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The Serious Threat Fatigue Poses for the Transportation Industry — and How Working with the Right Team Can Curb the Danger

Lack of sleep can lead to drowsiness, fatigue and overall poor health. Further, it increases the risk of severe crashes while on the road. But the transportation industry has an opportunity to get ahead on public safety and worker wellness.
By: | June 17, 2021

Sleep plays a vital role in cognitive function and our ability to stay on task, but few of us are getting the recommended seven hours of sleep each night. According to the Centers for Disease Control and Prevention, one in three U.S. adults gets less than the recommended seven hours. Trends suggest this is likely to continue. Further research from the CDC found that, since 1985, the percentage of U.S. adults sleeping six hours or less has increased by 31%.

Losing a few hours of sleep each night may not seem like a significant detriment, however sleep loss can be linked to a number of health and wellness concerns.

“Fatigue is associated with various chronic diseases,” said Dr. Anne-Marie Puricelli, National Medical Director Transportation at Concentra. “Diabetes, certain cancers and autoimmune diseases can find a link back to fatigue.”

Hypertension, heart attack, depression and more can also be connected back to a severe lack of sleep.

Additionally, a lack of sleep can lead to cognitive impairment and a drop in daytime productivity, a fact that can be dire when it comes to the transportation industry. The National Highway Traffic Safety Administration has estimated that drowsy driving costs an estimated $12.4 billion each year.

“A long-haul driver on the road for 13- to 14-hour shifts, coupled with sleeplessness, is more likely to crash and cause harm to the public, themselves and their employers,” said Dr. Puricelli.

This overall picture puts a high level of focus on effective fatigue management.

“The impact of fatigue on lost productivity, increased health care costs, and increased poor overall health are also of interest to the insurance industry — perhaps even more so than the risk of a crash. Not all drivers with fatigue and sleep apnea crash and while it is not an unsubstantial risk, it’s only one part,” said Dr. Michael Berneking, MD, FACOEM, FAAFP, Medical Director at Concentra.

Ninety-seven percent of employers in the transportation industry are concerned about fatigue as a safety risk, according to a report by the National Safety Council (NSC). But managing driver fatigue in the transportation sector doesn’t have to be a daunting task; employers can start by understanding the detriments of sleep deprivation and putting into play several health and safety practices to get ahead.

What’s Causing Driver Fatigue

Dr. Anne-Marie Puricelli, National Medical Director Transportation, Concentra

There is no one thing that’s contributing to a lack of sleep among drivers, but there are several trends that are important to note.

For one thing, the very job of a long-haul truck driver can be mentally and physically demanding.

“Drivers have to work in a fairly complex sensory and motor environment to be able to navigate their vehicles among all types of traffic and weather conditions,” said Dr. Berneking. “Hours of service can last up to 14 hours, with few breaks in between.”

In addition to that, drivers who are hauling goods across country are paid by the mile, so there’s added incentive to keep moving. They can be on the road for days on end without family, friends or other social support systems to lean on.

All of this can lead to stress, particularly mental stress, which the American Academy of Sleep Medicine has linked to sleep disturbances.

The health of a driver is also a contributing factor to driver fatigue. Sleep disorders are on the rise in adults, including insomnia, narcolepsy and various types of sleep apnea. One disorder that both Dr. Berneking and Dr. Puricelli are keeping an eye on is obstructive sleep apnea.

“Obstructive sleep apnea is the most common. It causes breathing to repeatedly start and stop while sleeping,” Dr. Puricelli explained. “It’s often seen in individuals who exhibit other conditions like hypertension, obesity and diabetes.”

Research estimates that one in 15 adults in the United States have obstructive sleep apnea, which is about 18 million people nationwide. Approximately 80% of these people are undiagnosed.

It may not surprise you that this kind of poor-quality sleep can have as big of an effect on driver functionality as lack of sleep. What you may not realize is that in some cases, it can even kill. Actress Carrie Fisher of Star Wars fame died of sleep apnea.

A Focus on Fatigue Management

Dr. Michael Berneking, Medical Director, Concentra

The potential cost of untreated OSA is significant. A Frost & Sullivan report found that undiagnosed obstructive sleep apnea can cost upwards of $149.6 billion. Recommending drivers for sleep tests when evaluating health and wellbeing can go a long way toward uncovering potential issues and implementing best practices before it’s too late.

“Untreated OSA increases risk of serious illness or death due to heart attack and stroke – the #1 and number #5 causes of death in U.S. in 2020. So treating fatigue and OSA has the potential to save all stakeholders – employers, patients and insurers a lot of money,” said Dr. Berneking.

In order for the transportation industry to effectively manage driver fatigue and prevent accidents and injuries and protect the overall health of drivers, Dr. Berneking said that all stakeholders must participate in fatigue management practices.

“Most drivers are not employed by companies with huge fleets; most are employed by small companies or are individual owner-operators,” he explained. “These smaller companies and individuals don’t have the same resources as larger companies, so it’s important that all stakeholders step up.”

Insurance carriers, as an example, can help put educational materials on sleep into the hands of their insureds and offer incentives for healthy sleep behaviors.

Encouraging the use of technologies, like wearables or monitors embedded in truck cabins, to observe driver behavior and alert supervisors to safety concerns is another place insurers can advocate for fatigue management.

“These types of technologies provide feedback almost instantaneously. If the driver happens to have three lane departures within a half-hour period, the technology can alert the supervisor. Then the supervisor can connect with the driver and have the driver pull over and take a break,” Dr. Berneking said.

Workers’ compensation partners can also provide assistance when it comes to fatigue management.

“With the growing concern of sleep disorders, those in the workers’ compensation space are uniquely positioned to encourage employers to educate drivers on their prevalence,” said Dr. Puricelli.

Work with the Right Stakeholders that Underscore the Importance of Sleep

As stated, there is no single cause of poor sleep in long-haul drivers, but trends that are arising require a hands-on approach, whether that be through additional guidance provided by insurance partners, providing educational material, and/or implementing technologies to monitor driving patterns.

Above all, employers must work with stakeholders that underscore sleep’s importance and can add a layer of safety to their overall operation.

“Concentra is one of the leaders in the health care community that trains and encourages its clinicians to be on the lookout for risk factors that could indicate the presence of a sleep disorder,” Dr. Berneking said. The training program is dynamic and comprehensive, he explained, equipping the team of clinicians with the tools they need to understand sleep disorders and their occupational, safety and chronic health risks.

“We work every day to go above and beyond what’s industry standard for regulating drivers. We do this, because we want our clinicians to have the resources and guidance they need to keep drivers — and others on the road — safe.”

Part of that safety comes down to providing drivers with the right educational materials to understand fatigue, its causes and the various sleep disorders, like obstructive sleep apnea, that can contribute to on-the-road drowsiness.

“Concentra makes it so that drivers know the steps taken to reduce fatigue, including screening for sleep disorders,” Dr. Puricelli said. “We provide the resources and materials and respond quickly when a driver is being evaluated for sleep disorders.”

To learn more, visit: https://www.concentra.com/.

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This article was produced by the R&I Brand Studio, a unit of the advertising department of Risk & Insurance, in collaboration with Concentra. The editorial staff of Risk & Insurance had no role in its preparation.




Concentra® is America’s leading provider of occupational medicine, delivering work-related injury care, physical therapy, and workforce health services from nearly 520 Concentra medical centers and more than 150 onsite clinics at employer locations nationwide.

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