Flawed sleep apnoea test needs rethink: ATA

By: Brad Gardner


Australian Trucking Association says subjective sleep apnoea test is failing to diagnose excessive sleepiness.

Flawed sleep apnoea test needs rethink: ATA
The ATA says subjective measures should not be used to determine if a truck driver is suffering from sleep apnoea.

 

The existing procedure used to determine if a truck driver may be suffering from sleep apnoea needs to change, the Australian Trucking Association (ATA) says.

The group says the Epworth Sleepiness Scale (ESS) is "flawed" because it relies on drivers self-reporting their levels of sleepiness by answering a series of questions.

The ATA says the ESS is "highly subjective" as a result and is leading to under-reporting of excessive sleepiness because some drivers answering the questions may feel their level of tiredness is normal or will pass.

The ATA wants an amendment made to Assessing Fitness to Drive medical standards to recognise the limitations of the ESS.

"The ATA recommends that the medical standards for sleep apnoea be amended to include a warning that the treating doctor should not rely on subjective measures of sleepiness like the ESS to rule out a patient having sleep apnoea," the ATA says.

"Subjective measures should only be used to assist in making clinical decisions."

The recommendation is contained in the ATA’s submission to the National Transport Commission, which has proposed changes to AFTD standards.

The standards apply to commercial and private drivers.

"The ATA has long argued that the approach to sleep apnoea in AFTD is flawed," the group says.

"In its submission to the last review of AFTD, the ATA warned that the use of the ESS led to the under-reporting of excessive sleepiness because of its subjectivity."

The ATA has, however, backed proposed changes to the standards covering hearing loss and deafness, including clarifying that a driver should only be referred for audiometry if there is a clinical indication of hearing loss.

Doctors are currently only required to seek a hearing test for drivers if they think hearing loss has occurred, but the ATA says it is aware of drivers being routinely referred for audiometry.

"This adds to the cost of AFTD medical assessments. In the case of TruckSafe, NHVAS [National Heavy Vehicle Accreditation Scheme] and WAHVA [Western Australian Heavy Vehicle Accreditation] assessments, the additional coast is entirely paid by drivers or their employers," the ATA says.

"The NTC proposal to revise the wording of the hearing standard and include a flow chart would make the existing requirement clearer for doctors and reduce the number of drivers referred unnecessarily for audiometry."

The NTC has also proposed allowing a commercial driver to be assessed for a conditional licence if they are wearing hearing aids but do not pass the hearing loss threshold.

"The second amendment would clarify the process for enabling safe, experienced commercial drivers to continue driving, even if their hearing loss with hearing aids exceeded the threshold," the ATA says.

"There are cases where career truck drivers have been unable to continue working because of the AFTD hearing requirements. The proposed amendment would be a balanced approach to enabling drivers like these to continue working, if they are assessed as being able to drive safely."

AFTD standards are designed to ensure commercial and private drivers are healthy enough to drive without causing a risk to themselves or other road users.

The NTC announced a review of existing standards in 2014.

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