Railroad Worker Excessive Daytime Sleepiness Study Benjamin Gerson M.D. University Services Philadelphia, PA 19154 [email protected].

Railroad Worker Excessive Daytime Sleepiness Study

Benjamin Gerson M.D.University Services

Philadelphia, PA 19154

[email protected]

UNIVERSITY SERVICESWHO WE ARE

MULTI-SPECIALTY MEDICAL SERVICES

TOXICOLOGY

FORENSIC: EMPLOYEE DRUG TESTING

CLINICAL

SLEEP DISORDERS / NEUROPHYSIOLOGY

CLINICAL RESEARCH

CONSULTING & LITIGATION SUPPORT

Goal of Study

Assess the risk for excessive daytime sleepiness (EDS) and Sleep Apnea in selected workers in safety sensitive positions

Demonstrate that a study can be executed successfully

Method

Screen:

Employees in selected safety sensitive positions due for re-certification were offered the opportunity to complete a [Epworth] Sleepiness Scale

The survey was mailed, faxed, or completed on-line

Scores of 10 or higher classified as “at risk”

Confirm:

Some of the at risk were tested by ambulatory device

Participant Method of Response

Sleepiness Score Distribution

Risk Percentage of EDS

Percentage of Subjects By Age

Summary of Sleepiness Scores by Age

Age Group n Mean SS Score

Std. Dev.

18-30 39 8.79 4.3331-44 168 8.85 4.4045-55 163 9.24 4.64≥ 56 62 7.50 4.53

Percentage of Subjects By Gender

Percentage of Subjects by Race

Participants by Position

Participants by Position

Number at Risk By Job Position

Comparison

Follow-Up Survey

A letter with a follow-up questionnaire was mailed to all participants who screened at risk

Participant was asked to follow-up with physician and then complete the questions

17 [10%] returned the follow-up survey

Online Version of Follow-Up Survey

Responses from Follow-Up Survey

Screening Results

There is evidence that the true proportion of participating employees that are at risk (SS ≥10) is greater than 35%. We can say with 95% confidence that the true proportion is contained within the interval (35.4%, 44.8%).

There is no evidence of a direct linear relationship between SS and age. There also is not enough evidence to show that age group was related to SS scores.

It will be difficult to make any conclusions about gender or race due to the subjects being predominantly white males.

Confirmation

Employees who scored 10 or greater on the Sleepiness Scale were offered the opportunity to wear a device to identify the presence of Obstructive Sleep Apnea

The unit was shipped and worn for one night

The unit was then shipped back to US for data interpretation

Confirmation Results

20 tests completed

18 confirmed positive for OSA

All participants scoring 11 or higher on screening

tested positive for sleep apnea

Confirmation Data

AHI vs BMI

Sleepiness Score vs BMI