No, this is not the death toll of the last five years from the war in Iraq. That number is less: 4,438 as of July 30, 2008. These 2006 numbers are the most recent data available for motor vehicle crashes involving large, commercial trucks in the United States. A recent AP article made headlines and newscasts around the country with this data. The article made note of how many unqualified drivers were qualified in error by medical examiners.
The Government Accountability Office found that many drivers had been passed on the medical exam, yet were receiving disability benefits for conditions which specifically excluded them in the qualification guidelines. These basic guidelines accompany every physical form a physician, nurse practitioner or physician assistant signs.
So what has gone wrong to make trucking one of the deadliest jobs in the U.S.? The Federal Motor Carrier Safety Administration summarized eight problems and gave recommendations for correction in 2001. One of the recommendations would require a minimum qualification standard for physicians, nurse practitioners and physician assistants. This requirement may take effect in 2009 and will require medical examiners to take a course and be certified to perform the exams. It will be similar to the examiner requirements needed to perform flight physicals for pilots. This effort would ensure that the examiner is familiar with the medical standard necessary for commercial drivers to safely perform their jobs.
It is readily apparent that a commercial truck or bus weighing up to 80,000 pounds can be deadly when it loses control and crashes. Medical problems including seizures, heart disease, anemia and uncontrolled sleep apnea are increased risk factors that compromise the safety of a commercial driver to safely operate a vehicle. Unfortunately, many medical examiners continue to “pass” drivers with these medical problems despite the explicit regulations against clearance.
Federal Motor Carrier Safety Regulations state that the employer is ultimately responsible for finding and using medical examiners “knowledgeable in the mental and physical demands required” and “proficient in the use of and use the medical protocols necessary to perform the medical examination.” A training course is now available for examiners wanting to pre-empt the requirement’s mandate. Companies should inquire whether their drivers’ examiner has the knowledge of the protocols required by the federal regulations. It is not always acceptable to have a driver have his physical performed by his personal doctor.
I frequently see clarification notes from a driver’s personal doctor stating the driver is “OK” to work because his diabetes is controlled by insulin, or his heart disease is stable with nitroglycerine. Rather, these problems disqualify a driver. I also see drivers with hypertension qualified for two years. A driver with hypertension, even if controlled, may only be certified for one year. Drivers are required to sign oaths affirming the truthfulness of their provided information. When disqualification means loss of livelihood, a subtle motivation for dishonesty can easily become an overt act of fraud.
The physical examination is neither complex nor difficult, but medical examiners must know the regulations regarding medical conditions that endanger commercial drivers and roadway travelers. Please call your medical examiners and ask if they are qualified to perform your commercial drivers’ examinations. iBi