A recently released study shows that the risk of a crash risk soars among truck drivers who fail to adhere to sleep apnea treatment.
Results show that the rate of serious, preventable crashes was 5 times higher among truck drivers with sleep apnea who failed to adhere to PAP therapy, compared with matched controls. In contrast, the crash rate of drivers with sleep apnea who were fully or partially adherent with treatment was statistically similar to controls.
“The most surprising result of our study is the strength and robustness of the increase in the crash risk for drivers with sleep apnea who fail to adhere to mandated treatment with positive airway pressure therapy,” said lead author Stephen V. Burks, PhD, professor of economics and management and principal investigator of the Truckers & Turnover Project at the University of Minnesota, Morris. “The results of our study support the establishment of obstructive sleep apnea screening standards for all drivers through the commercial driver’s medical exam.”
If we had a National Vision Zero Goal and Vision Zero Rulemaking Policies, what would we do with this information?
According to the authors, panels of medical experts previously convened by the Federal Motor Carrier Safety Administration (FMCSA) have recommended comprehensive sleep apnea screening for commercial drivers. However, rather than instituting mandatory screening, current federal regulations rely on drivers to self-report sleep apnea symptoms during a biennial medical examination to determine their fitness for duty. On March 8, 2016, the FMCSA and Federal Railroad Administration (FRA) issued a joint Advance Notice of Proposed Rulemaking, which is the first step as both agencies consider whether to propose specific requirements for screening, evaluating and treating rail workers and commercial motor vehicle drivers for obstructive sleep apnea.
If we were actually serious about saving lives, then we would do everything humanly possible to prevent crash deaths. Here’s a chance to do it right.
According to study co-author Charles A. Czeisler, PhD, MD, FRCP, chief of the Division of Sleep and Circadian Disorders at Brigham and Women’s Hospital, and Baldino Professor of Sleep Medicine at Harvard Medical School in Boston. “Given that the risk of heart disease, cancer, diabetes, dementia and premature death are similarly increased in people with untreated obstructive sleep apnea, regulatory agencies worldwide owe it to truck drivers and to the motorists who share the road with them to require objective screening, diagnostic testing, and treatment adherence monitoring for all commercial drivers.”
I just heard about a new book about traffic safety advocacy. Find out about it for yourself from Lou Lombardo, a safety advocate who does important work by watching out for timely news in the realm of traffic safety and sends out regular emails to keep others informed.
In Lou’s latest email below, I particularly noted the NY Times article, which stated that, without a law, safety advocates and regulators say, consumers must take the rental car company’s or dealer’s word that the repairs were made, and have limited ability to seek redress without that assurance. This emphasizes the need to go beyond voluntary measures:
Dear Care for Crash Victims Community Members:
On “October 7, 2004, two Houck sisters were killed in “a Chrysler PT Cruiser rented from Enterprise Rent-A-Car, that had been recalled for a safety defect that could cause an engine fire, but the corporation had failed to repair it.”
On December 4, 2015, the Raechel and Jacqueline Houck Safe Rental Car Act was signed into law.”
* The inequality of power of people vs. corporate and governmental power and money has never been greater.
* Safety victories are too rare in the U.S.A. today.
* The American people need to know that safety advances can be made with persistence plus political and community support.
See the press release below by one of my safety heroes Ben Kelley, about the struggles, on our behalf, of Carol Houck and her family.
New Book Gives Gripping Account
Of Eleven-Year Legal Saga Triggered
By Sisters’ Defective Rental Car Deaths
Monterey, CA –When the Houck sisters were killed in a fiery head-on collision late one afternoon in October 2004, California state police blamed it on Raechel Houck, 24, the driver. She had made an “unsafe turning maneuver,” they said. “It’s a very rural stretch and people can fall asleep or lose control easily or not pay attention.”
But in reality, a defective Chrysler PT Cruiser and a huge rental car company’s callous indifference to customer safety caused the tragedy. Even though Enterprise Rent-A-Car had been notified more than a month earlier that the PT Cruiser was under recall, it rented the vehicle to the young women without fixing its lethal defect – a flaw in the power steering hose that allowed flammable power brake fluid to leak onto hot engine surfaces and burst into flames.
