Meuleners Lynn, Fraser Michelle L, Govorko Matthew H, Stevenson Mark R
Curtin-Monash Accident Research Centre (C-MARC), Curtin University, Perth, Australia.
Monash University Accident Research Centre (MUARC), Monash Injury Research Institute, Monash University, Melbourne, Australia.
J Clin Sleep Med. 2015 Apr 15;11(4):413-8. doi: 10.5664/jcsm.4594.
To determine the association between obstructive sleep apnea (OSA), health-related factors and the likelihood of heavy vehicle crashes in Western Australia (WA).
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.
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).
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.
A commentary on this article appears in this issue on page 409.
确定阻塞性睡眠呼吸暂停（OSA）、健康相关因素与西澳大利亚州（WA）重型车辆碰撞可能性之间的关联。
这项病例对照研究纳入了100名在研究期间参与西澳大利亚州警方报告的碰撞事故的长途重型车辆司机（病例组），以及从西澳大利亚州卡车停靠站招募的100名在过去一年中未发生碰撞事故的长途重型车辆司机（对照组）。通过访员管理的问卷获取司机的人口统计学、健康和疲劳相关特征。使用诊断性流量向导对司机进行OSA检测。采用逻辑回归确定与长途重型车辆司机碰撞事故相关的健康相关因素。
通过流量向导诊断为OSA的重型车辆司机发生碰撞事故的可能性是未患OSA司机的三倍多（调整后的比值比：3.42，95%置信区间：1.34 - 8.72）。如果重型车辆司机报告被诊断为抑郁症（调整后的比值比：6.59，95%置信区间：1.30 - 33.24）或未完成疲劳管理培训（调整后的比值比：6.05，95%置信区间：1.80 - 20.24），碰撞风险会显著增加。年龄较大的司机（> 35岁）的碰撞风险比年轻司机低74%（调整后的比值比：0.25，95%置信区间：0.08 - 0.82）。
结果表明，临床医生对OSA和抑郁症进行更严格的筛查及后续治疗，以及强制性的疲劳管理培训，可能会减少重型车辆司机的碰撞事故。
关于本文的一篇评论发表在本期第409页。
