Medical Registry for Regulated Drivers

From the Federal Motor Carrier Safety Administration:

The National Registry of Certified Medical Examiners (National Registry) is a new Federal Motor Carrier Safety Administration (FMCSA) program. All commercial drivers whose current medical certificate expires on or after May 21, 2014, at expiration of that certificate must be examined by a medical professional listed on the National Registry of Certified Medical Examiners. Only medical examiners that have completed training and successfully passed a test on FMCSA’s physical qualification standards will be listed on the National Registry.

Additional details can be found by clicking HERE (National Registry Home Page) and HERE (FAQ about the new program).

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Driving and Vision Disorders

The National Highway Traffic Safety Administration (NHTSA) offers many resources for a wide range of safety concerns.

Here is an example of one of their latest videos:

You can find many more video based resources at NHTSA’s You Tube page — http://www.youtube.com/user/USDOTNHTSA

 

More Drivers Testing Positive for Pot…

CDOT Drugged driving 1Several news reports have been published recently citing an apparent increase drivers testing positive for marijuana in Washington State since it was legalized in January.

According to Reuters:

In the first six months with pot legal in the state, 745 drivers stopped by police tested positive for the drug’s psychoactive ingredient, THC, in their blood, the data show.

Over half of those were over the state’s new legal limit of 5 nanograms of THC per milliliter of blood.

By contrast, in each of the last two full years, about 1,000 drivers who were pulled over tested positive for THC.

The increase comes despite the fact that recreational-use pot stores will not open in Washington state until next year.

Washington State Patrol spokesman Bob Calkins said the findings, while preliminary, indicate more people may be driving impaired than was the case before Washington and Colorado in January became the first states to legalize recreational use of the drug.

Whether people are driving under the influence of pot, alcohol or prescription drugs, Calkins said, “It all comes back to a bad decision to drive while impaired.”

Interestingly, the number of people pulled over by the State Patrol (on suspicion of driving under the influence of EITHER drugs or alcohol) during the same time period was roughly the same as each of two prior years (they’re not pulling more people over, but more have been testing positive).

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A New York Daily News article that covers the situation in Washington State mentioned the following:

Washington State Patrol says it found THC, marijuana’s psychoactive ingredient, in the bloodstream of 745 drivers pulled over this year.

That’s a nine percentage point increase from where we were last year at this time, Sgt. Jason Hicks explained.

“It was previously illegal to drive under the influence of marijuana and it remains illegal,” Mason Tvert, spokesperson for the Marijuana Policy Project (MPP), told the Daily News.

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Drugged Driving: What is it?

NOTE: This article is part of a series investigating the definition of “impaired driving” as it occurs in society, traffic safety and driver safety professional networks.

Drugged driving, which can include a range of situations, seems to be on the increase.  I have to say “seems to be” since data collection and roadside testing are not as consistent for this issue as for other impairment issues such as drunk driving.

Drugged driving can occur from a number of situations:

  • use of OTC medicines,
  • use of prescription medications,
  • recreational use of illicit drugs,
  • chronic (repeat) use of illicit drugs,

Technically speaking any driver can use cold and flu remedies and drive, but if they’re involved in a crash, it may come back to haunt them in hindsight.  Many of these remedies plainly state that users should not drive withing a specified amount of time of using the medicine.

Prescribed medications can affect driving ability and it’s the duty of the doctor to make drivers aware of the possible side effects.  Per Federal regulations:

Title 49 CFR 382.213 states:

No driver shall report for duty or remain on duty requiring the performance of safety sensitive functions when the driver uses any controlled substance, except when the use is pursuant to the instructions of a licensed medical practitioner, as defined in Sec. 382.107 of this part, who has advised the driver that the substance will not adversely affect the driver’s ability to safely operate a commercial motor vehicle.

For regulated drivers (Commercial Motor Vehicle operators), there is effectively zero tolerance for illicit drug use.  So even though medical use of marijuana is legal in 18 U.S. states, regulated drivers are expressly prohibited from driving while under the influence of controlled substances; however  it’s possible that a non-regulated driver may drive while under the influence of marijuana depending on their state and local laws (most treat drugged driving as a zero tolerance policy, but not all).

For non-regulated drivers, most state laws include drugged driving with their drunk driving statutes, but some are beginning to separate the legislation to improve recordkeeping and statistics.  California is one of these states.  Specifically, AB 2552 moves each of the DUI categories – alcohol, drugs, and alcohol plus drugs – into separate sections of the vehicle code.  In other states, such as Washington and Colorado which recently approved the legalization of marijuana for recreational use will have to decide how to handle drugged driving.  Early discussions have focused on determining milligrams of THC in the blood which is a parallel approach to measuring Blood Alcohol Content (although detractors claim that THC and alcohol impair people in different ways, etc.)