The Houck sisters’ violent deaths were the start of an incredible eleven-year saga that culminated in the congressional passage last December of a landmark law, the Raechel and Jacqueline Houck Safe Rental Car Act of 2015, banning rental car companies from keeping recalled vehicles in service without fixing their defects. A new book, “Death by Rental Car: How The Houck Case Changed The Law,” by Ben Kelley, documents that saga in spellbinding detail. A “real-life courtroom thriller” that “reads like a suspense novel,” reviewers wrote.
In a foreword to “Death By Rental Car,” Ralph Nader calls it a “compelling story of corporate evasion and duplicity” and the “dedicated, persistent personal injury attorneys” who fought for the Houcks in their lawsuit against the giant rental car corporation – and ultimately won. The Houcks “saw beyond their own personal tragedy” when they pursued their lawsuit, Nader writes; it was a way to “advance the public’s right to know what both Chrysler and Enterprise Rental wanted kept secret. Drivers and passengers on the roads were in danger.”
“Death by Rental Car” gives a blow-by-blow account of Houck v. Enterprise, the parents’ hard-fought lawsuit against Enterprise. Drawing from the testimony of experts and witnesses in the lawsuit, the book takes the reader inside the litigation, in which the rental car corporation, despite overwhelming evidence to the contrary, aggressively attempted to blame Raechel Houck for causing the crash. But what caused the crash was the defect, which triggered an engine compartment fire. Smoke penetrated the passenger compartment, frightening Raechel and causing her to veer off the road and into the path of an oncoming tractor-trailer.
Challenging Enterprise’s campaign to shirk blame for the crash were two lawyers, Larry Grassini and Roland Wrinkle, who represented the Houck parents. They resolutely fought back against Enterprise’s “blame the victim” legal tactics and secrecy strategy and brought the case to a successful conclusion. When Enterprise tried to settle the case by paying the parents a few million dollars in return for their agreement to hide the facts of the crash and Enterprise’s role in causing it, they joined the Houcks in rejecting the offer. Grassini said he was “inspired by the bravery” of the Houck parents, who “refused to take any amount of money in exchange for muzzling them from exposing Enterprise’s business practice of renting recalled cars.”
After the trial in Houck v. Enterprise, the sisters’ mother, Carol “Cally” Houck, embarked on a crusade to win passage of new laws to forbid rental car companies from keeping recalled vehicles in service without first repairing them. Her criterion for an effective law was simple: “If it would have saved my daughters, it’s a good law. If it wouldn’t have, it’s no use.” Her effort, supported by leading safety advocacy groups in California and Washington, led to passage in December of the Raechel and Jacqueline Houck Safe Rental Car Act.
“Death By Rental Car” is available from Amazon.com in print and Kindle formats at this link. The book’s Table of Contents is below.
ABOUT THE AUTHOR: Ben Kelley is a nationally renowned expert on auto safety issues. The Los Angeles Times called him a “pioneer in vehicle safety research.” His commentaries have appeared in newspapers throughout the country and are featured on the www.Fairwarning.org consumer information website. His biography and bibliography are atwww.producthazardconsulting.com.
This week, I received a letter from Vice President Joe Biden in response to my December 9, 2015, letter to him asking that he champion our efforts to reduce the traffic safety tragedies in our country. I asked him to back our petition to President Obama requesting a Vision Zero Executive Order.
I truly appreciate his heartfelt letter expressing compassion for the loss of our daughters in a truck crash, and his promise to keep us in their prayers. He also mentioned that my commitment to the issue is inspiring.
Please pray that he is inspired to the extent of actively promoting our petition requests with the powers that be in Washington.
I hope that the truck trailer manufacturing community (and those who purchase from them) take a cue from the CMTA–a non-profit organization which is supporting an effective research strategy to find treatment for Charcot-Marie-Tooth, a hereditary disorder which multiple members of my family have.
CMTA has organized a collaborative process which brings together a global interdisciplinary team:
One of the most important ways the CMTA accelerates the research process is by putting together teams of top scientists recruited from an international body of scientific and clinical Key Opinion Leaders in CMT. The STAR program’s unique character stems from the willingness of the scientists to come together to advance CMT research collaboratively, sharing and communicating ideas, discoveries and research findings.
