Appleton Institute, Central Queensland University, Adelaide, South Australia, Australia.
Appleton Institute, Central Queensland University, Adelaide, South Australia, Australia.
Accid Anal Prev. 2021 Mar;151:105955. doi: 10.1016/j.aap.2020.105955. Epub 2020 Dec 28.
In developed countries, deaths attributable to driving or working while intoxicated have steadily declined over recent decades. In part, this has been due to (a) public education programs about the risks and (b) the deterrence value associated with penalties and prosecutions based on an individual being 'deemed impaired' if they exceed a proscribed level of blood alcohol or drug concentration while driving/working. In contrast, the relative proportion of fatigue-related accidents have remained stubbornly high despite significant public and workplace education. As such, it may be useful to introduce the legal principle of 'deemed impaired' with respect to fatigue and/or sleep loss. A comprehensive review of the impairment and accident literature was performed, including 44 relevant publications. Findings from this review suggests that a driver or worker might reasonably be 'deemed impaired' once the amount of sleep falls below five hours in the prior 24. Building on the legal principles first outlined in recent New Jersey legislation (Maggie's Law), this review argues that an individual can reasonably be 'deemed impaired' based on prior sleep wake behaviour. In Maggie's Law, a driver can be indirectly 'deemed impaired' if they have not slept in the prior 24 h. Based on the extant literature, we argue that, relative to drug and alcohol intoxication, this may be overly conservative. While roadside measurement of fatigue and prior sleep-wake behavior is not yet possible, we suggest that public education programs should provide specific guidance on the amount of sleep required and that post-accident forensic examination of prior sleep wake behaviours may help the community to determine unsafe behaviours and liability more objectively than is currently the case.
在发达国家，近年来因驾驶或工作时醉酒导致的死亡人数稳步下降。这在一定程度上是由于以下两个方面的原因：（a）关于风险的公众教育计划，以及（b）基于个人在驾驶/工作时血液酒精或药物浓度超过规定水平即被视为“受损”而进行的处罚和起诉的威慑价值。相比之下，尽管已经进行了大量的公众和工作场所教育，但与疲劳相关的事故的相对比例仍然居高不下。因此，引入关于疲劳和/或睡眠不足的“视为受损”的法律原则可能是有用的。对关于损伤和事故的文献进行了全面审查，包括 44 篇相关出版物。这一综述的结果表明，一旦在过去 24 小时内的睡眠时间少于五小时，驾驶员或工人就可能被合理地视为“受损”。基于最近新泽西州立法（Maggie's Law）中概述的法律原则，本综述认为，根据个人先前的睡眠-觉醒行为，可以合理地将其视为“受损”。在 Maggie's Law 中，如果驾驶员在过去 24 小时内未睡觉，则可以间接被“视为受损”。基于现有文献，我们认为，与药物和酒精中毒相比，这可能过于保守。虽然目前还无法对疲劳和先前的睡眠-觉醒行为进行路边测量，但我们建议公众教育计划应提供有关所需睡眠时间的具体指导，并且对先前睡眠-觉醒行为的事后法医检查可能有助于社区更客观地确定不安全行为和责任，而不是目前的情况。
