The National Transportation Safety Board on Feb. 6 renewed its call for sleep apnea screenings and treatment after investigating two separate commuter railroad collisions in the New York City metro area, reports Safety and Health Magazine.

According to an agency press release, NTSB determined that fatigue from “undiagnosed severe obstructive sleep apnea” was a common cause in the crashes in Brooklyn, NY, on Jan. 4, 2017, and Hoboken, NJ, on Sept. 29, 2016. The collisions resulted in a combined 218 injuries and one death.

“The broader issues of reducing fatigue-related accidents and demanding medical fitness are both on NTSB’s ‘Most Wanted’ list of transportation safety improvements. Once more, these accidents remind us why,” Chairman Robert Sumwalt said. “The traveling public deserves alert operators. That is not too much to ask.”