The Results are in. Absence of Sleep Apnea Screening Caused 2 Deadly Train Crashes in New York

Federal investigators have recently blamed Obstructive Sleep Apnea (OSA) for two deadly train crashes that happened in the New York City metropolitan area. After the crashes in both the Hoboken Terminal of the New Jersey Transit and the Brooklyn Terminal on the Long Island Rail Road, the investigators found that both drivers suffered from OSA. However, neither were diagnosed or properly screened for it after their employment.

While both railroads now have been testing their drivers for sleep apnea after the crashes, it still isn't a requirement across the nation. In a recent hearing in Washington, DC, Robert L. Sumwalt, chairman of the National Transportation Safety Board, was shocked that the federal government withdrew from a proposed rule for screening train crews for sleep apnea. According to the New York Times, Sumwalt stated, "The public deserves alert operators. That's not too much to ask."

This was after yet another train crash in South Carolina with Amtrak, which killed an engineer and a conductor. This crash had a few similarities with the crashes in Hoboken and Brooklyn, however, the cause is not yet determined and is still being investigated.

Both of the crashes in 2016 and 2017 involved the trains running off the track, and both of the train crashes in 2016 and 2017 involved driver fatigue. While screening for sleep apnea and other sleep disorders is not a difficult task and inexpensive, there are still a number of railroads that do not screen their workers routinely and the Federal Railroad Administration (FRA) does not require them to do so.

During the Obama Administration, a proposal was in place to require testing for train conductors and other locomotive operators to be screened for sleeping disorders. However, in August 2017, this proposal was reversed by the Trump Administration, in an attempt to alleviate federal restrictions on workers.

Now, as federal investigators have reached their conclusion, they are questioning whether or not the reversal of this proposal was the right move for the administration to take.

What the two crashes involved

On an average work day, at the peak hours of rush hour, a New Jersey Transit train had full cars with passengers ready to go into work in September 2016. But, once the train went into Hoboken station, it failed to stop, went over a post at the track and only stopped once it hit a wall at the end of the terminal.

The result? One hundred and ten people were injured and one woman died on the platform because of a piece of fallen debris.

A similar accident happened in January 2017. During rush hour peak times, the Long Island Rail Road train pulled into the Atlantic Terminal Station in Brooklyn. Instead of coming to a complete and total stop, the train crashed into a room beyond the track. While no one was killed, over 108 people were injured.

Both damages from the crashes were estimated to cost millions of dollars.

Another similarity between both crashes is that both conductors had obstructive sleep apnea, and both were not diagnosed. The sleep disorder is characterized by the patients pausing in their breathing while asleep because of an obstruction in their airway. This sleep disorder can unfortunately affect anyone, at any age, with any gender. But, the symptoms are often brushed aside as not serious, or they aren't noticed by the patient at all because they are asleep.

With obstructive sleep apnea, the patient is getting a fragmented night of sleep where, according to NTSB member Dr. Nicholas Webster, would lead to a decrease in oxygen levels and an increase in carbon dioxide levels while the patient is asleep. Webster further explains, "When the buildup of carbon dioxide gets too high, the brain detects it and the person arouses or awakes to breath."

Because the patient is waking up repeatedly throughout the night, the patient will undoubtedly experience daytime fatigue. This makes sleep apnea a huge risk for those running a train, or other locomotive vehicles, which not only puts them at risk, but those around them as well.

One of the train engineers, Thomas Gallagher (involved with the crash in Hoboken), reportedly had routine physical examinations, but he only was tested for sleep apnea completely in 2013. And, in this screening, he was found to be at risk for developing the sleep disorder in the future. Since 2013, Gallagher's sleep apnea screenings were either incomplete or unable to be found.

In regards to the Long Island Rail Road, according to CNN, "sleep apnea screenings were planned, but not implemented [...] and as a result the engineer had not been screened."

Now, both the New Jersey Transit and the Mass Transit Authority (MTA), who also runs the Long Island Rail Road, require sleep apnea screening for their locomotive operators. A spokeswoman of the New Jersey Transit stated to CNN in an email, "We particpated in and cooperated fully with the NTSB's investigation and are pleased that the NTSB acknowledged our aggressive sleep apnea screening protocol." Their protocol also involves that if a "safety-sensitive employee," such as a train engineer, conductor or brake operators, tests positive for a sleep disorder, then they would be restricted from duty until they get approved from medical personnel.

The MTA, including the Long Island Rail Road, now requires their train operators and bus operators to be screened properly for sleep apnea, and any other sleep disorder. According to a statement received by CNN, "As of November 30, 2017, 9,729 employees have been screened, 2,079 employees have been referred for sleep studies and 1,185 have been diagnosed with sleep apnea and are now in the company's treatment compliance monitoring programs."

We can probably all agree that this is a step in the right direction, and we can also see that maybe sleep apnea is finally being taken seriously. However, more still needs to be done.

As of right now, no railroad organization is required federally to test their operating crews for sleep apnea in the United States. According to the Economist, "America has by far the largest rail network in the world, with more than twice as much track as China."

Safety should be a priority for both the passengers and the operating crews on board. Without these regulations, safety is at risk. Both the National Transportation Safety Board and the Trump Administration need to take action before more people are injured as a result of an undiagnosed sleep disorder, such as sleep apnea.