67-4

5/90

Women in their 50’s: just under 10%Men in their 50’s: 10-20%22)At least 80% of moderate or severe obstructive sleep apnea (OSA) among the middle-aged24)Excessive daytime sleepiness detected by the Epworth sleepiness scale (ESS) may fail to identify those with SRBD1). OSA: 1.21 ~ 4.8920)people in Japan suffer from glaucoma, and 90% of them are not aware of their condition5). Glaucoma affects one in 20 people aged 40 years and over in Japan6). The number of patients is thought to increase in this aging society. Previous studies showed that most glaucoma patients were usually unable to detect their own visual field defects until the changes had reached an advanced stage7).Glaucomatous visual field defects have been associated with motor vehicle accidents previ-ously8-11). A previous study reported that traffic accidents were 1.65-fold more frequent in drivers with glaucoma8). McGwin demonstrated that patients with moderate or severe visual field defects with glaucoma in the worse eye incur a higher risk of traffic accidents than those with no visual field defect9). Elsewhere he reported that drivers with glaucoma whose visual fields were impaired as defined by pattern deviation were involved in at-fault traffic accidents twice the frequency of those not severely impaired10). Various reports examined the parts of drivers’ visual fields in which defects are significantly related to traffic accidents8, 10, 12, 13). In addition, drivers with glau-coma had greater impairment in their observation ability, lane positioning and planning approach, and their errors were more common at intersections, Table 2　Glaucoma and sleep-related breathing disorders (SRBD) share the common characteristics of high prevalence, unrecognized symptoms and increased involvement of those affected in motor vehicle accidents (MVAs).PrevalenceUnder-diagnosisFold increase in MVAs*Further evidence still needs to be established11).Ophthalmologic disorders (glaucoma, cataract, etc.)Sleep-related breathing disorders (SRBD)Cardiovascular diseases (arrhythmias, infarctions, etc.)Neurological conditions (stroke, syncope, dementia, epilepsy, seizures, etc.)Chronic respiratory failureOtolaryngological disorders (vertigo, hearing loss, etc.)HypoglycemiaAllergic disordersDrug-associated conditionsGlaucoma5%6)50 ~ 90%23)At-risk for accidents＊8-10)Table 1　Possible causes of health-related traffic accidentsboth traffic light-controlled and right-of-way-con-trolled14). Older drivers with glaucoma had delayed hazard response times and first fixation on hazards, and therefore they need to improve their rapid eye movements to detect hazards effectively15), leading to significant changes in the pattern of eye move-ments in patients with glaucoma16). Screening is important considering the occurrence of serious traffic accidents.Glaucoma share some common characteristics with SRBD, which is also attracting attention as a cause of traffic accidents (Table 2). SRBD impair night-time sleep quality and quantity, leads to excessive daytime sleepiness, fatigue, inattentive-ness resulting in traffic accidents17-19). Obstructive sleep apnea (OSA) was accompanied by a 1.21 to 4.89-fold increase in risk for traffic accidents20). Drivers with SRBD who did not adhere to their treatment were involved in five-fold more acci-dents than those who did21). Glaucoma and SRBD are highly prevalent6, 22), and thus a strategy should include screening a broader range of the popula-tion. They potentially cause serious accidents in the workplace, especially for those working in transportation services. Both glaucoma and SRBD SRBD325Glaucoma and SRBD