You are currently browsing the tag archive for the ‘road traffic accidents’ tag.
In Wales on Sunday Dr Keir Lewis, a consultant at Prince Phillip Hospital, Llanelli, and head of the sleep service for Hywel Da Health Board, said the number of people suffering from conditions such as obstructive sleep apnoea (OSA) has risen dramatically in the past 10 years – putting severe strain on the NHS. He also correctly highlights the fatal risk to drivers of this condition, and gives some shocking examples.
Dr Lewis said one of the major problems faced and posed by OSA suffers was their fitness to drive. “We know from US-Canadian insurance claims and driving simulators that untreated people with OSA are five to seven times more likely to suffer a road crash. It’s one of the few conditions that kills people other than the sufferer. I’ve had someone coming in with severe symptoms of OSA but didn’t realise it until the police were called when someone spotted him driving straight across a roundabout. When we monitored his sleeping he was actually stopping breathing 140 times in an hour.”
“I also had a man fall asleep while he was operating a crane and it was only when he fell out and landed in water did he wake up and realised how severe his problem was. And we have treated other people who have fallen asleep behind the joystick of a plane and someone who fell asleep pouring molten metal. It was when he was on the burns unit, that the staff noted him stopping breathing.”
Employing the emergency services to a fatal road accident on a motorway costs taxpayers about £250,000 – the amount Dr Lewis said is enough to run an OSA service for a year – and the risk of accidents is increasing as the population gets more obese. Dr Lewis said: “We think about 80% of people who suffer from OSA are still undiagnosed and even the 10% to 20% who get diagnosed take about eight to 10 years from onset of symptoms to eventual treatment. Because it is a gradual condition people don’t necessarily realise why they are feeling like they do and blame age.”
The BBC reported last week that the NHS is struggling with a “tidal wave” of sleep disorders related to obesity, according to specialists. They report that the number of people being referred for sleep problems in Scotland has risen 25% over the past three years, with about 80% of patients being overweight. Figures for the rest of the UK are not available but doctors at sleep clinics in Scotland say their experience is probably mirrored elsewhere. The DVLA estimates 20% of serious incidents on major roads are caused by sleepy drivers.
Dr Tom Mackay, an expert in sleep disorders, at the Royal Infirmary of Edinburgh says he is facing a “tidal wave” of cases. There are now more new cases of sleep apnoea being diagnosed than lung cancer and emphysema combined. Dr Mackay said: “Over the past five to 10 years we have noticed quite a rise in the number of people being referred to us. That rise seems to be accelerating. We are now seeing 2,500 new patients each year. We are reaching capacity in terms of what we can cope with, and there is an undoubted link with people’s weight. For a man, if you’ve got a collar size of more than about 17.5in (44cm) then that is a marker for too much flesh around your neck. That roughly equates to a waist size of about 36in.”
Dr Mackay urged anyone who thinks they may be suffering from sleep apnoea to get properly diagnosed. The DVLA does not usually remove the driving licence of patients who are undergoing treatment.
Meanwhile the British Lung Foundation is so concerned about the steep rise in cases that it has made sleep disorders a priority for action.
The BBC has made this video report on one patient’s success in beating sleep apnoea through losing weight.
I am pleased to announce I have been awarded the Middle East Hospital magazine award for excellence in respiratory care, and making an outstanding contribution to healthcare in the Middle East. The Snoring Disorders Centre took a stand at the Arab Health exhibition in Dubai this year to raise awareness of the negative impact that OSA is having in the UAE and wider Middle East, and I met with healthcare professionals interested in treating this issue in the Arab region. I also be attended Saudi Medicare in Riyadh in April to spread the message further around the region.
Levels of obesity, hypertension and heart disease are rocketing in the wealthy Middle East, mainly due to the life-style out there. People are working long hours, eating rich calorie-laden food, driving everywhere and not exercising enough. I believe that the success I have had in Lincolnshire can be replicated in the Middle East by raising awareness of the condition, and forming long-term partnerships with local hospitals, doctors, and government departments.
With the low level of awareness of sleep apnoea in the Middle East it’s no surprise that road accident rates out in Dubai and the UAE are dreadful. In fact road traffic accidents are the second major cause of deaths in the UAE. There are 3500 fatalities per year from RTAs in Saudi Arabia alone, and OSA could well be a factor in many of them.
