Moving the HME Industry Forward

Respiratory/Sleep

Heavy Sleep Presence at Medtrade Validated by Another Government Report

November 24, 2014

WASHINGTON, DC – Numerous sleep medicine exhibitors at last month’s Medtrade testified to the growing awareness of sleep disorders. Now the National Transportation Safety Board (NTSB) has put sleep apnea directly in the crosshairs by advocating the testing of rail engineers to check for sleep-disordered breathing.

The recommendation was one of many issued by the NTSB in a special investigation report spurred by five NY-based Metro North Railroad accidents between May 2013 and March 2014. Taken together, the accidents killed six people and injured 126.

The report examines several common safety management problems present in all the accidents. Last month the NTSB released accident briefs identifying the probable causes of these accidents.

 ”Metro-North and the Metropolitan Transportation Authority have much work yet to do,” said NTSB acting chairman Christopher A. Hart. “The FRA [Federal Railroad Administration] has much work to do as well. Railroad safety across the country depends on the FRA turning decisively to the task.”

NTSB investigations revealed that Metro-North safety programs that were in place were not effectively used to manage the safety of its operations and employees. Furthermore, Metro-North did not effectively investigate accidents and incidents to identify and fix safety deficiencies. In addition, known deficiencies were not corrected.

According to an analysis in Gannett News by Cara Matthews: The pointers repeat many suggestions the federal agency and Metro-North have been talking about and working on for much of the past year as the probes unfolded. The suggestions include testing engineers for sleep apnea — a rest-stealing disorder that played a role in the fatal Dec. 1, 2013 derailment in the Bronx — as well as procedures to better identify and report risks.”

The report examined not only the safety gaps at Metro-North and MTA, but also problems with FRA regulations, inspection, and oversight that allowed the safety gaps to exist. Had previous NTSB recommendations been implemented by the FRA, many of the safety issues encountered in these accidents could have been prevented, the report noted.

Examination of the FRA’s national inspection program revealed that its system for prioritizing enforcement efforts was ineffective and that current methodology may not be effective in identifying systemic safety issues. This resulted in a lower FRA presence at Metro-North while track conditions were deteriorating, which increased the risk of a catastrophic accident.

The NTSB issued recommendations to the FRA, Metro-North, and the MTA, as well as several other entities. The recommendations address Metro-North safety policy and safety programs, safety protocols, rules on screening for obstructive sleep apnea and other sleep disorders, and track inspection plans.

“The FRA responded to the criticism by saying it is working on a set of rules for railroads to mitigate problems with fatigue and to identify sleep disorders,” writes Matthews. “The incidence of sleep apnea is increasing, Hart said during the meeting Wednesday morning in Washington, D.C.”

An abstract of the NTSB special report is available at: http://www.ntsb.gov/doclib/reports/2014/DCA14SS005_Abstract_Metro_North_Railroad_Accidents.pdf