The CMTA’s funding and operations focus is on translational research that will lead as directly as possible to therapeutic treatments of CMT. To further this goal, the CMTA has put in place a STAR Advisory Board that includes both a Scientific Expert Board and a Therapy Expert Board. The CMTA’s STAR (Strategy to Accelerate Research)
This is the kind of strategy which we hope will be taking place at, and following, the Underride Roundtable on May 5, 2016, at the Insurance Institute for Highway Safety (IIHS) Vehicle Research Center in Ruckersville, Virginia.
March has historically been a momentous, memorable month for truck underride safety advocacy. Not that other months are totally devoid of such activity, but I have observed a noticeable pattern:
The Insurance Institute for Highway Safety (IIHS) has studied and reported on the truck underride problem for many years. After our underride crash on May 4, 2013, we discovered that they had published a report on this issue just a few months earlier on March 14, 2013, as well as a prior report on March 1, 2011.
On the 37th anniversary of our marriage, our family launched the AnnaLeah & Mary Stand Up for Truck Safety Petition on March 19, 2014, with one of the petition requests being to improve truck underride protection (rear, side, and front on tractor trailers, as well as for Single Unit Trucks).
Later that week, on March 23, 2014, I published a Youtube video to explain why we had launched the petition and what we were asking for–including an upgrade of the weak, ineffective federal underride standards.
During the almost three years which have passed since that terribly tragic day in May, we continue to uncover new (to us) information which surely should have led to improved underride protection long before now. For example, about a month ago, I became aware of a March 16, 1977 (when I was 21–just a few days from my wedding) Senate Investigative hearing, which was reported on in the March 29, 1977 IIHS Status Report.
This is how that report began: The Insurance Institute for Highway Safety has released the results of a crash test program focused on the deadly problem of car-into-truck underride crashes. Appearing as lead-off witness at a March 16 Senate Investigative hearing, the Institute’s president, William Haddon, Jr., M.D., presented crash test films and analyses showing that: The 25 year-old federal “rear end protection” standard for devices on the backs of tractor-trailers and trucks is “a sham.”
Further, Haddon warned Senators, “Blood has been shed, heads literally have rolled and countless thousands of Americans have been injured because these agencies did not act. Further inaction would be inexcusable.”
On March 5, 2016, we delivered our second petition to Washington, DC, when we took our Vision Zero Petition Book with 20,000 signatures to the Department of Transportation and President Obama. We asked for a Vision Zero Executive Order to pave the way for Vision Zero Rulemaking policies so that a truly effective and comprehensive underride standard can be issued.
On March 10, 2016, the Vision Zero Petition Book and 20,000 signatures were posted as a Public Comment on the current rear underride rulemaking.
On March 12, 2016, Jerry and I were privileged to participate in a successful side guard crash test in Hillsborough, North Carolina. This innovative side/rear combination can be retrofit to existing trucks on the road. Imagine the potential for saving lives!
On March 2, 2016, just three days prior to our recent delivery of the Vision Zero Petition, I discovered a March 19, 1969, Federal Highway Administration underride rulemaking document on the Federal Register which indicated that their intent was to extend underride protection to the sides of large vehicles! Eight years before my wedding day, when I was 13 years-old, DOT was intending to call for stronger underride protection. And yet, 44 years later, when my daughter Mary was 13 and AnnaLeah was 17, we still had not gotten it right! That’s just wrong!
It is my fervent hope that, when March2017 rolls around, we will be celebrating a vastly improved federal standard–enthusiastically and immediately adopted by the trucking industry–for all-around-the-truck underride protection at higher speeds, including now-exempt single unit trucks as well as retrofitted to existing trucks and trailers.
If this seems like a costly venture, try comparing it to the price paid by thousands upon thousands of individuals and families during the past decades of ineffective underride protection–added to the countless precious people who will be saved in the years to come from tragic, preventable death by underride.
