In a special investigation report issued yesterday, the National Transportation Safety Board (NTSB) made several recommendations to Metro-North regarding the need for better sleep disorder screening of its employees. The report examines safety management problems in several accidents, including the deadly train derailment in the Bronx, NY, on December 1, 2013. The engineer at the helm was later found to have sleep apnea, which was undiagnosed at the time of the accident.
The new NTSB recommendations to Metro-North pertaining to sleep disorders are as follows:
- Revise your medical protocols for employees in safety-sensitive positions to include specific protocols on sleep disorders, including obstructive sleep apnea.
- Develop and publicize to your safety-sensitive employees a list of medications, including over-the-counter and prescription medications, that may not be used by locomotive engineers or conductors in active service.
- Develop and implement protocols to routinely screen and fully evaluate your safety-sensitive employees for sleep disorders and ensure that such disorders are adequately addressed if diagnosed.
The report also included the following NTSB findings:
- Metro-North Railroad current medical protocols lacked appropriate guidance regarding sleep.
- Metro-North Railroad and the Long Island Railroad did not have adequate protocols to screen employees, especially those performing safety-sensitive functions, for sleep disorders despite implementation of a protocol at New York City Transit.
- Had the Metropolitan Transportation Authority implemented uniform screening protocols across all of its properties based on the success at New York City Transit, the Metro-North Railroad engineer’s sleep disorder could have been detected and controlled prior to the December 1, 2013, derailment in the Bronx.
- Without evaluating safety-sensitive employees for sleep disorders or other medical conditions, increased risk to employees, passengers, and the general public will remain, and the Federal Railroad Administration has not adequately addressed the issue.
- Had the Federal Railroad Administration implemented National Transportation Safety Board recommendations R-02-24 and R-12-16, or complied with the legislated time limit in the Rail Safety Improvement Act of 2008 to require fatigue management plans by railroads, Metro-North Railroad would have been required to appropriately screen, evaluate, and treat the engineer for obstructive sleep apnea prior to the December 1, 2013, derailment in the Bronx, and thus could have prevented the accident.
- In many instances, primary care providers do not adequately evaluate their patients for obstructive sleep apnea, as occurred in the case of the engineer in the December 1, 2013, derailment, and insufficient healthcare provider training on the topic is the most likely cause.
The NTSB also released recommendations to the Association of American Railroads, the American Public Transportation Association, the American Short Line and Regional Railroad Association, the Brotherhood of Locomotive Engineers, and the Sheet Metal, Air, Rail and Transportation Workers as follows: collaborate to develop a model national labor agreement that supports effective programs for addressing sleep disorders and other medical conditions among safety-sensitive train operating personnel.
The NTSB also issued the following recommendation to the American College of Physicians: enhance initial and ongoing training to ensure that Board-certified physicians in Internal Medicine can successfully identify the risk factors for, evaluate, and effectively treat obstructive sleep apnea among their patients.
The NTSB also issued the following recommendation to the American Academy of Family Physicians: enhance initial and ongoing training to ensure that Board-certified physicians in Family Medicine can successfully identify risk factors for, evaluate, and effectively treat obstructive sleep apnea among their patients.
The NTSB also issued the following recommendation to the Long Island Railroad: develop and publicize to your safety-sensitive employees a list of medications, including over-the-counter and prescription medications, that may not be used by locomotive engineers or conductors in active service.