Screening, diagnosis, and management of obstructive sleep apnea in dangerous-goods truck drivers: to be aware or not?
The aims of this study were: to evaluate a homogeneous sample of truck drivers of dangerous goods (TDDGs) in order to assess the prevalence of obstructive sleep apnea (OSA), and to verify the secondary risk of motor vehicle accidents (MVAs) and near miss accidents (NMAs) in this population.



A sample of 283 male TDDGs was evaluated. None of the subjects reported OSA symptoms before screening. Clinical and physical evaluation, Epworth Sleepiness Scale (ESS), and the items on OSA from the Sleep Disorder Score (SDS) questionnaire were used to select subjects with suspicion of OSA. Polysomnography (PSG) was performed to confirm the diagnosis of OSA. The frequency of MVAs and NMAs was assessed at baseline for the whole sample, and also for the drivers with severe OSA after two years of continuous positive airway pressure (CPAP) treatment.



The mean age of the sample was 42.3 ± 8.3 years. A total of 139 (49.1%) subjects had suspected OSA, and the PSG study confirmed the diagnosis in 35.7%. A significant association between OSA severity and NMAs was observed, and subjects with severe OSA showed a near five-fold increased risk of NMAs (OR = 4.745, 95% CI 1.292-17.424, p = 0.019). After two years of CPAP treatment, the rate of NMAs was comparable with drivers without OSA, showing the efficacy of therapy.



This study showed an unexpected high prevalence of OSA in TDDGs. Untreated subjects with severe OSA had a significantly increased risk of NMAs. In professional drivers, screening, treatment, and management of OSA are mandatory for reducing road accident risk and improving road safety.
Sleep Disorder Centre, Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy; State Police Health Service Department, Ministry of the Interior, Rome, Italy.
Sergio
S
Garbarino
Sleep Disorder Centre, Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy.
Ottavia
O
Guglielmi
Department of Robotics, Brain and Cognitive Science, Italian Institute of Technology (IIT), Genoa, Italy.
Claudio
C
Campus
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Barbara
B
Mascialino
Refining and Marketing Division, ENI S.P.A., Milan, Italy.
Domenico
D
Pizzorni
Centre of Epilepsy Surgery, 'C. Munari', Niguarda Hospital, Milan, Italy.
Lino
L
Nobili
Sleep Disorder Centre, Department of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy.
Gian Luigi
GL
Mancardi
Department of Clinical Neuroscience, Sleep Disorders Center, Università Vita-Salute San Raffaele, Milan, Italy. Electronic address: ferinistrambi.luigi@hsr.it.
Luigi
L
Ferini-Strambi
D000063:Accidents, Traffic / Q000517:prevention & control* / Q000706:statistics & numerical data; D000328:Adult; D001334:Automobile Driving / Q000592:standards* / Q000706:statistics & numerical data; D001364:Awareness; D045422:Continuous Positive Airway Pressure / Q000379:methods; D006970:Disorders of Excessive Somnolence / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D018986:Motor Vehicles; D017286:Polysomnography; D015995:Prevalence; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D011795:Surveys and Questionnaires
Continuous positive airway pressure; Excessive daytime sleepiness; Obstructive sleep apnea; Truck driver health