Federal Register / Vol. 69, No. 190 / Friday, October 1, 2004 / Notices 58995

1Elshaug, A. Reid, K. and Damson, D. 1998, The 

circadian effects of irregular work schedules on 

sleep. In W.P. Colquhoun (ed.), Aspects of Human 

Efficiency (London: English Universities), 273–282.

2 2004, National Sleep Foundation Workshop on 

Shift Work Sleep Disorder, March 4–5, Washington, 

DC.

3Pilcher, J. and Coplen, M. 2000, Work/Rest 

Cycles in railroad operations: effects of shorter than 

24-hour shift work schedules and on-call schedules 

on sleep. Ergonomics, Vol. 43, No. 5, 573–588.

4Ohayton, M, Lermoine, P., Arnaud-Briant, V., 

and Dreyfus, M., 2002, Prevalence and 

consequences of sleep disorders in a shift worker 

population. Journal of Psychosomatic Research, 53, 

577–583.

Class or classes of air carriers which 

the public agency has requested not be 

required to collect PFCs: Operations by 

Air Taxi and Commercial Operators 

including: Air Lexington, Inc., Florida 

Jet Service, Inc., Buxmont Aviation 

Services, Inc., Piedmont Hawthorne 

Aviation, Inc. 

Any person may inspect the 

application in person at the FAA office 

listed above under FOR FURTHER

INFORMATION CONTACT and at the FAA 

Regional Airports office located at: 

Federal Aviation Administration, 

Eastern Region, 1 Aviation Plaza, 

Jamaica, New York 11434–4809. 

In addition, any person may, upon 

request, inspect the application, notice 

and other documents germane to the 

application in person at the Roanoke 

Regional Airport Commission.

Issued in Dulles, Virginia, on September 

23, 2004. 

Terry J. Page, 

Manager, Washington Airports District Office, 

Eastern Region.

[FR Doc. 04–22024 Filed 9–30–04; 8:45 am] 

BILLING CODE 4910–13–M

DEPARTMENT OF TRANSPORTATION

Federal Railroad Administration 

Notice of Safety Advisory 2004–04; 

Effect of Sleep Disorders on Safety of 

Railroad Operations

AGENCY: Federal Railroad 

Administration (FRA), DOT.

ACTION: Notice of Safety Advisory.

SUMMARY: FRA is issuing Safety 

Advisory 2004–04 to alert the railroad 

community, and especially those 

employees occupying safety-sensitive 

positions, to the danger associated with 

degradation of performance resulting 

from sleep disorders that are 

undiagnosed or not successfully treated. 

Alertness (vigilance) and unimpaired 

cognitive functions are important to the 

safety of railroad operations. Of 

particular concern to FRA are those 

employees who dispatch or operate 

trains or who inspect and maintain 

signal systems. Many of these 

employees work unpredictable 

schedules and long hours, making it 

difficult for them to achieve adequate 

rest even if otherwise healthy. This 

advisory contains suggested measures 

that railroads and employees should 

utilize to prevent work-related errors 

and on-the-job accidents as a result of 

sleep disorders.

FOR FURTHER INFORMATION CONTACT: A. 

Scott Kaye, Office of Safety, RRS–4, 

Mail Stop 25, Federal Railroad 

Administration, U.S. Department of 

Transportation, 1120 Vermont Avenue, 

NW., Washington, DC 20590. Telephone 

202–493–6303.

SUPPLEMENTARY INFORMATION: 

Factual Background 

On November 15, 2001, Canadian 

National Railway Company/Illinois 

Central Railroad Company (CN/IC) 

southbound Train 533 and northbound 

Train 243 collided near Clarkston, 

Michigan. Both crewmembers of Train 

243 were fatally injured, and both 

crewmembers of Train 533 sustained 

serious injuries. The track and 

equipment damaged in the accident was 

valued at approximately $1.4 million. 

The National Transportation Safety 

Board (NTSB) determined that the 

probable cause of the accident was 

crewmembers’ fatigue, which was 

primarily due to the engineer’s 

untreated, and the conductor’s 

insufficiently treated, obstructive sleep 

apnea. NTSB Report No. RAR/02/04. 

Sleep apnea is a sleep disorder 

characterized by cessations of breathing 

during sleep, and therefore partial 

awakenings during a sleep period. 

Sleep disorders represent a serious 

health problem in American society and 

a significant economic concern. 