A lot has been happening recently in our safety advocacy efforts. In order to make that information readily available, but not take up too much space on the Home Page, I will list some of the posts as links here:
A Very Mary Birthday: What Mary would have done & what I did without her on her birthday How would Mary have celebrated her 17th birthday today? Well, I don’t know for sure. But I know that she would have enjoyed making her own homemade pizza with us tonight. (Or would she have chosen something else for her birthday meal?) . . . Whatever she would have chosen to do on her special day, Mary would have made the most of it because “every day’s a holiday with Mary” and she knew how to live joyfully — when she wasn’t grumpy, that is. . .
Knights of the Underride Roundtable: Finding Some Common Ground to Protect Travelers! On June 24, 12 people from diverse backgrounds met around a table at the IIHS offices in Arlington, Virginia, to continue the good work begun at the Underride Roundtable on May 5, 2016. This time, we rolled up our sleeves and hammered out a written recommendation for better rear underride guard requirements for tractor-trailers. To save lives.
Media Coverage of the first Truck Underride Roundtable held at IIHS on May 5, 2016 You will find multiple links below reporting on the Underride Roundtable, which took place on May 5, 2016 at the Insurance Institute for Highway Safety’s Vehicle Research Center in Ruckersville Center, co-hosted by them with the Truck Safety Coalition, and our family (AnnaLeah & Mary for Truck Safety). . .
With the Underride Roundtable coming up soon, I put together a post with links to just about everything I have ever found out about underride. I hope that someone makes good use of the information provided: Underride Roundtable To Consider Underride Research From Around the Globe.Also included is an Dragon Underride Protector Wish List form which I hope people will fill out and send to me.First photo is of a German researcher. I included an article about his work, with a link to help you translate it from German to English. Just tryin’ to be helpful!
An impressive group headed for the Truck Underride Roundtable at IIHS May 5. I heard from Andy Young today. He will be the Moderator for the Panel Discussion at the Underride Roundtable next week. He is eagerly anticipating that event after just returning from attending “The Commercial Vehicle” show in Birmingham England. He said that he has lots to share from that experience. I’m looking forward to hearing all about it.I am also happy to be able to say that at the Underride Roundtable on May 5, 2016, over 65 representatives from the trucking industry, government, safety advocates, engineers, crash reconstructionists, attorneys, and media will be on hand at the Insurance Institute for Highway Safety’s Vehicle Research Center to “sit down at the table together” and discuss and demonstrate truck underride crashes.
May Day: Remembering Our Butterfly Girls–Full of Life, Frozen in Time Last year, I saw this statue of two young girls excited about a butterfly in a jar. It reminded me so much of AnnaLeah and Mary. We decided to get it this year to help us as we remember the 3rd anniversary of our truck crash, on May 4, 2013, which took Mary and AnnaLeah from us.
Delivery of a Vision Zero Petition to Washington; What I have learned in our battle for safer roads I am having a difficult time getting this post started. I shared about it briefly here and Russell Mokhiber graciously shared our story as well. Now I want to give a more in-depth report of our trip to Washington, DC, on March 3 and 4 to deliver over 20,000 Vision Zero Petitions. I want to be able to report that I am hopeful about the impact of our Vision Zero Petition. But I am mostly frustrated and angry. . .
Witnessed safety defect in action at underride crash tests; this is what snuffed out my daughters’ lives. We have been following the progress of Aaron Kiefer’s development of an innovative side/rear underride guard, which he has designed on his own time when not working as a crash reconstructionist or spending time with his family. So we eagerly welcomed his invitation to help out in his MacGyver-style crash test this past Saturday. (By the way, I am a big fan of MacGyver–watched every episode on DVD with Mary & AnnaLeah.)Aaron wanted to take this opportunity to test his design and find out what changes might be needed to make it a marketable and affordable option for trailer owners to install as a retrofit safety improvement. We joined a crew of his family, friends, and fellow crash reconstructionists at a junkyard in the Triangle area. . .
Are you aware that Death by Motor Vehicle is one of the leading causes of death?32,719 people died in U.S. traffic crashes in 2013. Two of those people were my daughters, AnnaLeah (17) and Mary (13). That number decreased to 32,675 deaths in 2014–down by 44, but still far too many deaths in my book. In fact, early estimates show 2015 trending higher.And how many of those deaths were due to truck underride and could have been prevented by a stronger, more effective underride protection system? Underride deaths are preventable and unnecessary and now is the time to take extreme action to reduce these deaths–no matter who caused the crash!I survived a horrific truck crash in which our car was pushed by a truck into the rear of another truck. Backwards. My daughters in the back seat were not so fortunate; they went under the truck and the truck broke their innocent bodies. . .
