Drug Interaction Side Effects

MEDICAL REVIEW BOARD WARNING

FMCSA’s Medical Review Board has asked certified medical examiners to include the possible interaction of certain prescribed drugs in their decision on whether to medically qualify a driver. The issue is the prescribed mixture of both narcotics and depressants.

Primary care physicians have found this combination to be effective in treating certain medical problems. However, during a DOT
physical, the medical examiner should consider the potential side effects, which can include sleepiness as well as slowed or difficult breathing, and the affect on safety.

The Medical Board’s recommendation does not prohibit the use of these drugs by commercial motor vehicle drivers. To do that would require that FMCSA go through the rulemaking process.

This recommendation reinforces the point that medical examiners are charged with basing their qualification decision on the potential safety affects of the driver’s condition and treatment regimen. Even though the prescribed treatment may be medically sound, the driver may not be qualified if there are safety concerns.

Court Issues Ruling

SCREENING GUIDELINES CLARIFICATION

Most likely we’ll be waiting years for a Sleep Apnea Final Rule to become effective. Until then it comes down to recommendations from the Medical Review Board and company policy. Recently a court decision shed some light on this process.

Crete Carrier Corp. had a company policy that all drivers with a body mass index of 35 or higher must be tested for sleep apnea. Driver Robert Parker was notified that a test was required. He refused the test and went to his primary care physician. His physician wrote a note stating
that a test was not required. Based on this driver Parker again refused the test. The driver was suspended for failure to comply with company policies.

The driver filed a suit claiming wrongful termination. The Eight Circuit Court of Appeals recently handed down their decision. The court found that “The sleep study requirement is job-related because it deals with a condition that impairs drivers’ abilities to operate their vehicles. It is consistent with business necessity.” The company policy was found to be legitimate and non-discriminatory.

The current Medial Review Board recommendations cite a Body Mass Index of 40 or higher that should be used to trigger a sleep study. However, this is not a regulation, only a recommendation. Based on that and the recent court ruling, motor carriers can deviate from the recommendation since untreated sleep apnea can impair driving ability.

Roadcheck Results

IS IT ALL ABOUT PRE-TRIP INSPECTIONS?

The Commercial Vehicle Safety AlliDrugance has released the results of this year’s Roadcheck Event. Overall 4% of the drivers and 17.8% of the vehicles inspected were placed out of service. Taking a look at only the Level I inspections, the most comprehensive, the results are 3.4% of the drivers and 21.5% of the vehicles.

Of those drivers placed out of service, 63.2% were the result of hours of service violations. It will be interesting to see how this number is impacted next year as we get closer to the ELD mandate.

Of those vehicles placed out of service, the breakdown is:

• Brake Systems: 27.4%
• Tires / Wheels: 18.5%
• Brake Adjustment: 18.3%
• Lighting Devices: 11.7%
• No other violation is over 10%

There’s nothing new in those statistics, and some of them can easily be impacted by a thorough pre-trip inspection. However, is that the only factor here? Brake systems are the highest factor in vehicle out of service. This covers a lot of area but includes lining and brake drum condition as well as hose and slack adjuster condition. These conditions are not evident during a pre-trip inspection. Brake adjustment is the third highest cause of OOS, yet it’s not detectable during even the most diligent pre-trip inspection.

Holding drivers accountable for performing thorough pre-trip inspections is important. However, diligent vehicle maintenance is equally important. Tractors generally receive more attention than trailers because of engine servicing needs. Trailers often only get a thorough look during the annual DOT inspection.

For many carriers the Vehicle Maintenance BASIC is one of the most troublesome. The best plan to counteract this is to take a look at not only driver practices, but also examine your fleet maintenance cycles.

You can count on us to provide expert guidance to keep your safety and compliance programs on track.

Ryan Billet
National Transportation Consultants, Inc.