Identification and treatment of professional drivers at risk of road accidents from excessive daytime sleepiness. A population-based survey on drivers transporting dangerous goods

Excessive daytime sleepiness (EDS) in drivers accounts for approximately 22% of road accidents. Such accidents result in higher mortality than from other causes: 11.4% vs. 5.6%. Obstructive Sleep Apnea Syndrome (OSAS), a disease that most often involves EDS, has a significantly high prevalence (12%) among more than 40-year-old males. Moreover, it is a risk factor for cardioand cerebro-vascular diseases. Recent data confirm that in professional drivers the occurrence of OSAS is significantly higher (17%) than in the general population. Adequate treatment of this disease can drastically reduce the risk of road accidents among the population affected. The aim of the study was to obtain a diagnostic tool for OSAS screening, to be applied on a large scale for effective prevention in a typical homogenous population of dangerous goods drivers in North-western Italy. The outcome of the survey was: A) high and unexpected prevalence of OSAS, ~ 30% with RDI>10 (number of apnea+hypopnea/hour) reveals some pathological features and, more importantly, 8.5% with RDI>30 shows values that can be associated to a severe condition. B) analysis of the results of the questionnaire, the clinical examinations and the polysomnography (PSG) and elaborate a simple and effective diagnostic tool in order to identify these disorders, applicable on a large scal,e for the prevention of the above mentioned risk factors among professional drivers. Occupational physicians and or general practitioners might detect OSAS on the basis on the score obtained from the answers to a some items in the questionnaire and on easily measurable anthropomorphic parameters. Still keeping PSG as the "gold