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US Agencies Abandons Plans to Require Sleep Apnea Testing

August 8th, 2017

With the recent decision by the Federal Railroad Administration and the Federal Motor Carrier Safety Administration to abandon a plan to require railroads to test train crew members for a dangerous sleep disorder, I am completely outraged!

I believe the recent judgement from President Trump that it is not necessary to test drivers is lunacy.  Sleep apnea affects too large a percentage of our population to ignore the screening and treatment. If our health care system did more to screen and treat apnea it would save hundreds of millions of dollars and prevent many diseases.

Anyone driving a bus, piloting an airplane, or driving a train must be evaluated for sleepiness during the day.   If they have sleep apnea they will be very tired during the day and this has been shown in many studies to impact their judgement and result in accidents and loss of life that is otherwise preventable.

We already have seen many major catastrophes associated with Sleep Apnea:

Challenger disaster

Chernobyl Nuclear Reactor Meltdown

AA Flight 1420

Exxon Valdez oil spill

Michigan Train wreck

Metro-North Train derailment  Bronx 2013

In a recent study (April 2016) University of Minnesota Morris study: Crash risk is 5x higher among truckers not adhering to sleep apnea treatment. Anderson, Burks, Journal Sleep.

Truckers who fail to maintain their sleep apnea treatments have a fivefold increase in the risk of serious, preventable crashes.  That's the finding of new research from the University of Minnesota Morris. The study released Monday is the largest analysis to date of crash risk among commercial truckers who have the breathing disorder. It comes as a debate heats up over whether to require sleep apnea screening for truckers.

People who have obstructive sleep apnea stop breathing temporarily during sleep. The condition disrupts normal rest patterns and causes daytime fatigue. Drowsy driving can affect anyone, but it's especially worrisome in the commercial trucking industry because of the risk of crashes involving a big rig. The study compared 1,600 truckers diagnosed with sleep apnea to a group of truckers who passed an apnea screening test and were unlikely to have the disorder.  Drivers who consistently followed a sleep apnea treatment plan had crash rates over 100,000 road miles that were similar to the comparison group.

But crash risks were significantly higher for drivers who didn't follow through with their treatment.  "The people in the control group and adherent group would have about 14 serious preventable truck crashes (out of 1,000 drivers). And the drivers in the nonadherent group would have 70," said Stephen Burks, an economics and management professor at the University of Minnesota Morris who led the study. "That is a big difference by anyone's standard."

The study looked at crashes that are reportable to the U.S. Department of Transportation. The incidents were serious enough that a vehicle was towed, someone required immediate medical attention away from the scene, or there was a fatality.

Truck drivers involved in these events could have prevented the crashes and should have taken actions to avoid them, Burks added. "The fact that we're looking at preventable crash data, it has sharpened our results and made the relevance of our results greater."

Medical experts estimate that up to 28 percent of commercial drivers have obstructive sleep apnea. Crash data from 2004 to 2013 show that sleepy commercial vehicle operators caused as many as 8,900 traffic deaths in the U.S. over that time period.  Some firms have already acted.

Burks' findings were drawn from Green Bay, Wis.-based Schneider, a huge North American trucking company that has an employer-mandated program to screen, diagnose and monitor the condition among its drivers. It supplies its truckers with a free sleep apnea breathing device that tracks how often drivers wear it and uploads the data to the company's medical service provider for follow-up. Drivers who don't comply with the program can be terminated.

The National Transportation Safety Board and the National Academies of Science, Engineering and Medicine recently signaled their concern about sleep apnea and driving. Both entities recommended officials address the sleep apnea issue in commercial vehicle operators, something Burks supports.

The findings in the above study suggest that commercial truck drivers should be regularly screened for sleep apnea and required to treat it if they have it in order to continue driving, according to Stefanos Kales, associate professor in the Department of Environmental Health at Harvard Chan School, Chief of Occupational Medicine at Cambridge Health Alliance, and senior author of the study. “Mandating screening, diagnosis, and treatment would reduce large truck and bus accidents, and therefore deaths and injuries among the motoring public,” he said.

In 2000, 2008 and 2012, the Medical Review Board made recommendations to the FMCSA about screening, diagnosis, treatment and monitoring for commercial drivers with obstructive sleep apnea.

Some truckers feel that mandatory testing would be intrusive.  Perhaps if they understood that if they have this problem and remain untreated that their lives are at risk.  The consequences of not treating this condition include: heart attack, stroke, diabetes, atherosclerosis, anxiety disorders, depression, GERD, in ability to concentrate, impotence, fatigue, headaches and many more medical conditions.

Within their role as a public transportation driver….putting many people’s lives at risk is perhaps the most serious consequence of all.  The public has a right to use public transportation that is safe and regulated.

I agree with NYS Senator Chuck Schumer’s demand of a reversal on the decision by US federal agencies to abandon plans to require sleep apnea screening for truck drivers and train engineers. For more information on sleep apnea, please visit our page.

Sincerely,

Steven Lamberg DDS, Diplomate ABDSM

140 Main Street ~ Northport, NY 11768

(631) 261-6014

Happy Fourth of July!

June 28th, 2017

Happy Independence Day from Dr. Steven Lamberg and team! The Fourth of July celebrations in America may have changed a lot over the years, but there is no doubt that we Americans love to celebrate the anniversary of our country's independence! Today we're devoting the Steven Lamberg, DDS blog to some fun facts about the Fourth!

