Borrelli I
Istituto di Medicina del Lavoro, Facoltà di Medicina e Chirurgia A. Gemelli, Università Cattolica del Sacro Cuore di Roma.
G Ital Med Lav Ergon. 2007 Jul-Sep;29(3 Suppl):621-2.
This study assess the need of development of a common protocol to detect occupational driver with high risk of driving accidents. Several studies have indicated that excessive sleepiness and daytime alertness cause an increased risk of driving accidents in occupational drivers. Excessive daytime sleepiness affects 4 to 12% of general population. The 37% of drivers reported that they have nodded off or fallen asleep at least once in their driving career. A substantial percentage of drivers suffer from sleep-disordered breathing, narcolepsy, sleep deprivation, poor sleep hygiene, changes in wakefulness-sleep circadian rhythm. Some important factors in determining driver sleepiness are duration of the drive, driving at night, more experience as driver, arduous schedules. There is a lack of awareness among the public and among physicians and authorities in general of the problem posed by sleepy drivers. There isn't a national surveillance system that identify sleep loss or sleepiness in relation to work. The first target of a screening program protocol should be to detect the presence of obstructive sleep apnea. Overnight polysomnography in a sleep laboratory is normal practice for diagnosing obstructive sleep apnea but it is expensive. The ambulatory approach can be used to expedite management of screening in occupational driver.
本研究评估了制定一项通用方案以检测具有高驾驶事故风险的职业驾驶员的必要性。多项研究表明，过度嗜睡和日间警觉性会增加职业驾驶员发生驾驶事故的风险。过度日间嗜睡影响4%至12%的普通人群。37%的驾驶员报告称，他们在驾驶生涯中至少有过一次打瞌睡或睡着的情况。相当一部分驾驶员患有睡眠呼吸紊乱、发作性睡病、睡眠剥夺、睡眠卫生差、觉醒-睡眠昼夜节律改变。决定驾驶员嗜睡的一些重要因素包括驾驶时长、夜间驾驶、驾驶经验更丰富、日程安排繁重。公众以及医生和当局总体上对嗜睡驾驶员所带来的问题缺乏认识。没有一个全国性的监测系统来识别与工作相关的睡眠不足或嗜睡情况。筛查项目方案的首要目标应该是检测阻塞性睡眠呼吸暂停的存在。在睡眠实验室进行夜间多导睡眠图检查是诊断阻塞性睡眠呼吸暂停的常规做法，但费用昂贵。动态监测方法可用于加快职业驾驶员的筛查管理。
