title: Fatal Consequences: Obstructive Sleep Apnea in a Train Engineer.
abstract: This special report describes the findings of the National Transportation Safety Board's investigation into the probable cause of the derailment of a Metro-North passenger train in the Bronx, New York on December 1, 2013, that resulted in 4 deaths and injuries to 59 additional persons. A key finding in the medical investigation was the engineer's post-accident diagnosis of severe, obstructive sleep apnea, and the probable cause of the accident was determined to be the result of the engineer having fallen asleep while operating the train. This accident highlights the importance of screening, evaluating, and ensuring adequate treatment of obstructive sleep apnea, particularly among patients working in positions where impairment of physical or cognitive function or sudden incapacitation may result in serious harm to the public.
authors.affiliation: National Transportation Safetey Board, Washington, DC.
authors.forename: Mary Pat
authors.initials: MP
authors.lastname: McKay
mesh_terms: D000062:Accidents, Occupational / Q000401:mortality*; D003072:Cognition Disorders / Q000209:etiology; D057210:Delayed Diagnosis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D009518:New York; D011890:Railroads; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000503:physiopathology; D014940:Work Schedule Tolerance
keywords: accidents; diagnosis; railroads; sleep apnea syndromes