title: The role of sleepiness, sleep disorders, and the work environment on heavy-vehicle crashes in 2 Australian states.
abstract: Heavy-vehicle driving involves a challenging work environment and a high crash rate. We investigated the associations of sleepiness, sleep disorders, and work environment (including truck characteristics) with the risk of crashing between 2008 and 2011 in the Australian states of New South Wales and Western Australia. We conducted a case-control study of 530 heavy-vehicle drivers who had recently crashed and 517 heavy-vehicle drivers who had not. Drivers' crash histories, truck details, driving schedules, payment rates, sleep patterns, and measures of health were collected. Subjects wore a nasal flow monitor for 1 night to assess for obstructive sleep apnea. Driving schedules that included the period between midnight and 5:59 am were associated with increased likelihood of crashing (odds ratio = 3.42, 95% confidence interval: 2.04, 5.74), as were having an empty load (odds ratio = 2.61, 95% confidence interval: 1.72, 3.97) and being a less experienced driver (odds ratio = 3.25, 95% confidence interval: 2.37, 4.46). Not taking regular breaks and the lack of vehicle safety devices were also associated with increased crash risk. Despite the high prevalence of obstructive sleep apnea, it was not associated with the risk of a heavy-vehicle nonfatal, nonsevere crash. Scheduling of driving to avoid midnight-to-dawn driving and the use of more frequent rest breaks are likely to reduce the risk of heavy-vehicle nonfatal, nonsevere crashes by 2-3 times.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Stevenson
authors.forename: Jane
authors.initials: J
authors.lastname: Elkington
authors.forename: Lisa
authors.initials: L
authors.lastname: Sharwood
authors.forename: Lynn
authors.initials: L
authors.lastname: Meuleners
authors.forename: Rebecca
authors.initials: R
authors.lastname: Ivers
authors.forename: Soufiane
authors.initials: S
authors.lastname: Boufous
authors.forename: Ann
authors.initials: A
authors.lastname: Williamson
authors.forename: Narelle
authors.initials: N
authors.lastname: Haworth
authors.forename: Michael
authors.initials: M
authors.lastname: Quinlan
authors.forename: Ron
authors.initials: R
authors.lastname: Grunstein
authors.forename: Robyn
authors.initials: R
authors.lastname: Norton
authors.forename: Keith
authors.initials: K
authors.lastname: Wong
mesh_terms: D000063:Accidents, Traffic / Q000523:psychology / Q000706:statistics & numerical data*; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018986:Motor Vehicles / Q000706:statistics & numerical data*; D009517:New South Wales / Q000453:epidemiology; D010561:Personnel Staffing and Scheduling / Q000706:statistics & numerical data; D012307:Risk Factors; D012456:Salaries and Fringe Benefits / Q000706:statistics & numerical data; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D014851:Wakefulness; D014904:Western Australia / Q000453:epidemiology; D014940:Work Schedule Tolerance; D055815:Young Adult
keywords: heavy vehicles; road accidents; sleepiness