Do it, President Obama, for We the People of this United States of America! #VisionZero I firmly believe that, in order to move as a nation Toward a Vision of Zero Crash Deaths, it will take take a commitment to a National Vision Zero Goal and a coordinated endeavor of government, private industry, workers of every skill imaginable, and informed citizens. Anything short of this will be disjointed and less effective, which translates into — not simply unmet project goals but — people dying. It is not an impossible dream but it will require sacrifice and will be well worth the effort. . .
He has told you, O man, what is good; and what does the LORD require of you but to do justice, and to love kindness, and to walk humbly [circumspectly] with your God? Micah 6:8
So many things are running through my head that could make up multiple posts. But I will summarize them all here and see what happens with it.
First of all, in regards to the condition of the underride guard on the trailer crash tested on Saturday. At the time when it was purchased for use in the crash test, the underride guard was already in sub-standard condition. Had it been in a collision, it is quite likely that underride would have occurred. And how many other trailers on the road are in similar condition? Something’s wrong with this picture. Witnessed safety defect in action at underride crash tests; this is what snuffed out my daughters’ lives.
In that same post, I asked forgiveness of those who have lost loved ones in underride crashes. I don’t want to be misunderstood. I was not confessing any particular personal failure to address the underride problem because I have done nothing but pursue a solution ever since I found out about it. (Although I, too, have part of the problem by putting my head in the sand regarding traffic deaths in general.) What I was doing was speaking on behalf of this nation and society and industry and government. I was repenting for our country’s great sin of omission in not doing something to prevent this murderous Death by Underride — especially when it has been known that it needed to be addressed and research has shown that it can be addressed. I was following Daniel’s example when he confessed and repented before the LORD for what his people, the nation of Israel, had done.I prayed to the Lord my God and confessed:
The other thing which I just wanted to mention again is the idea of a nationwide network of Vision Zero Traffic Safety Community Action Groups. I have observed through my involvement in social media safety advocacy that there are a multitude of individuals and organizations attempting to impact the traffic safety problem. Unfortunately, with a likewise multitude of specific issues upon which they are focusing, efforts to address the problem are fragmented and scattered. It seems to me that if we all come together, at least on some level, we could be more effective.
I firmly believe that, in order to move as a nation Toward a Vision of Zero Crash Deaths, it will take a commitment to a National Vision Zero Goal and a coordinated endeavor of government, private industry, workers of every skill imaginable, and informed citizens. Anything short of this will be disjointed and less effective, which translates into — not simply unmet project goals but — people dying. It is not an impossible dream but it will require sacrifice and will be well worth the effort.
Among other things, I also believe that it will take listening to the hundreds of thousands of families who have lost loved ones due to traffic crashes and apologizing, as a society, for letting them down–for not addressing it as the priority it should be.
Bring a deeper measure of healing and hope by acknowledging their frustration and anger and grief. Let them know that they are being heard and that their petitions for change are being taken seriously.
Set a National Vision Zero Goal and then give these motivated people a voice. Launch a nation-wide network of Vision Zero Traffic Safety Community Action Groups which can channel their zealous energy in positive ways. In concert with a White House Vision Zero Task Force and a Cabinet which is authorized to conduct Vision Zero rulemaking, these groups could work at the local level as a powerful tool for changing the future and moving us more surely Toward Zero Crash Deaths, Serious Injuries, and Fear of Traffic.
Do it, President Obama, for We the People of this United States of America!
We have been following the progress of Aaron Kiefer’s development of an innovative side/rear underride guard, which he has designed on his own time when not working as a crash reconstructionist or spending time with his family. So we eagerly welcomed his invitation to help out in his MacGyver-style crash test this past Saturday. (By the way, I am a big fan of MacGyver–watched every episode on DVD with Mary & AnnaLeah.)
Aaron wanted to take this opportunity to test his design and find out what changes might be needed to make it a marketable and affordable option for trailer owners to install as a retrofit safety improvement. We joined a crew of his family, friends, and fellow crash reconstructionists at a junkyard in the Triangle area.
