Obstructive sleep apnea, health-related factors, and long distance heavy vehicle crashes in Western Australia: a case control study.

STUDY OBJECTIVES: To determine the association between obstructive sleep apnea (OSA), health-related factors and the likelihood of heavy vehicle crashes in Western Australia (WA). METHODS: This case-control study included 100 long-haul heavy vehicle drivers who were involved in a police-reported crash in WA during the study period (cases) and 100 long-haul heavy vehicle drivers recruited from WA truck stops, who were not involved in a crash during the past year (controls). Driver demographics, health, and fatigue-related characteristics were obtained using an interviewer administered questionnaire. Drivers were tested for OSA using a diagnostic Flow Wizard. Logistic regression was used to determine health-related factors associated with crash involvement among long distance heavy vehicle drivers. RESULTS: Heavy vehicle drivers diagnosed with OSA through the use of the FlowWizard were over three times more likely to be involved in a crash than drivers without OSA (adjusted OR: 3.42, 95% CI: 1.34-8.72). The risk of crash was significantly increased if heavy vehicle drivers reported a diagnosis of depression (adjusted OR: 6.59, 95% CI: 1.30-33.24) or had not completed fatigue management training (adjusted OR: 6.05, 95% CI: 1.80-20.24). Crash risk was 74% lower among older drivers (> 35 years) than younger drivers (adjusted OR: 0.25, 95% CI: 0.08-0.82). CONCLUSION: The results suggest that more rigorous screening and subsequent treatment of OSA and depression by clinicians as well as compulsory fatigue management training may reduce crashes among heavy vehicle drivers. COMMENTARY: A commentary on this article appears in this issue on page 409.