Sleep Apnea Screening for Metro-North Crew

Sleep Apnea

One year after a deadly accident, sleep apnea screening has been recommended for the drivers and engineers who make up Metro-North’s crew. Federal regulators have determined the cause of the derailment in the Bronx on Dec. 1, 2013, as being due to the driver, William Rockefeller Jr., falling asleep at the controls.

Rockefeller was subsequently diagnosed as having obstructive sleep apnea. This ailment was further aggravated due to a change of shifts for him, which resulted in a disturbance to his normal sleep patterns.

Rockefeller was manning the controls of the Poughkeepsie-to-Manhattan morning commuter train. It is suspected that he fell asleep as it was rounding a curve. The recommended speed at the curve is 30 mph, but Rockefeller was doing 82 mph when the train hurtled off the tracks. Four passengers were killed and over 70 suffered injuries.

Metro-North regularly conducts medical evaluations of engineers. Obstructive sleep apnea, a disorder that can cause permanent fatigue, has not been a part of that examination.

This necessity has tragically been brought home to the Metropolitan Transportation Authority, parent of Metro-North. On Monday, December 15, 2014, a New York railroad commuters committee recommended that obstructive sleep apnea screening should be applied to all 410 Metro-North crew – drivers and engineers as well as 20 others in training.

The proposal will be presented to the full MTA board for a vote on Wednesday, Dec. 17. The scheduled start date is January 2015.

The plan calls for a pilot program to be conducted over a seven-month period by Persante Health Care Inc., a Mount Laurel, New Jersey-based firm, which specializes in this disorder. This program is estimated to cost the Metropolitan Transportation Authority up to $200,000.

MTA’s own health personnel will first test all crew members. Engineers and trainees will have to complete a survey and undergo a physical examination at Metro-North’s medical facilities. Those who display symptoms of obstructive sleep apnea, based on test results, will be referred to Persante Health Care Inc.

They will undergo further tests, training, treatment and at-home sleep monitoring via special devices. These will then be mailed back to Persante, and engineers will undergo more testing and treatment if necessary. They will be referred to sleep disorder specialists for more focused therapy if called for.

Since a sleep study at a medical facility is prohibitively expensive, at-home tests have become increasingly favored by patients and insurance companies. Aetna, the health insurance giant, estimates a one-third reduction in costs for at-home testing as compared to laboratory examinations. At-home apnea tests involve fewer sensors and no attending staff.

Sleep Apnea

As a new precautionary measure, officials further announced that if found to be successful and necessary, this pilot program may be expanded to cover engineers of the New York City Transit (subway system) and the Long Island Railroad.

Metro-North president Joseph Giuletti stated that this decision was a big step undertaken by the organization in their endeavors to follow the best in safety practices. The pilot study would be an important advance in securing the safety of their commuters, as well as improving the heath of their employees.

Sleep apnea screening for the Metro-North crew is hoped to reduce the possibility of accidents. There have been precedents in the transportation industry where undetected sleep apnea disorder has caused near-disasters. Earlier this year, the NTSB recommended that sleep apnea screening be applied to MTA crew members and railroad engineers, to eliminate the risk of being overcome while at the controls.

By Bina Joseph

Sources:

New York Post

Hartford Courant

USA Today

Photo by Jon-Lewis – Flickr License

Photo by JBLM PAO – Flickr License

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