The Trump administration is forging ahead with a controversial decision to scrap Obama-era plans to require that all truck, train and bus operators be screened for sleep apnea.

The elimination of the rule, part of the White House’s push to slash federal regulations, has reignited a debate over how to balance safety concerns with regulatory relief.

Safety advocates warn that killing the proposal could put lives at risk at a time when traffic deaths are already climbing at historic rates: Fatalities in large truck crashes have increased by 20 percent since 2009.

“It’s incredibly dangerous to think someone behind the wheel of an 80,000-pound rig might have this disorder and fall asleep while driving,” said Catherine Chase, vice president of governmental affairs for the Advocates for Highway and Auto Safety.

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The administration “has stepped away, instead of stepping toward, the problem of addressing fatigue. Truck death crashes are on the rise, and we need to think of solutions instead of taking away potential answers.”

Growing alarm over sleep apnea

The Federal Railroad Administration (FRA) issued a safety advisory last fall urging railroads to screen and treat workers for obstructive sleep apnea amid growing concern that the condition can cause workers to fall asleep on the job.

The recommendation was supposed to serve as a placeholder while the agency wrote new rules requiring railroads and other transportation companies to screen their operators for the sleeping disorder. The FRA also issued a safety advisory on the issue back in 2004, prompting some railroads to start their own sleep apnea programs.

The latest safety effort came in the wake of reports that the engineer of a New Jersey Transit train, which slammed into a crowded station platform and killed one woman, had severe sleep apnea but wasn’t diagnosed until one month after the crash.

The incident was just the latest example of an untreated sleep disorder being a factor in a fatal crash. The condition was linked to a 2013 Metro-North derailment in New York and a deadly 2000 tractor-trailer crash in Tennessee.

After the 2013 incident, in which the engineer dozed off before crashing, Metro-North tested its engineers and determined that about 18 percent of them suffered from sleep apnea.

Sleep apnea causes a person’s airways to close and stops their breathing during sleep, leading to potentially dangerous daytime drowsiness. In one severe case, a man with the condition was found to only be getting 15 minutes of restorative sleep per night.

That’s particularly concerning for commercial vehicle operators, who often work long shifts with irregular hours. Drowsy driving is responsible for tens of thousands of U.S. road crashes every year.

While airplane pilots with sleep apnea can’t even fly until they have been fully treated for the condition, it wasn’t until the Obama administration that formal federal mandates were in the works to ensure those operating planes, rails, buses and trucks were properly screened.

“If they’re not identified in the first place, how can they receive the treatment that they need?” Chase said.

Trump reverses course

The FRA and the Federal Motor Carrier Safety Administration announced last week, however, that they would be abandoning plans to require sleep apnea screening and treatment for all rail and truck operators.

The administration said it gathered significant information and held public listening sessions on the idea but “did not receive sufficient data to support future rulemaking at this time.”

“The agencies determined that current and upcoming safety programs appropriately address fatigue risks, including OSA [obstructive sleep apnea],” said a spokesperson for the Department of Transportation (DOT).

“FRA will continue to monitor railroads’ voluntary OSA programs and compliance with fatigue risk management plans, once implemented as part of risk reduction and system safety program.”

The industry, which lobbied against the change, points out that the White House’s action does nothing to prevent carriers and railroads from testing for sleep apnea, which many companies already voluntarily do, nor does it exempt drivers from a requirement to be regularly examined by a DOT-certified medical examiner.

Companies have also taken other measures to reduce fatigue, such as through modifying schedules and implementing training education programs.

“As an industry committed to safety, railroads recognize that employee fatigue is a real concern. Long before the FRA began examining standards, the industry took innovative steps to combat fatigue in the workplace,” said a spokeswoman for the Association of American Railroads. “Those efforts continue. Every railroad has their own plans to ensure crews are properly rested.”

Safety advocates argue that there is no enforcement mechanism or recourse if a company chooses not to screen and treat its employees for the condition.

“There’s no way to hold someone to that responsibility,” Chase said. “While one company may do it, another may not. Therefore you’re sacrificing the safety of all motorists.”

The National Transportation Safety Board said in a statement that it was disappointed that the FRA dropped the “much-needed rulemaking” and pointed out that sleep apnea has been the probable cause of 10 highway and rail accidents investigated by the safety board in the past 17 years.

Some members of Congress have slammed the decision, with Senate Minority Leader Charles Schumer Chuck SchumerVideo of Lindsey Graham arguing against nominating a Supreme Court justice in an election year goes viral Graham signals support for confirming a Supreme Court nominee this year Pelosi orders Capitol flags at half-staff to honor Ginsburg MORE (D-N.Y.) vowing to keep fighting for the proposal and Sen. Cory Booker (D-N.J.) calling the move “shortsighted and dangerous.”

Sen. Richard Blumenthal (D-Conn.) told The Hill he is spearheading a letter to demand a more thorough explanation from the administration about why it pulled the proposal.

“I was outraged. ... This rule reversal is inexcusable,” Blumenthal said Wednesday. “The slew of crashes and tragic incidents resulting from inadequate safety screening for sleep disorders are examples of why we need this rule.”

Will other safety rules get the ax?

The reversal is ratcheting up concern that other safety rules could get caught in the crosshairs of President Trump’s effort to reduce regulations.

The White House put out an executive order in January requiring agencies to revoke two regulations for every new rule they want to issue, with exceptions for emergencies and national security.

“There is a great deal of concern about what the White House push to slash regulations will entail,” said Henry Jasny, vice president and general counsel for the Advocates for Highway and Auto Safety.

Some rules in the pipeline that safety advocates worry could now be on the chopping block include a proposal requiring electronic speed limiters for large trucks and buses and a plan requiring all future vehicles to have safety signaling and communication technology.

Similar debates over how to maintain safety without over-regulating the transportation industry have played out in Congress even before Trump came to office.

In 2015, lawmakers suspended the Obama administration’s proposed changes to an “hours of service” rule that would have ensured truck drivers got more restorative sleep during the night.

Safety advocates say that the Trump administration could shoulder some of the blame if another deadly crash is linked to undiagnosed sleep apnea.

“Focus — this is really important — the Trump admin killing common sense safety regulations like these mean more accidents, more deaths,” said Sarah Feinberg, former FRA administrator under President Obama, in a tweet this week.