DOT Medical Board Issues Sleep Apnea Screening Recommendations

Following a two-day session last week, the Federal Motor Carrier Safety Administration’s (FMCSA) Medical Review Board issued recommendations after examining obstructive sleep apnea (OSA) and its relation to commercial motor vehicle (CMV) drivers, such as ready mixed concrete mixer truck drivers. While the Medical Review Board doesn’t hold any regulatory power to mandate the recommendations, this is the latest development in the efforts by both FMCSA and the Federal Railroad Administration (FRA) to craft new regulations for testing and treatment of OSA for CMV drivers and train conductors.

The Medical Review Board’s recommendations, in part, include suggested OSA screening for:

a.Individuals with a Body Mass Index (BMI) ≥ 40 mg/kg2.

b.Individuals with a BMI ≥ 33 and < 40 mg/kg2 in addition to and at least three or more of the following:

i.Hypertension (treated or untreated);

ii.Type 2 diabetes (treated or untreated);

iii.History of stroke, coronary artery disease or arrhythmias;

iv.Micrognathia or retrognathia;

v.Loud snoring;

vi.Witnessed apneas;

vii.Small airway;

viii.Neck size > 17 inches (male), 15.5 inches (female);

ix.Hypothyroidism (untreated);

x.Age 42 and above; or

xi.Male or post-menopausal female.

This past May, NRMCA testified before FMCSA and FRA on potential new requirements for testing and treatment of OSA for CMV drivers. NRMCA testified that such a new regulation is redundant, as there is already a current framework in place to manage OSA among drivers. As well, NRMCA stated there are drastic implications for drivers outside of any health considerations that should by examined; such as financial hardship and future employment obstacles. Both FMCSA and FRA will likely look to the recommendations for crafting a final rule on OSA.