The NHS Institute for Innovation and Improvement is publishing a profile of the Snoring Disorders Centre, outlining the service and the impact it has had both for individual patients and Lincolnshire as a whole. This will be put up on the NHS Innovations website and circulated throughout the NHS as an example of best practice in service innovation. Here is an extract on the benefits the service has had in road accident reduction:
“Occupational road related deaths and accidents in Lincolnshire average about 79 per year. 20% of car accidents are shown to be sleep related although it’s uncertain how many are due to obstructive sleep apnoea. The cost of each fatal accident is around £1.64 million, so every accident prevented is of significant benefit to society and to the NHS. Many of our patients admit to feeling drowsy at the wheel.
“By December 2010, the number of fatal road traffic accidents had fallen from 79 to 45. This represents a saving of over £55 million to the economy, including the NHS. A contributory factor may be that the service has treated over 1,200 patients with sleep apnoea and these people are now able to drive more safely, rather than being in fear of falling asleep at the wheel.
“One patient who drives 50,000 miles a year for work said using the CPAP machine to treat his sleep apnoea has turned his life around: ‘For four or five years I struggled to sleep and I used to need two naps every day just to get through the day. My GP referred me to Mr Oko when I said I had trouble sleeping. Within weeks he got me on a CPAP machine which I use every night and I’ve never looked back. It’s made a huge difference to my life’.”
Carole Upcraft has launched an e-petition calling for the government to pressure lorry drivers to have tests for sleep apnoea, which causes daytime sleepiness and fatigue.
Her son Daniel, 32, suffered brain damage and his fiancée Nicola Culshaw, 33, was killed when their car was hit by a lorry while queuing for the Dartford tunnel on the M25 in April last year. The lorry driver, 40-year-old David Thomas from Upminster, was initially charged with causing death by dangerous driving, but the case was dropped when it was discovered he had undiagnosed sleep apnoea.
Library supervisor Mrs Upcraft, of Knoll Rise, Orpington, said: “There is no point in being vengeful here. We just need to find a positive out of what happened. We do not want another family to go through what we have gone through. Research shows that 41 per cent of HGV drivers have a sleep disorder of one kind or another, but most of them won’t be aware of it.”
The petition reads:
Tired drivers cause violent deaths & horrific injuries
Responsible department: Department for Transport
I would like a debate to raise awareness for the early diagnosis of HGV drivers with sleep apnoea. Last year my son and his fiancee were crashed into by a driver who had undiagnosed sleep apnoea. My son was left with serious brain injuries and his fiancee was killed. The driver was charged with death by dangerous driving but days before the trial the case was dropped by the CPS as he was driving unaware of this medical condition. There are clear criteria and indicators as to who is likely to suffer this condition. Please help raise awareness with haulage employers and GP’s. So that no other person is killed by a condition that is treatable.
To sign the petition, which needs 100,000 signatures to be considered by the government, go to epetitions.direct.gov.uk/petitions/5851
The father of Toby Tweddell, who was killed in a road accident in 2006, has spoken out on radio 5 live calling for all lorry drivers to be screened for sleep apnoea. The driver responsible for the accident also joined the call for action.
This tragic case demonstrates the fatal consequences of the lack of awareness of the condition, both within the medical profession, and by drivers themselves. It also shows that commercial drivers have nothing to fear from a positive diagnosis as the driver in this case was absolved of resposibility for the accident having been misdiagnosed. He is still driving today having been treated successfully.
The coroner of the case, and Toby’s parents both called for screening at the time of the killing, and five years later nothing has been done and road deaths due to sleep apnoea have continued. However, with the Corporate Manslaughter Act now in full force a similar case could now result in the driver’s employers being sued for negligence. Hopefully companies will now take action before this happens again.
The BBC reported at the time, “Mr Tweddell, 25, from Sale, Greater Manchester, was killed when a lorry driver ploughed into a queue of traffic on the M62 in Merseyside in 2006. Lorry driver Colin Wrighton had been suffering obstructive sleep apnoea. The 54-year-old’s condition had yet to be diagnosed but he had complained to his doctor about feeling tired four months before the accident. Tests had been run for diabetes, which came back negative.
“Mr Wrighton was initially charged with causing death by dangerous driving, but the Crown Prosecution Service offered no evidence against him after his sleeping condition was revealed. In giving his narrative verdict, which was released as a statement, the coroner said: “It is my intention to prepare a Rule 43 Report to the Lord Chancellor concerning obstructive sleep apnoea in an endeavour to reduce the number of deaths that arise annually from this condition.”