The impact of these initial steps to legalize recreational marijuana use on driving and crashes is hard to predict, but the increased availability may be an indicator that crashes from this form of drugged driving may rise.

A recent news report (click here) stated that;

“If a California company has its way, recreational marijuana users in Colorado and Washington state will one day be able to get their pot out of vending machines. “One day we envision these machines to be accessed, when it’s allowed, 24 hours a day,” Vincent Mehdizadeh, the founder and chief consultant of a subsidiary of Medbox that produces, installs and consults on the vending business, told NBC News. “

While firms look for additional ways to market marijuana to consumers, California is work to better understand the current scope of drugged driving.  The California Office of Traffic Safety (OTS) recently conducted a survey of drivers and found that:

  • more drivers tested positive for drugs that may impair driving (14 percent) than did for alcohol (7.3 percent). 
  • Of the drugs, marijuana was most prevalent, at 7.4 percent, slightly more than alcohol.

  • Of those testing positive for alcohol, 23 percent also tested positive for at least one other drug. This combination can increase the effect of both substances. 
  • Illegal drugs were found in the systems of 4.6 percent of drivers
  • 4.6 percent also tested positive for prescription or over-the-counter medications that may impair driving.

  • More than one quarter (26.5 percent) of drivers testing positive for marijuana also tested positive for at least one other drug. 

According to the press release (click here) from OTS, the survey was conducted in the following manner:

“Over 1,300 drivers voluntarily agreed to provide breath and/or saliva samples at roadside locations set up in nine California cities.  The samples were collected between 10:00 p.m. and 3:00 a.m. on Friday and Saturday nights, the peak times of impaired driving.  Breath samples were examined for alcohol, while saliva samples were tested for THC (the active ingredient in marijuana), major illegal drugs, plus prescription and over-the-counter medications that may adversely affect driving.”

Summary

Drugged driving is a serious issue.  Crash reductions and traffic safety are every driver’s responsibility.  Being qualified medically, and being fit from a wellness standpoint, are critical to operating in a “safe manner”.  Employers may be uncomfortable with delving into the wellness of their employees, but ignoring it doesn’t work to prevent crashes either.  Education about the issue is a good place to start so that employees will be enabled to make better choices on their own about staying healthy behind the wheel.

Ultimately, employers who are already moving towards “zero tolerance” of the use of hand held cell phones and texting should be ready to institute similar policies against driving while buzzed on medications, OTC caplets or recreational drugs.

What do you think?  Join the discussion at our Facebook page, or our Linked In networking group.

About SafetyFirst — we are a driver safety firm offering best-in-class services to fleets throughout North America.  We have many imitators, but our programs have been repeatedly validated in head-to-head comparison to our competition.  Whether you are looking for a better coaching program, a way to translate greater savings from your existing telematics program, or to streamline your record-keeping processes for better management reporting (and less work), talk to us — we can help.

The Doctor is Out…Driving While Medically Unqualified

NOTE: This article is part of a series investigating the definition of “impaired driving” as it occurs in society, traffic safety and driver safety professional networks.

The Federal Motor Carrier Safety Administration (FMCSA), has enforced regulations to prevent drivers from operating Commercial Motor Vehicles while impaired in a number of ways.  One area that the organization has been working very hard to enhance is keeping medically unqualified drivers from behind the wheel.
Traditionally, this has been done (mainly) by requiring a biennial (once every two years) or more frequent (if a notable health/medical condition exists) visit to a certified medical doctor for a physical exam.  To provide an additional set of elements to the “safety net” there are substance abuse testing protocols completed by the employer, and roadside inspections to spot driver irregularities during the course of the year.
In theory, this system of checks and balances should capture the majority of exceptions and assure a consistent pool of qualified drivers.  However, a recent report published in November 2012 by the Government Accountability Office (GAO) “…found that these controls were vulnerable to abuse or manipulation.”  This report describes key controls designed to prevent medically unfit or impaired commercial drivers from operating commercial vehicles, and examples of commercial drivers with potentially disqualifying impairments related to epilepsy, drugs, or alcohol who managed to drive despite the existence of the key controls.
It also points out how some of the worst issues will be addressed by MAP-21 (link to summary here)
The study that led to the report was conducted in the following manner:
“To identify key controls, GAO reviewed FMCSA policies and regulations, and interviewed officials. Cases were identified on the basis of FMCSA roadside-inspection data, DOT’s Commercial Driver License Information System (CDLIS), a national database of all commercial drivers, and SSA disability insurance files. From this analysis, GAO identified commercial drivers who were driving with an epilepsy diagnosis. GAO also randomly selected 100 individuals to determine whether the driver was receiving SSA disability benefits when the state issued or renewed the driver’s CDL.” [underline added for emphasis]
Notable findings from GAO report summary:
“Matching CDL holders with Social Security Administration (SSA) disability files produced 204 commercial drivers who drove a commercial vehicle as recently as 2011 despite having epilepsy, a disqualifying medical condition characterized by sudden seizures and unconsciousness. Thirty-one of these drivers were involved in accidents, demonstrating the threat to public safety posed by medically impaired drivers. GAO also identified 23 cases where state licensing agencies issued or renewed CDLs for drivers after they were, according to SSA records, diagnosed with epilepsy or had drug or alcohol dependence noted, which could also disqualify them from driving under DOT regulations.  However, because DOT did not require state licensing agencies to maintain drivers’ medical certifications at the time of GAO’s review, it is unlikely that states knew of the drivers’ conditions. In fact, they were unable to provide medical certifications for any of the 23 individuals. States are now required to electronically store medical certificates for new and renewing CDL applicants and will be required to electronically maintain this information for all CDL holders by January 2014. Doing so could help prevent ineligible drivers from obtaining or renewing CDLs in the future.”

