National Transportation Safety Board Washington, D.C. 20594 Safety Recommendation

“The National Safety Board (NTSB) has investigated a number of
accidents and incidents in all modes of passenger transportation involving operators with sleep
disorders. These accidents include the following highway accidents in which the NTSB
identified commercial drivers with obstructive sleep apnea (OSA).
On July 26, 2000, the driver of a tractor-trailer travelling on  Interstate 40 near
Jackson, Tennessee, collided with a Tennessee  Highway Patrol vehicle trailing construction
vehicles, killing the state trooper inside.
The tractor-trailer then travelled across the median and
collided with a Chevrolet Blazer heading in the opposite direction, seriously injuring the driver
of the Blazer.  The tractor-trailer driver was 5 feet, 11 inches tall, weighed 358 pounds, and had
been diagnosed with and had undergone surgery for OSA, though he had not indicated either the
diagnosis or the surgery on examinations for medical certification.  The NTSB found that the
driver’s (unreported) OSA, his untreated hypothyroidism, or complications from either or both
conditions predisposed him to impairment or incapacitation, including falling asleep at the wheel
while driving.  The NTSB determined that the probable cause of the accident was the driver’s
incapacitation, owing to the failure of the medical certification process to detect and remove a
medically unfit driver from service.”

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