Dear Charles,

Yes, we use both Epworth (sleepiness) and Berlin (sleep apnoea) for a national distribution team (including FLT, car (sales and travelling engineers) and LGV) routinely as part of their 1-5 yearly health assessments (separate to their statutory medicals). This is viewed as an 'essential' business risk reduction strategy not a 'nice to have wellness screening' aspect. 

We started about 2 years ago. In my opinion Epworth alone is not enough as it is an estimation, 'what are you chances of' whereas Berlin actually asks 'have you fallen asleep or nodded off at the wheel' you would be amazed the number of staff that admit yes (and not just at traffic lights too..... - eek!)

I also use them in other safety critical aspects - e.g. high risk confined space in aviation industry (fuel tanks in airplane wing entry  - very tight, warm cosy space with or without RPE) and system monitoring - the clue was when the engineer said he would doze off in a training session and sometime the flipchart would suddenly appear full of text....), working at heights. Plus for shift workers as a screening tool.

We decided that asking 'do you have sleep apnoea' was a bit reactive also, how do they know if you don't ask them the screening questions or they have never been tested? It was also an opportunity to challenge poor sleep hygiene habits and myths around sleep etc as well as a reminder of their responsibility in relation to the offence of dangerous driving - 'driving when unfit, including having an injury, being unable to see clearly, not taking prescribed drugs, or being sleepy' (CPS.gov.uk). I remember a training video clip I saw once - where the individual was driving a simulator after lunch wired up to an machine recording brain activity and brainwaves. Technically his brain was asleep nearly 1-2 mins before his head nodded and about 3 minutes before his eyes closed - the opening window, drinking caffeine, turning on the radio does not work.

Sleep apnoea can be a cause of a range of physical and mental health problems including high BP.

It was a major opportunity to be proactive for a change - part of our decision making was based on research from the States which detailed anonymous reporting of sleepiness and accidents, near misses in truckers. Plus the European PRAISE report from the ETSC - European Transport Safety Council.

I will get on my soapbox for a mo - when I did the research for the proposal business case to include all drivers in the screening programme (in addition to their statutory medicals) as well as cover sleep factors, I was amazed at how supposed fleet management company guidance do not really cover the health aspects in any depth. Just seems to get missed... they seem to think than a D4 medical once every 5-25 years is enough, remember if you don't set the clear expectation that they should tell you if their health changes (and give them a route to do so) and if you don't ask annually - 'has your health changed?' they may not tell you as they do not think it is important - OH advisors may think differently!! 

We ended up with one chap being referred to OHP and being restricted (obesity was a major factor plus a near-miss sleepiness episode). We referred probably around 10 people (drivers and engineers) to GP for further assessment and referral. Some have sleep apnoea others have nasal defects etc but still affects quality and length of sleep. 
We also picked up a number of staff who did not meet the newer D4 vision standards so they got sent off to their optician for checking. Some were younger chaps who were not due a medical till 45 i.e. could have been driving for another 10-20 years without a medical .....  
The high mileage (15-45,000 per year) car/van drivers had a range of health issues, particularly high BP which puts them at a higher risk of a cardiovascular health episode at the wheel - plus it is harder for them to access healthcare if they are all over the country.

I have a pile of resources saved on my pc so feel free to email me off-line for more info.

Hope that provides a bit of food for thought. As a safety practitioner as well as an OHA I think we need to be looking more strategically in relation to managing occupational road risk (MORR), being more proactive and raising the profile to ensure that the health aspects of MORR are not assumed to be purely 'statutory medical' based. 

Catherine Tye RN SCPHN(OH) PgDipOSH
Health, Safety and Wellbeing Practitioner
 
Harmony Health and Wellbeing Limited | mobile: 07730 985926 | email: [log in to unmask] 

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