Moreover, untreated sleep disorders can 

result in impaired work performance, 

including possible loss of alertness and 

situational awareness, which could in 

turn present an imminent threat to 

transportation safety. In general terms, 

sleep disorders range from fairly 

common disorders, such as insomnia 

(the inability to initiate or maintain 

sleep) to relatively rare sleep disorders 

such as narcolepsy (inappropriate and 

uncontrollable sleep episodes). Railroad 

employees who typically work on-call 

are especially vulnerable to sleep 

disorders such as circadian rhythm 

disorders,1 and shift work sleep 

disorder,2 a relatively recent addition to 

sleep disorders listed in the Diagnostic 

and Statistical Manual of Mental 

Disorders published in 1994 by the 

American Psychiatric Association 

(better known as the DSM IV), which 

cuts across all types of shift work jobs. 

Studies of on-call work schedules that 

lead to alterations in the timing or 

duration of sleep and the sleep-wake 

cycle have also been shown to lead to 

significant sleep and circadian rhythm 

disturbances in railroad workers.3

One of the more common sleep 

disorders is sleep apnea, affecting as 

many as 18 million Americans. 

Researchers estimate that the prevalence 

of sleep apnea in the general population 

is between 8–12%, depending on the 

measure used (mild, moderate or 

severe). Some researchers have also 

estimated the prevalence of severe sleep 

apnea in the general population 

between 3–5%, about 90% of whom are 

still undiagnosed, clearly demonstrating 

a significant problem. Obstructive sleep 

apnea, circadian rhythm disorders, and 

rotating shifts, have been found to be 

significant predictors of work-related 

accidents.4 Although severe sleep apnea 

is considered one of the more 

debilitating sleep disorders and is a 

significant risk factor for on-the-job 

accidents, it is also one of the most 

easily diagnosed and treated of all sleep 

disorders.

According to the National Sleep 

Foundation, untreated sleep disorder 

sufferers are three times more likely to 

have automobile accidents. The 

National Highway Traffic Safety 

Administration estimates that more than 

100,000 auto crashes annually may be 

fatigue-related. These incidents result in 

an estimated 1,500 deaths and tens of 

thousands of injuries and lasting 

disabilities. Sleep disorders also tend to 

be more prevalent in an aging 

population. The average age for a 

railroad operating employee is now 

approaching 50. 

While the impact of sleep disorders is 

unique to each individual and can be 

related to a variety of other factors and 

medical conditions such as obesity, 

depression, age and gender, evidence is 

clear that significant risks exist for those 

with undiagnosed and untreated sleep 

disorders. Some of these risks include 

excessive daytime sleepiness, greater 

risk of cardiovascular disease, memory 

loss, and increased risk of accidents to 

name a few. For these and other reasons, 

the NTSB has been concerned about the 

impact of sleep disorders and other 

medical conditions on railroad safety. 

Following its investigation into the 

collision near Clarkston, Michigan, the 

NTSB issued three recommendations to 

FRA:

58996 Federal Register / Vol. 69, No. 190 / Friday, October 1, 2004 / Notices 

5The hours of service law is an important defense 

against excessively long hours of work. However, it 

was enacted prior to completion of the major body 

of fatigue research. Although FRA may not vary the 

terms of the statute, FRA is empowered to authorize 

pilot projects directed at fatigue mitigation upon 

joint petition of the railroad and employees 

affected. FRA continues to encourage development 

of approaches to fatigue prevention and mitigation, 

especially with regard to providing predictable 

work schedules that do not induce fatigue and that 

offer ample opportunity for rest.

‘‘Develop a standard medical examination 

form that includes questions regarding sleep 

problems and requires that the form be used, 

pursuant to 49 CFR part 240, to determine 

the medical fitness of locomotive engineers; 

the form should also be available for use to 

determine the medical fitness of other 

employees in safety-sensitive positions.’’ (R–

02–24). 

‘‘Require that any medical condition that 

could incapacitate, or seriously impair the 

performance of, an employee in a safetysensitive position be reported to the railroad 

in a timely manner.’’ (R–02–25). 

‘‘Require that, when a railroad becomes 

aware that an employee in a safety-sensitive 

position has a potentially incapacitating or 

performance-impairing medical condition, 

the railroad prohibit that employee from 

performing any safety-sensitive duties until 

the railroad’s designated physician 

determines that the employee can continue to 

work safely in a safety-sensitive position.’’

(R–02–26).

FRA agrees with the safety concerns 

as expressed by the NTSB. This Safety 

Advisory, which has been developed 

after consultation with industry parties 

participating in the North American Rail 

Alertness Partnership, is an initial step 

in addressing the concerns identified by 

the NTSB. 

However, in evaluating the 

recommendations, FRA has noted the 

importance of addressing these needs 

within a proper framework of 

accountability, scientific credibility, 

professional discipline, and fairness. 

Further, FRA notes that conditions that 

could threaten employee fitness for duty 

are not limited to sleep disorders. 

