1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164 
Sleep apnoea is a disorder that has had fatal consequences on the road.
Page 28
Page 29
If you've noticed an error in this article please click here to report it so we can fix it.
Dvervveight, middle-aged drivers are particularly susceptible. Sally Nash
asks if employers should be required to check if any employees suffer.
Aecording to government research, driver sleepiness is thought to cause around one in 10 of all road collisions. And the bad news doesn't end there — 40% of all fatigue-related crashes involve someone who was at work at the time, according to Loughborough Sleep Centre, There are many reasons for feeling tired, whether it's from having a new baby or working excessive hours. For some, it might be a question of feeling tired for a few hours or a few days. However, anyone with the condition obstructive sleep apnoea (OSA) — which causes interruptions in breathing while asleep — will tend to feel tired continually.
Perhaps the most worrying fact of all is that many people who suffer from OSA do not know they have it. As many as one truck driver in six could be suffering from the condition, according to a Respironics study which was featured on BBC1's Real Story in2005. A typical sufferer is a middle-aged man who is overweight with a big neck and takes a size 17 collar or more. Approximately 4% of middle-aged men arc thought to suffer from the condition, al though not all are overweight.
OSA has hit the headlines recently following a number of fatal collisions involving truck drivers who were subsequently diagnosed with the condition. In August 2005, three people were killed on the A82 near Alexandria, Scotland by a truck driven by Colin Kane. In July 2006, Malcolm,Janice, Richard and George Dowling were killed on the A34 near Bicester, Oxfordshire by a truck driven by Ian King. In August 2006, Toby Tweddell was killed at the M62 Rocket Interchange on Merseyside by a truck driven by Colin Wrighton.
In every case the drivers of the trucks all of whom suffered unknowingly from sleep apnoea had fallen asleep at the wheel. Kane, King and Wrigh ton were each prosecuted for causing death by dangerous driving, but the outcomes of the three cases differed.
Evidence
On I October 2007, just before the case came to court, the Crown Prosecution Service decided to offer no evidence against Wrighton. who was acquitted. On 12 October 2007, a Scottish jury found the case against Kane unproven, guided by the judge who reportedly told the jury that if Kane had an attack of sleep apnoea but had no way of knowing he would suffer such an attack, he could not be held responsible.
ln contrast, on 7 December 2007 Ian King was convicted by the jury at Oxford Crown Court, and later sentenced to three years and ine months in prison.
Ian Rothera,transport lawyer at Nottingham law firm Rothera Dawson, says the situation of a driver falling asleep at the wheel is well enough covered by dangerous and careless driving legislation. Similar situations apply in respect of many other medical conditions (such as angina and diabetes) when the driver's knowledge of the condition and its possible effects on his or her driving may determine liability for a road traffic collision, adds Rothera.
As far as the driver's responsibilities are concerned, the holder of a vocational licence must notify the DVLA and cease driving. Before being permitted to resume driving, the medical specialists at the DVLA must be satisfied by suitable expert medical evidence that the licence holder's condition is being satisfactorily and effectively treated (see panel, above).
Employers' responsibilities include the usual health and safety at work issues, exercising the required duty of care, ensuring compliance with the drivers' hours rules, and setting realistic work schedules and sensible shift patterns "Drivers are understandably concerned about reporting sleep problems to their employers because of the risk to their job security. However, an employer should certainly be on the lookout for any warning signs and hopefully have a culture of encouraging confidential discussion and a system of monitoring, mentoring and appraisal," says Rothera.
Diagnosis
Nic Tweddell's son Toby, mentioned earlier, was killedinAugust 2006 when a truck ploughed into the back of his car in a morning rush-hour queue on the M62 motorway on the edge of Liverpool. Tweddellis now calling for the mandatory testing of drivers. "Since this court case, we have become aware of the prevalence of sleep apnoea, particularly among middle-aged men, and the fact that it is largely undiagnosed," he says. "The present system is dependent on drivers self-reporting sleepiness and/or medical practitioners spotting the problem on the basis of their judgement, knowing that by diagnosing sleep apnoea they would put their patient temporarily out of work."
Tweddell believes the industry should striving towards testing drivers for the condi tion,particularly those presenting the high-risl. indicators of being middle-aged and over weight. "If this was the case, the majority o sleep apnoea sufferers in road haulage an passenger transport would quickly be identi fled for treatment,"Tweddell says."That woulc remove a maj or accident hazard from our road: not to mention improve the quality or life for ; large number of sufferers. By far the most effec tive mechanism for bringing about this changi would be concerted action by employers" David Urpeth, a partner at law firm Irwin Mitchell who specialises in workplace injur accidents,supportsTweddell's argument.
He points out: "Employers are under a leg duty to provide a safe place of work whic includes assessing the risks faced by thos people who drive for a living. One of those risk is sleep apnoea. Employers must accept thkdriving carries potentially lethal risks and a such, that must be carefully and properl managed,he concludes •