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Sleepiness, Circadian Dysrhythmia, and Fatigue in Transportation System Accidents

1988; Oxford University Press; Linguagem: Inglês

10.1093/sleep/11.6.503

1550-9109

J. K. Lauber, Phyllis Kayten,

Occupational Health and Performance

Good morning, ladies and gentlemen.I am delighted to be here in San Diego to take part in the second annual meeting of the Association of Professional Sleep Societies.Although my small role in this meeting will soon be over, I intend to spend the next couple of days here in order to learn more about sleep and sleep-related problems.This is information badly needed.Although, as you will see in a few minutes, we have investigated many accidents in which sleep loss, sleep disorders, fatigue, and circadian factors are clearly implicated, I don't think we have the foggiest notion of the true prevalence of these factors in transportation system accidents.One of the most perplexing problems our accident investigators face is how to determine what role, if any, fatigue played in a specific accident.Unlike metal fatigue, human fatigue generally leaves no telltale signs, and we can only infer its presence from circumstantial evidence.We need your help to develop better investigative techniques, which in turn should lead to better ideas for preventive measures.And this would benefit everyone.The total cost of transportation system accidents is difficult to estimate.The National Safety Council (Accident Facts, 1987 edition) reported 47,900 deaths resulting from highway accidents in 1986 and estimated $57.8 billion in lost wages, medical expenses, insurance costs, and property damage.The Insurance Information Institute estimated $76 billion "economic loss" resulting from 1985 highway accidents (Insurance Facts, 1986~7 Property/Casualty Fact Book).According to figures reported to the Federal Railroad Administration by all railroads, in 1986, there were $167.5 million in "reportable damages" in that industry; but the Chase, MD Amtrak accident alone resulted in $82.8 million in "reportable damages" plus insurance payouts, and according to some figures I saw recently, $900 million in insurance payouts were made last year for worldwide aviation accidents.One estimate indicates that a single major accident can cost an airline as much as $500 million in total losses.It does not take sophisticated economic analysis to realize that transportation system accidents pose a tremendous economic burden on society, and it is impossible to quantify the personal suffering and loss resulting from deaths and injuries.It is widely recognized that most transportation system accidents are due to human error.Depending on the specific mode of transportation and other considerations,