National guidelines issued late last year by a federal bureaucratic organisation called the National Transport Commission have concluded that being overweight makes you unfit to to a job which requires a lot of sitting down. That sounds silly enough on its own, but the main concern of the National Transport Commission seems not to be that being overweight increases the risk of heart attacks or diabetes (although they are slightly concerned about that, which on the latter point seems pretty silly seeing as the vast majority of diabetics are very good at managing their condition), but rather that being overweight is likely to make someone fall asleep. Seriously, you couldn’t make this stuff up (unless you’re a federal bureaucrat, it seems).
The Daily Telegraph had a story on this today because the New South Wales government has sadly decided to follow along with the bizarre federal guidelines, and plans to suspend overweight train drivers [1].
Under changes to national rail safety standards, all safety-critical CityRail workers – including drivers – will now have to keep their body mass index (BMI) under 40 or face being declared temporarily unfit for work.
[..]
Drivers with a BMI over 40 are now required to undergo a sleep study while workers with a BMI between 35 and 40 and who have other risk factors, such as type 2 diabetes or high blood pressure, will also have to undergo further testing before being allowed to return to the job.
(h/t Henry Budd, The Daily Telegraph [1])
The article goes on to state that being overweight is the leading cause of sleep apnoea…not that there’s a direct connection between the two things, just that there’s an increased chance.
It seems like a pretty flimsy reason to suspend someone from a job which they’ve been doing without a problem. In fact, it sounds like discrimination, and I’d love to see how this policy would stack up against anti-discrimination laws.
At this point you might be thinking I’m making mountains out of molehills and that it’s a sensible idea to ensure that train drivers are able to safely drive trains. When I heard the story, I thought a similar thing but for a different reason. I thought “surely there has to be more to this…surely they wouldn’t suspend drivers just because of their weight, surely there would have to be another factor involved before they would suspend someone”, so I had a closer look at the National Transport Commission’s guidelines, and it turns out that they’re even tougher than the Daily Telegraph article makes them sound.
On pages 117 and 118 of the “National Standard for Health Assessment of Rail Safety Workers October 2012 [2]” there is an explanation of signs and symptoms of sleep apnoea which, if present, warrant further investigation. That’s fair enough, but then it goes on:
The presence of the following risk factors should also increase the suspicion of sleep apnoea, even in the absence of self-reported sleepiness:
• a body mass index (BMI) ≥ 40
• a BMI ≥ 35 and either
− diabetes type 2; or
− high blood pressure requiring 2 or more medications for control.
BMI should therefore be calculated routinely as part of the periodic health assessment for Safety Critical Workers (refer to Figure 22). Sleep apnoea may be present without the above features; however, the standard identifies these risk factors as a basis for further investigation and classification as Fit for Duty Subject to Review (refer to Table 17).
Note the phrase “even in the absence of self-reported sleepiness”…effectively what this is saying is that, even if a person shows absolutely no signs of dozing off while working, if they are overweight, they have to be subjected to an entirely unwarranted sleep apnoea risk assessment and suspended from duty until the risk assessment is carried out. Given that NSW rail systems are run by government-owned corporations, this means that taxpayer dollars have to be spent on:
1) The wages of an unnecessarily suspended train driver and the wages of someone covering their shifts
2) The medical people who are engaged to carry out these assessments (which in this case involves keeping a train driver in a medical facility overnight to watch them sleep)
3) The countless bureaucrats who have to administer this whole scheme
All because a train driver is overweight.
If that’s not bad enough, the guidelines continue by declaring that people who are overweight are just as dangerous as:
• those who experience moderate to severe excessive daytime sleepiness (ESS score of 16–24)
(see below)
• those with a history of frequent self-reported sleepiness while driving or working
• those for whom work performance reports indicate excessive sleepiness
• those who have had a motor vehicle crash or other incident caused by inattention or sleepiness.
Workers with these high-risk features have a significantly increased risk of sleepiness-related incidents.
They should be referred to a sleep disorders specialist to assess if sleep apnoea or another medical condition is causing their excessive daytime sleepiness. These workers should be classed as Temporarily Unfit for Duty until the disorder is investigated, treated effectively and fitness for duty status determined.
I accept that being overweight does make people more likely to have various medical conditions, but I absolutely reject the idea that just because someone is overweight they should be immediately suspected of having all of these conditions until they cane prove that they don’t, or that they should be labelled as being as dangerous as people who actually show some symptoms of a problem.
It bothers me that train drivers are being subjected to this nonsense, and it bothers me that dozens of government bureaucrats who comes up with, and will have to enforce, these silly guidelines.
But what bothers me the most is the next logical step. If train drivers, who drive vehicles which can only travel on very narrow passageways called train tracks and are therefore at a relatively low-risk of maiming or killing members of the general public when compared to other forms of transport which can go virtually anywhere, are subject to these guidelines, how long will it be before these guidelines are expanded to cover drivers of other vehicles, such as cars, which are certainly much more likely to be involved in a serious collision if the driver suffers some sort of medical problem while driving?
First they came for the train drivers…I might not be a train driver, but I won’t stay silent as this is an illogical decision, and it’s very likely that it will have consequences for the rest of the population if people don’t make a noise about it. I shudder to think of the economic impacts if road authorities decide to take overweight drivers off the road until they can prove that they don’t have a medical problem.
This, in my view, is one situation where the presumption of innocence until guilt can be proven is being subverted, and the ramifications could be a serious and unwarranted reduction in freedom and liberty for everyone, not just train drivers.
Samuel