Here is a link to the full GAO Report – http://www.gao.gov/assets/660/650388.pdf

Bottom-line is that drivers with “serious medical conditions” can still meet FMCSA fitness requirements because “…medical determinations rely on subjective factors and patient self-reporting, [therefore] it is not possible to systematically determine whether these drivers had disqualifying medical conditions.”

This will require changes to how medical qualifications are completed and recorded.  The GAO report summarizes several key changes that are on the way or will be here very soon:

  • “As of January 30, 2012, individuals renewing or applying for a CDL must submit a copy of their current medical certificate to their state licensing agency, making state licensing agencies responsible for ensuring that drivers have current medical certificates on file.
  • “In April 2012, FMCSA published a final rule establishing a National Registry of Certified Medical Examiners.
  • “The 2012 final rule provides requirements for all healthcare professionals responsible for issuing medical certificates for interstate truck and bus drivers to complete a training course on the Federal physical qualifications rules and to pass an examination to assess the examiners ability to apply the rules, and advisory criteria in a consistent manner when making the determination whether a driver meets the qualification standards.
  • “FMCSA has announced its plans to initiate a new rulemaking that would enable the agency to require medical examiners on the National Registry to submit to the agency the medical certificate information on each individual who applies for a medical certificate. The agency would then have the ability to transmit to the state driver licensing agency the medical certificate. This process will significantly decrease the likelihood of drivers being able to falsify medical certificates.
  • “Specifically, the law [MAP-21] requires DOT to establish, operate, and maintain a national clearinghouse with records relating to the results of positive drug and alcohol tests of commercial drivers or instances of refused tests. Once the clearinghouse has been established, employers must request and review their CDL drivers’ records from the clearinghouse annually. The MAP-21 Act also requires DOT to develop a method to electronically notify an employer of each additional positive test result or other noncompliance.
  • “Specifically, the law requires DOT to establish, operate, and maintain a national clearinghouse with records relating to the results of positive drug and alcohol tests of commercial drivers or instances of refused tests. Once the clearinghouse has been established, employers must request and review their CDL drivers’ records from the clearinghouse annually. The MAP-21 Act also requires DOT to develop a method to electronically notify an employer of each additional positive test result or other noncompliance.

Summary

Drivers have a responsibility to be safe while behind the wheel.  Employers (motor carriers) have a responsibility to properly qualify and monitor the ongoing qualification status of those who drive for them.

Driver impairment, whether from drugs, alcohol, fatigue or medical conditions is foreseeable (through testing and qualification programs) and preventable so long as everyone does their part. 

To find out in hindsight that heavy vehicle crashes occurred where drivers were also receiving Social Security Administration disability benefits (and were not medically qualified to drive) is tragic if it were a mistake and a travesty if it occurred knowingly but was ignored.

SafetyFirst specializes in driver safety programs for both regulated and non-regulated fleets.  We have clients throughout the USA and Canada utilizing a wide range of proprietary database systems (for compliance with company or Federal policies affecting drivers, crash reporting, training documentation, qualification reminders, etc.), hotline coaching programs, and varied training/educational approaches.  We also consult with larger fleets and insurance carriers on developing strategies to assure effective implementation of telematics programs and other high capital projects where safety results depend on data analysis and translation to behavior safety outputs to realize and capture measurable gains.