  • My, how we have grown! This year the United States Census Bureau estimates that our country has 313.9 million residents celebrating the Fourth of July this year, but back in 1776 there were just 2.5 million members of the country.
  • Our country loves to show how proud that we are of our independence. Did you know that there are 31 United States places with the word “Liberty” in their names? The state of Iowa actually has four towns with the word Liberty in the name: Libertyville, New Liberty, North Liberty, and West Liberty.
  • The United States loves Fourth of July food! It is expected that around 150 million hot dogs are eaten on the Fourth each year. One of the Fourth's most popular sides, potato salad, goes just perfectly with the hotdogs and hamburgers that are standard Fourth of July fare. Some people choose potato chips instead, but we wouldn't have such a plethora of potatoes if not for the prodigious production of the states of Idaho and Washington -- they provide about half of all the potatoes in the United States today!
  • Americans love celebrating the Fourth outdoors: About 74 million Americans fire up their BBQ grill every Fourth of July.
  • The Chinese contribution: Did you know that Americans have spent more than $211 million on fireworks that were imported from China?

No matter how your family chooses to celebrate the Fourth, stay safe, take precautions, and don't forget to brush after your fabulous Fourth feast!

Five Things You Didn't Know About Cavities

June 21st, 2017

Most people know when they have a cavity—they can either see it on their tooth or... ouch! They can feel it! But there are certain things that many of our patients don't know about cavities that could save them a trip to our Northport office!

1. Not all sugars are created equal

It's quite well known that eating dietary sugars in excess along with poor oral hygiene leads to dental decay such as cavities. This is due to the fact that the bacteria in your mouth feed on these sugars and excrete acids as a byproduct of that process, thus causing decay. But xylitol, a sugar alcohol derived from birch or corn, actually prevents the bacteria from converting sugars into acids.

Xylitol is available in the form of gum, mints, toothpaste, and even in a granulated form much like regular cane sugar. You might consider trying some xylitol products between meals to keep your mouth clean and fresh.

2. It's not always what you eat but HOW you eat

Are you a grazer, always snacking between meals and never satisfied? We now know that this kind of eating can contribute to cavities and other oral health problems.

Every time you eat anything with carbohydrates in it, you're feeding the bacteria in your mouth, which in turn produce acids. If you're constantly eating, it doesn't allow your saliva time to bring the pH of your mouth back into a more alkaline, neutral state. It takes your saliva about 20 minutes to neutralize the acids in your mouth after eating.

It's especially easy to harm your teeth in this way with soft drinks, sipping all day long. So, it's best to avoid sugary drinks and junk food, and if you need a snack opt for healthy vegetables or what are known as "detergent foods." If you do decide to drink a soft drink or eat something sugary, have it all at once and not over the course of the day.

3. Flossing is one of the most important oral hygiene techniques

Although most of our patients are aware that they need to brush, sometimes they can get lackadaisical when it comes to flossing. And that's a big mistake. Flossing is one of the most important (and we daresay, easiest) things someone can do to help prevent cavities and tooth decay.

You see, as we've already mentioned, the bacteria in your mouth that cause cavities feed on the food you eat. So if you've got pieces of that food stuck between your teeth all day and night, every day, that's asking for a problem.

Flossing clears that bacteria-feeding food out from between your teeth. Floss daily and whenever you decide to do it, morning or night, just do it!

4. A dry mouth can lead to cavities and tooth decay

Your teeth's best defense against cavities and tooth decay is actually your saliva! We've already talked about the pH neutralizing effect saliva has. So if you find you have a dry mouth often, make sure to have some water to sip on. Or why not try some xylitol mints or gum to get your saliva production kicked into action?

5. Over-brushing can damage your enamel

If you brush like a construction worker with a jackhammer, you should ease up! Brushing too hard can scrape away at your teeth's enamel, which leaves them more susceptible to cavities and decay. Brush lightly, with your brush angled at the gum line for two minutes, twice a day. That's all that is required!

Is gingivitis preventable?

June 14th, 2017

The earliest sign of gum disease is called gingivitis (sometimes called periodontal disease), and is an inflammation of the gums. If left untreated, gingivitis can lead to gum tissue loss, loss of bone that supports the teeth, and eventually tooth loss. The good news is that gingivitis is easily treatable at Steven Lamberg, DDS. Better yet, gingivitis is nearly 100 percent preventable.

Gingivitis is usually caused when plaque and bacteria accumulate on the gums, generally due to poor oral hygiene. A patient with gingivitis will have red and puffy gums that will likely bleed when he or she brushes or flosses.

It is almost entirely within our patients’ power to prevent gingivitis by brushing and flossing on a daily basis. In addition to good oral health habits, regular visits to see Dr. Steven Lamberg will also help with early detection. We can often detect minor inflammation and other signs of gingivitis before it causes any discomfort or issues.

If left untreated, gingivitis will eventually progress to periodontitis, a breakdown of the tissue and bone that support the teeth. Smokers, women who are pregnant or menopausal, people with heart disease, diabetes, epilepsy or HIV infection, and people who suffer from poor nutrition are more likely to have gum disease.

To learn more about gingivitis, or if you suspect you have gingivitis, we encourage you to give us a call at our Northport office today!

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