for corporate use, and determining whether these training materials were subsequently used in group training, say, at a carrier's own training classroom equipped to reach larger numbers of drivers. Analyses of individual interactions with the NAFMP website are limited because one cannot determine whether a visitor has changed his or her behavior after completing various course modules and whether those who have made such recommended lifestyle changes have actually improved their health.
From page 216...
... 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 man­ agers, 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 • xamining possibilities for the development and evaluation e of incentive-based programs for improving health and fitness, including regular coaching, assessment, and support.


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