Drowsy Driving in Massachusetts: From Science to Policy

Background

On June 26, 2002, a 19-year-old driver collided with and killed Major Rob Raneri, who was on his way to work at the Devens Reserve Forces Training Area in Ayer, Massachusetts. The driver told police that he had not slept in 24 hours because he was up all night playing video games. Major Raneri was survived by his fiancée, Major Amy Huther, who learned a week after his death that she was carrying his child. This tragedy deprived the U.S. military of a decorated hero, a woman of her husband to be, and a little girl of her father.

Sadly, as the Sleep Research Society (SRS) knows well, this is far from an isolated tragedy. Data collected by the National Highway Transportation Safety Administration (NHTSA) indicate that 80,000 drivers fall asleep at the wheel every day in the U.S. Every two minutes, a drowsy driver causes a motor vehicle crash. In a landmark 2006 study, the Institute of Medicine estimated that 20 percent of all serious injuries from motor vehicle crashes were caused by drowsy driving. An independent NHTSA video observational study similarly demonstrated that 22 percent of all motor vehicle crashes and near misses were caused by drowsy driving. Tragically, two thirds of these drowsy driving crashes occur in young people, just at the prime of their lives.

Development of Model Drowsy Driving Legislation

Through our work studying the effects of sleep deprivation on safety, we (Drs. Czeisler and Landrigan) became acquainted in 2004 with Massachusetts State Senator Richard Moore. Senator Moore, Chair of the Massachusetts Legislature’s Joint Committee on Healthcare Financing, has a longstanding interest in public health and safety, and was very interested in the emerging data on the effects of sleep deprivation on safety. Prompted by the tragic death of Major Raneri, Senator Moore approached us for advice on how to incorporate circadian and sleep science into drowsy driving legislation that he was crafting.

At the time that this legislation was first proposed, New Jersey had recently passed “Maggie’s Law”, which states that “driving after having been without sleep for a period in excess of 24 consecutive hours” constitutes recklessness under vehicular homicide statute. A potential limitation of this law is that an inadequately brief sleep episode during the 24-hour period could be sufficient to undermine the letter of the law. Consequently, when we first reviewed the proposal to create “Rob’s Law” in Massachusetts, named after Major Raneri, we wanted to be sure that any recommendations that we made to the legislators were evidence-based. In addition, we wished to ensure that enforcement of any new laws regarding drowsiness were accompanied by an appropriate educational campaign. We therefore:

  • Recommended that Massachusetts carefully consider initiation both of an educational campaign and legislative efforts to reduce drowsy driving;
  • Proposed that any specific recommendations regarding determination of drowsiness and enforcement of drowsy driving laws be established by a multi-disciplinary commission that included experts in sleep science or sleep medicine as well as experts in enforcement and the legislative process; and
  • Sought input from the professional sleep societies about possible evidence-based drowsy driving recommendations for Massachusetts.

Late in 2004, the SRS asked us to serve on a Presidential Task Force on Sleep and Public Policy, chaired by Dr. Czeisler. In addition to Drs. Czeisler and Landrigan, this taskforce included past and present leaders of the SRS, the American Academy of Sleep Medicine (AASM), and the National Sleep Foundation (NSF) – David F. Dinges, Ph.D., James K. Walsh, Ph.D., and Larry Epstein, M.D. Over the ensuing year, the task force held a series of meetings, including an all-day meeting held at the Massachusetts State House, in which the Task Force interviewed Massachusetts State Senator Richard Moore. Over the course of these deliberations, the Task Force developed recommendations for model legislation that were later formally endorsed by the SRS, the AASM, and the NSF.

The Legislative Process. Massachusetts Senator Richard Moore filed Rob’s Law at the beginning of 2006, but concerns about enforcement of drowsy driving legislation slowed its progress through the legislative system. In June 2006, however, amendments to the existing Junior Operator’s Bill that affects drivers-in-training and new drivers came up for consideration. Senator Moore recognized this as an opportunity to address drowsy driving among teenagers, which we were keen to pursue given the prominence of young drivers in drowsy driving crashes. Drowsy driving amendments were proposed to the Junior Operator’s Bill, but these stalled in committee initially. We therefore wrote a series of letters to the leaderships of both the Massachusetts House and Senate and to members of the Transportation Committees in each chamber that summarized the drowsy driving problem and requested further discussion about the issue. Ultimately, we met with several key Senators and personally presented the case for the bill. This proved to be critical, as the Junior Operators’ Bill then made it out of the Senate committee and was passed by the Senate as a whole.