The morning was for set-up. Then we took a break for some brats and chips before devoting the afternoon to three crash tests. I had been unsure before arriving as to how a pick-up could tow a car and make it crash into a trailer. It became clear to me when I saw Aaron’s pulley contraption.
Test 1 was a side crash. The collision of the car into the side guard caused the innovative side guard to pop off its brace. But, as Aaron and Jerry said, the test was successful because the side guard stopped the car from going under the trailer beyond the windshield; it prevented Passenger Compartment Intrusion (PCI). People in the car could have walked away alive.
Test 2 was a second side guard crash with the same car. Again, the car did not go under past the windshield and there was no PCI. The guard would have protected the people in the car from death and/or severe injuries. This time the added aluminum brace at the rear sheared off. Aaron thinks that he will have to go back to the drawing board and make a stronger brace.
Test 3 was a rear crash test. This time the side guard got rolled up and set aside. The trailer was turned around and the test car set up to aim at the rear of the trailer. The original rear underride guard on the trailer had actually been damaged at some point in the past and only had four of its original eight bolts. (That was the condition the underride guard was in when Aaron purchased the trailer, which had sustained damage from collision with an overpass. The guard had clearly not been properly maintained.)
In this crash, the underride guard failed and the car rode under the trailer. There was PCI and, if there had been people in the car, they would not have escaped unharmed. The added brace on the outer edge did not hold up. In fact, it was still fastened on (come to think of it, as it took a lot of work to unfasten it from the trailer afterward), but the original underride guard popped entirely off and flew to the side — doing nothing to stop the car from going under the truck.
Aaron had actually aimed the car to hit the left outer edge of the trailer, which he had reinforced with some aluminum braces. (Note: The current federal standard, as well as the proposed improved rule, does not require this area of the trailer to be protected against underride.) Instead, the car hit the vertical bar of the guard; the entire original guard then popped off and the car went under the truck.
It’s back to the drawing board for Aaron to find a way to improve his design. It was definitely a great success in that it prevented deadly side underride. On top of that, the trailer was not damaged by the collision (except for a few little nicks). But the bracing needs to be made stronger.
From what I could see, the day’s events only served to strengthen Aaron’s resolve to put a stop to senseless deaths, which he sees all-too-often in his work. I for one am truly thankful for the wonderful work he is doing, along with the group of people who willingly set aside a Saturday to support his effort.
The day gave me a deeper appreciation for all who take the time to solve the problem of preventable traffic fatalities. This includes the Virginia Tech Senior Design Team and Wabash and Manac and many researchers for decades, such as George Rechnitzer and Raphael Grzebieta in Australia and Luís Otto Faber Schmutzler in Brazil, and countless other un-named individuals.
It was also personally very intense. As one participant commented, “That was violent!”
Indeed, it was very violent. All three crashes gave me a jolt. But after the third crash, which resulted in deadly underride, I found myself standing still in the aftermath. Others were busy finding tasks to measure the results and get the clean-up started–including getting the car unstuck from under the trailer. But all I could do was stand there and stare.
Not until the next day really did it all begin to sink in: how I had witnessed from observing from afar what I and my children had gone through ourselves (although with a different crash scenario). I had watched, as an onlooker, the instantaneous destruction of a vehicle and how it was that AnnaLeah’s life had been inconceivably snuffed out in the twinkling of an eye and how, in a matter of mere seconds, Mary’s body had been broken beyond repair by just such a tragically-unresolved traffic safety problem.
It seemed like my own body experienced whiplash as it tensed up and relived, through traumatic muscle memory, what I had gone through. Meanwhile my heart continues to break with the grief that knows no end even as I process this experience.
It is beyond my comprehension how we, in this country, can allow such things to occur year after year without moving heaven and earth to learn how to prevent these tragedies. I can only ask forgiveness, and apologize to the countless families who have lost loved ones through violent death by motor vehicle, for letting them down–for not addressing it as the priority it should be. As a society, we have dropped the ball.
Jerry said several times, “It’s not every day you get to see a dream become a reality–kind of a humbling experience actually.” May there be many more such days.
