FMCSA Pulls Back on Sleep Apnea, Removing Exemption Requirement for Diabetic Drivers

The Federal Motor Carrier Safety Administration (FMCSA) has made significant announcements regarding two pending rulemakings, first the obstructive sleep apnea ANPRM and the notice concerning elimination of the exemption requirement for Diabetic drivers.
 
Sleep Apnea Rulemaking Withdrawn
 
Despite noting lingering concerns about the potential dangers of obstructive sleep apnea, FMCSA also announced in the Federal Register on Aug. 7 plans to formally withdraw a 2016 advance notice of proposed rulemaking seeking information on the potential for adopting standards to assess risks associated with transportation workers in safety sensitive positions diagnosed with apnea.
 
“The agencies have determined not to issue a notice of proposed rulemaking at this time,” the announcement said. “OSA remains an on-going concern for the agencies and the motor carrier and railroad industries because it can cause unintended sleep episodes and resulting deficits in attention, concentration, situational awareness and memory, thus reducing the capacity to safely respond to hazards when performing safety sensitive duties,” the announcement said. “The agencies received valuable information in response to the ANPRM and a series of public listening sessions in May 2016.”
 
The announcement also said, “The agencies believe that current safety programs and FRA’s rulemaking addressing fatigue risk management are the appropriate avenues to address OSA.”
 
The ANPRM sought information from interested parties regarding moderate to severe obstructive sleep apnea “to better inform their decision on whether to take regulatory action and, if so, how to craft the most effective and efficient regulations to address the potential safety risks associated with untreated OSA.”
 
One of its ultimate aims was to offer guidance to medical examiners on how to diagnose apnea when they administer physical exams.
 
In the ANPRM, the two agencies posed a series of questions addressing several areas, including:
 
• Whether apnea is a problem among individuals occupying safety-sensitive positions in highway and rail transportation;
• Cost and benefits of regulatory actions that address the safety risks associated with motor carrier and rail transportation workers in safety-sensitive positions who have OSA;
• Qualifications and restrictions for medical personnel;
• Treatment effectiveness.
 
The agency reminded medical examiners that there are no FMCSA rules or other regulatory guidance and that medical certification determinations for drivers are made by the examiners based on their medical judgment rather than a federal regulation or requirement.
 
Although welcomed by medical professionals and nonprofit safety groups, the prospects of regulatory guidance for driver diagnosis and treatment of obstructive sleep apnea raised concerns in the industry.

New Driver Diabetes Form For Medical Professionals
 
The FMCSA took another step toward removing a requirement that all drivers with insulin-treated diabetes seek a formal exemption to be allowed back behind the wheel.
 
In a Federal Register announcement, FMCSA said it is seeking public comment on a new form that could be used by the treating clinician to help better evaluate an insulin dependent diabetic commercial motor vehicle driver’s reaction to treatment and ability to drive on an annual basis, rather than relying on decisions by medical examiners and an FMCSA panel who have never treated the driver. This new form was recommended by the agency’s Medical Review Board as part of a review of the existing exemption process.

FMCSA said that following the medical board’s evaluation, it is considering the use of a new assessment form that would include a variety of information about a driver’s diabetes collected by the treating physician. The form would include information about insulin use, blood glucose monitoring, progressive eye diseases, and other relevant signs of possible complications, and would be passed on to the certified medical examiner administering a driver’s physical.
 
“Information used to determine and certify driver medical fitness must be collected for our highways to be safe,” the agency said. “FMCSA expects that 100 percent of drivers who are treated with insulin and intend to operate a commercial motor vehicle in interstate commerce will have the form completed by the treating physician.”

Comments are due by Aug. 28.

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