This was not the end of the story, however. As the amendments to the Junior Operators’ Bill made by the Senate–including the drowsy driving amendments–had not been passed by the House of Representatives, the differences between the two versions had to be worked out in a Conference Committee. With the assistance of Representative Brad Hill, who championed passage of the Junior Operator’s Bill in the House, as well as the support of key Senators, these steps finally happened in December 2006. On December 26, 2006, the Conference Committee reported the final bill out favorably, including the language that the SRS Board had endorsed regarding drowsy driving. The bill then went to Governor Mitt Romney’s desk for signature. Governor Romney signed the bill into law on January 4, 2007, as one of his very last acts as Governor. Had he not signed the bill before leaving office, the bill would have died, and the entire process would have gone back to square one.

The new Junior Operators’ Bill contains three critical elements related to drowsy driving:

  • All junior operators are prohibited from driving from 12:30am to 5:00am, a time of high risk of a motor vehicle crash due to drowsiness.
  • All junior operators will receive training on sleep deprivation’s role in motor vehicle crashes as part of required driver education programs.
  • A special multi-disciplinary commission will be established to investigate the role of sleep deprivation in driving accidents, and to determine how scientific and legal standards should be applied to address this problem. The commission will make recommendations regarding development of education on drowsy driving, standards for determining drowsiness, and appropriate enforcement. Recommendations will be made to the legislature and governor by December 1, 2007.

Future Steps

On January 5, 2007, Governor Deval Patrick took office in Massachusetts. Formation of the Commission on Drowsy Driving is pending. At the same time, Rob’s Law, which would further extend the issue of drowsy driving to drivers of all ages, is being re-introduced into the current legislative session by Senator Moore.

 

We are very interested in sharing our experiences in Massachusetts with individuals who would like to spearhead similar efforts in their own states. Development of drowsy driving laws is unquestionably a complex process, but with careful deliberation, recruitment of legislative partners, and some effort, progress can be made. By working through these hurdles, sleep scientists have the opportunity to translate their research on sleep deprivation and performance into tangible public safety improvements. Widespread passage of evidence-based drowsy driving laws could eliminate many needless deaths.

Our recommendations

  • In order to advance legislation on drowsy driving, it will be essential to have one or two committed individuals in each state with background in sleep or circadian rhythms who will serve as scientific experts.
  • Using the model legislation endorsed by the SRS Board as a starting point, we would anticipate that from start to finish, development of recommendations, meeting with legislators, providing testimony, etc. will take between 30-50 hours of work, though the amount of work could vary considerably by state, depending on how actively one's legislative allies are working on the issue.
  • It is important to enlist the support of victims or families of drowsy driving crashes in your state whenever possible. Unfortunately, given the prevalence of drowsy driving crashes, this may not be difficult. A victim can be a key ally in the legislative process. The victim's senator and representative (as well as your own) could serve as a legislative champion.
  • Identifying legislative champions (ideally in both the Senate and House in each state) is an essential step. Legislators with leadership roles on public health and/or transportation committees are ideal, but approaching one's own or a victim's state senator and representative can be a good place to start. It is easier for a legislator's voting constituent to gain access to him or her than it is for someone from outside of a legislator's district. Let your representative's staff know where you live when trying to set up a meeting. Written letters and phone calls are both useful. When you get a meeting, come prepared with current laws from other states, local statutes (e.g. junior operator, drunk driving laws), and data on sleep deprivation and driving safety.
  • After identifying a champion, you will need to obtain the help of the legislator or his/her staffer to determine how best to introduce drowsy driving legislation. This may involve fostering additional allies initially, or having the legislator or staffer draft legislation with your help. The SRS model legislation and Massachusetts legislation may help with this.
  • Write letters to all key senators/representatives (on relevant committees) identified by your champion. Be sure to send copies of those letters to your legislative champion(s).
  • Try to engage the press. A newspaper article on a victim of a drowsy driving crash, an op-ed piece, or an editorial can be extremely effective ways of attracting the attention of the legislature and moving a bill along.
  • Be prepared to attend meetings/conferences and fundraisers, and provide testimony to legislative committees as needed.
  • Be patient. Development of legislation takes a long time, and requires the involvement of many people. Often, legislation will be introduced into the Senate or House for several years in a row before it gains sufficient momentum to move forward through the various committees to a vote. Regular meetings with legislators to provide additional information and ask how you can be helpful are essential for keeping your project moving forward.

We look forward to hearing from SRS members interested in pursuing this issue further.

Christopher P. Landrigan, M.D., M.P.H.
Director, Sleep and Patient Safety Program
Brigham and Women’s Hospital
Harvard Medical School
Member, SRS Presidential Taskforce on Sleep and Public Policy
617-525-7310
clandrigan@rics.bwh.harvard.edu  
Charles A. Czeisler, Ph.D., M.D.
Baldino Professor of Sleep Medicine
Brigham and Women’s Hospital
Harvard Medical School
Past President, SRS
President, SRS Foundation
617-732-4013
caczeisler@rics.bwh.harvard.edu