Weeding out sleepy bus drivers

KUALA LUMPUR: Commercial vehicle drivers will soon have to undergo routine medical check-ups to monitor their health and ensure they are not suffering from sleep-related disorders.

Health Minister Datuk Seri Liow Tiong Lai said this would be part of the new guidelines in the manual, “Medical Examination Standards for Vocational Drivers Licensing”. “The guidelines have been prepared. We are now putting in place the screening centre before they can be introduced,” he told the New Straits Times.

Among the guidelines are that drivers who are diagnosed with obstructive sleep apnoea (OSA) should consult a sleep specialist and his case reviewed annually to ensure adequate treatment was maintained.

(OSA is a condition that causes interrupted breathing during sleep, according to the United Kingdom National Health Services.)

Drivers would not be qualified for licensing if:

moderate or severe OSA is established, until treatment is effective.

there is history suggestive of OSA indicated by severe daytime sleepiness and crashes caused by inattention or sleepiness, or an Epsworth sleepiness scale score of 16-24, until investigated and treated.

However, if the treatment has been satisfactory, a licence may be granted, upon the recommendation of a specialist.

The guidelines came in the wake of a joint survey conducted by the Malaysian Institute of Road Safety Research (Miros) and Universiti Kebangsaan Malaysia on 289 bus drivers, where 128 or 44.3 per cent of them were found to have sleep disorders.

The study revealed that of the figure, 28.7 per cent (83 drivers) had mild OSA, nine per cent (26) had moderate OSA and 6.6 per cent (19) severe OSA.

Sleep Disorder Society Malaysia president Dr Muhammad Muhsin Ahmad Zahari believed the number could be higher than 44.3 per cent if other sleep-related disorders, such as narcolepsy, were taken into account.

(Narcolepsy is a condition where the person falls asleep suddenly without warning.)

To address the issue, Dr Muhsin recommended that commercial vehicle drivers be subjected to sleep studies in addition to their medical examinations prior to obtaining licence approvals.

"Miros and UKM should also follow up on these bus drivers at the clinic for further management."

However, one of the study's researchers, Miros crash injury sciences and prevention unit head Dr Norlen Mohamad, said it was not possible to follow up on these drivers because of the ethical issues involved in research.

"The information of the participants cannot be disclosed, not even to the operators.

"Nevertheless, since the results of the study have been made known, drivers and operators can take note of the possible indicators of sleep apnoea and do something about it."

He said that obesity, frequent snoring, waking up often while sleeping, excessive daytime sleepiness, hypertension, diabetes mellitus, smoking and alcohol consumption and large neck circumferences were risk factors for sleep disorders.

However, he stressed that the nature of the job of bus drivers was not the cause of the disorder as sleep apnoea was intrinsic in nature and not caused by external factors.

"It is a condition where a person lacks quality of sleep.

"Those with sleep apnoea experience obstruction in their airways while sleeping a few times hourly, which causes them to wake up and promptly fall back to sleep.

"This results in fatigue and sleepiness in the daytime, hence the concern for safe driving."

He said irregular sleeping hours did not contribute to sleep apnoea but may lead to insufficient sleep.

"Bus drivers and operators should not rely on the authorities to monitor the industry.

"If a driver shows signs of sleep apnoea, he should get a check-up."

Dr Norlen suggested that bus operators introduce new pre-employment guidelines and screening procedures for recruiting drivers as well as monitor their employees' health.

Meanwhile, Land Public Transport Commission chairman Tan Sri Syed Hamid Albar said the agency would set up a database of drivers, detailing their traffic offences and medical condition.