Accordingly, in the fall of 2003, FRA 

awarded a contract for a comprehensive 

study to determine the need for, and 

options for implementing, medical 

standards for railroad employees in 

safety-critical occupations. Upon receipt 

of a final report from that study, FRA 

will evaluate the appropriate framework 

for addressing in greater detail the 

NTSB’s recommendations. 

While FRA has regulations that 

address the fitness of employees, the 

regulations are limited to hearing and 

vision requirements for locomotive 

engineers (49 CFR part 240) and the 

control of alcohol/drug use (49 CFR part 

219). FRA also enforces the hours of 

service law (49 U.S.C. 21101–21108), 

which specifies the maximum hours of 

duty and minimum periods of release 

for certain safety-critical employees.5

Need for Action Now 

The FRA and NTSB have investigated 

numerous human factor accidents that 

were the result of errors caused by loss 

of alertness or loss of situational 

awareness. While there are no existing 

data to justify the inference that 

undetected or untreated sleep disorders 

were a causal factor, several factors, 

including the Clarkston, Michigan 

collision, data extrapolated from other 

modes of transportation, and the 

prevalence of sleep disorders within the 

general population, clearly demonstrate 

that there is a threat to railroad 

operations from undiagnosed or 

incompletely treated sleep disorders. 

This threat exists, not only in train 

operations, train dispatching, and signal 

maintenance, but also in the operation 

of motor vehicles, on-track equipment, 

and other machinery. Approximately 

35% of all train accidents reported to 

FRA are attributed to human factors, of 

which fatigue, and more particularly, 

sleep disorders, play an undetermined 

role. Most employee casualties in train 

incidents and non-train incidents also 

involve a human factor component. 

Recommended Actions 

Therefore, FRA recommends that 

railroads and representatives of 

employees, working together, take the 

following actions to promote the fitness 

of employees in safety-sensitive 

positions: 

(1) Establish training and educational 

programs to inform employees of the 

potential for performance impairment as 

a result of fatigue, sleep loss, sleep 

deprivation, inadequate sleep quality, 

and working at odd hours, and 

document when employees have 

received the training. Incorporate 

elements that encourage selfassessment, peer-to-peer 

communication, and co-worker 

identification accompanied by policies 

consistent with these recommendations. 

(2) Ensure that employees’ medical 

examinations include assessment and 

screening for possible sleep disorders 

and other associated medical conditions 

(including use of appropriate checklists 

and records). Develop standardized 

screening tools, or a good practices 

guide, for the diagnosis, referral and 

treatment of sleep disorders (especially 

sleep apnea) and other related medical 

conditions to be used by company paid 

or recommended physicians during 

routine medical examinations; and 

provide an appropriate list of certified 

sleep disorder centers and related 

specialists for referral when necessary. 

(3) Develop and implement rules that 

request employees in safety-sensitive 

positions to voluntarily report any sleep 

disorder that could incapacitate, or 

seriously impair, their performance. 

(4) Develop and implement policies 

such that, when a railroad becomes 

aware that an employee in a safetysensitive position has an incapacitating 

or performance-impairing medical 

condition related to sleep, the railroad 

prohibits that employee from 

performing any safety-sensitive duties 

until that medical condition 

appropriately responds to treatment. 

(5) Implement policies, procedures, 

and any necessary agreements to—

(a) Promote self-reporting of sleeprelated medical conditions by protecting 

the medical confidentiality of that 

information and protecting the 

employment relationship, provided that 

the employee complies with the 

recommended course of treatment; 

(b) Encourage employees with 

diagnosed sleep disorders to participate 

in recommended evaluation and 

treatment; and 

(c) Establish dispute resolution 

mechanisms that rapidly resolve any 

issues regarding the current fitness of 

employees who have reported sleeprelated medical conditions and have 

cooperated in evaluation and prescribed 

treatment. 

FRA acknowledges that some of the 

above recommendations may have 

already been institutionalized in one 

form or another by various segments of 

the industry; in this case, FRA suggests 

a review of current policies and 

procedures for relevancy. 

FRA believes that the 

recommendations set forth above, if 

implemented by industry parties, could 

advance the successful management of 

sleep disorders. Taken together with the 

results of FRA’s broader study of 

potentially impairing medical 

conditions, lessons learned could 

provide a sound foundation for more 

formal action by industry, government, 

or both.

Issued in Washington, DC, on September 

21, 2004. 

Grady C. Cothen, Jr., 

Acting Associate Administrator for Safety.

[FR Doc. 04–22025 Filed 9–30–04; 8:45 am] 

BILLING CODE 4910–06–P