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FMCSA convenes medical board to review sleep apnea sentiment

Aug. 9, 2016
Trucking groups question need for rulemaking, costs, impacts

The public comments are in, but before moving forward with a rule to address obstructive sleep apnea (OSA) in truck drivers, the Federal Motor Carrier Safety Administration wants to hear from its panel of medical experts.

In an announcement published Tuesday, FMCSA has called a meeting of its Medical Review Board for later this month, during which the five medical professionals will make recommendations to the agency as to the public’s views on the Advance Notice of Proposed Rulemaking regarding sleep apnea, published in March.

Nearly 600 comments were filed with the docket, and the agency held three listening sessions around the country to hear from truck drivers, medical practitioners, trade groups, and fleets on opportunities and challenges for determining the extent of OSA in “safety sensitive” transportation positions, and for possible screening and treatment solutions.

“As with any regulation, any future rule to require OSA screening and treatment for commercial truck drivers should be based on sound data and analysis, including the potential costs and benefits,” American Trucking Assns. says to open its formal comment. “It is also vital that FMCSA have a firm understanding of the actual crash risk that OSA poses, of which there has been minimal data to date.”

Along with posing numerous issues with regard to current crash data and sleep science, ATA emphasizes the need for any rule to “minimize cost and operational burdens,” such as allowing medical examiners (MEs) to grant drivers “conditional qualification status” so they that can continue to work through the OSA evaluation process. The agency should also avoid requiring a driver who has previously undergone a sleep test to submit to a follow-up test when seeking to renew the medical certification, ATA suggests.

ATA also argues that, “far too often,” drivers are designated for screening because they exhibit a single risk factor, and that MEs should be directed “to be cautious” when using the potentially misleading body-mass index (BMI) when assessing overall health.

In its filing, the Owner-Operator Independent Drivers Assn. notes the “substantial” impact an OSA regulation could have on small business truckers—90 percent of DOT authorized carriers. OOIDA notes that the cost of screening and treatment is a “very significant concern” for its members.

“OOIDA opposes any regulations requiring OSA screening until FMCSA identifies OSA as the cause of a not-insignificant number of truck crashes,” OOIDA states. “FMCSA should then be able to demonstrate that there are valid, reliable methods of screening and treatment for OSA that evaluate every driver under uniform procedures that can be followed by all medical examiners. Finally, that screening and those treatments should be amenable to clear and coherent regulations.”

The organization also argues that the rulemaking “exposes the unconstitutional vagueness” of the FMCSA’s current medical certification rule, which now lists sleep apnea in the updated medical certification form. The agency added this criterion to the form without the deliberation and analysis that is required of the rulemaking process, according to OOIDA.

“The comments to the rulemaking clearly illustrate that until the Agency decides upon well-defined, concrete rules (or decides that no such rules are possible), drivers will continue to be subjected to dramatically different, or no certain, standards for OSA referral, diagnosis and treatment, and incur dramatically different burdens and costs,” OOIDA says, before concluding that flexibility in the hours of service rule would provide “a greater and immediate impact on driver safety” than an OSA rulemaking.

The complete set of comments is available here.

The MRB meeting will be held on Monday and Tuesday, August 22-23, from 9 a.m. to 4:30 p.m., EDT, at the FMCSA National Training Center, 1310 N. Courthouse Road, Arlington, VA, 6th floor. It is open to the public and oral comments from the public will be heard during the meeting, subject to the discretion of the chairman, according to the FMCSA notice.

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