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Updated information about the FMCSA proposed medical ruling for CDL requirements.

According to Trasport Topics, the Federal Motor Carrier Safety Administration last week issued a final rule requiring all interstate truck drivers to prove they have passed medical examinations and proposed a separate rule setting up a national registry of qualified examiners.

The rule would require proof of an exam to obtain and keep commercial driver license.

This  new rule, long sought by safety advocates, also will require states to merge commerical driver license records and truk drivers’ medical examination certificates into a singe electronic record that law enforcement officials could check at any time.

Current federal regulations require that commercial drivers pass medical exams every two years, but in most states, drivers are required only to prove evidence of their medical certifications to their employers or when asked by roadside inspectors or law enforcement officers.

Under the new rule, drivers will be required to keep their state licensing agencies informed each time they pass their mandated medical exams, which is every two years for drivers who don’t have special medical conditions. Some drivers with medical problems are required to pass medical exams as often as every three months!

The new driver medical requirements are intended to help prevent medically unqualified drivers from operating on the nation’s highways by providing state licensing agencies with a means of identifying interstate CDL holders who are unable to obtain a medical certificate.

FMCSA also said this rule would deter drivers from submitting falsified medical certificates because enforcement personnel would have electronic access to information about the medical certificate and the identity of the medical examiner.

After the new rule is implemented, drivers will no longer be required to carry a medical certification care in thier wallets.

*Did you know… During 2007, FMCSA and its state partners conducted more than 3.4 million roadside inspections, citing drivers with more than 145,000 violations for failing to have medical examination  certificated in their possession and issued 6,105 violations for physically unqualified drivers.

It is said that the propsed medical examiners rule would help prevent “doctor shopping” and fraud.

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DOT (Department of Transportation) proposal requires testing

The U.S. Department of Transportation has proposed new regulations that would require truck drivers at risk for sleep apnea to get tested and treated in order to obtain their licenses.

The move is aimed at reducing the number of truck crashes caused by driver fatigue, said Rex Patty, a nurse practitioner at WorkCare, a regional healthcare in Topka, Kan.  The Federal Motor Carrier Safety Administration estimates that approximately 141,000 large truck crashes that occurred during a 33-month study perios  18,000 or 13% were related to drivre fatigue.

Not all driver fatigue is the result of sleep apnea, but about 28% of truckers amy be at risk, compared to around 10% in the general population, said Patty.

Drivers with certain risk factors for OSA would be evaluated by a DOT provider and, if necessary, referred to their private physician for a sleep study.

It is estimated that 45% to 50% of (at risk) drivers will need additional evalation, and 70% of that outcome would need treatment known as the CPAP therapy; or Continouse Positive Airway Pressure.

Drivers diagnosed with OSA would need at least one week of treatment before they could get back behind the wheel. They would need to meet a minimym compliance of four hours or more each night 70% of the time, with periodic re-evaluations to maintain their license.

Trucking companies and independent drivers aren’t embracing the proposed rules. The most talked about is cost. On average, and depending on the severity of a persons OSA, CPAP machines and specific testings could cost up to $1,000.

  Cost concerns go well beyond intitial diagnosis and treatment.

DOT made is very clear that ‘If they are not compliant, they are disqualified to drive.’  Trucking companies can have a driver they depend on that can’t drive, and at this point, nobody knows how they get re-qualified. They are still under determination for what that may mean.

  It could be six months to a year before the proposal is finalized.

Sleepy brains prone to power failure:

 Being deprived of sleep even for one night can make the brain unstable and prone to sudden shutdown, like a power failure- brief lapses that hover between sleep and wakefulness.

  It’s as though it is both asleep and awake and they are switching between each other very rapidly, causing such disorientation in a sleep deprived person. Imagine your sitting in a room watching a movie with the lights on. In a stable or wakeful brain the light stay on all the time, where-as a sleep brain, the lights will suddenly go off and you’ve dozed off, unaware.

  The findings also suggest that people who are sleep deprived alterante between periods of near-normal brain function and dramatic lapses in attention and visual processing. Researchers did brain imaging studies on 24 adults who performed simple tasks involving visual attention when they were well rested and when they had missed a nights’ sleep.

  The researchers used a type of brain imaging know as functional magnetic resonance imaging or fMRI, which measures blood flow in the brain.

  They found significant, momentary lapses in several areas of the brain, which seemed to frequently falter when the people were deprived of sleep, but when these same people were well rested. These people were doing tasks and trying to work very hard through their sleepiness, to remember what they had learned.

  These lapses seem to suggest that loss of sleep renders the brain incapable to fully fending off involuntary drive to sleep. The study also makes it clear how dangerous sleep deprivation can be while driving on a highway, when even a four-second lapse could lead to a major accident.

…Yup, Driving Under Influence of Sleeping Pills!

  Now there has become a growing hazard on the roadway, the kind where motorist smash into parked cars, plows over sidewalks and drives in the wrong direction, all the while oblivious to the destruction thats left behind, it’s a new kind of hit and run! -These drivers aren’t drunk, stoned -they’re under the influence of Ambien, the newest popular prescription sleeping pill!

  Ambien is regularly popping up as a factor in traffic arrests, involving drivers who don’t even remember getting behind the wheel; according to a post found in The New Yourk Times.

  In some states toxicology laboratories, Ambien showed up in the top 10 list of drugs found in impaired drivers. In Wisconsin, Ambien was detected in the bloodstreams of 187 arrested drivers from 1999 to 2004.

  And as more insomniacs turn to this drug -(not like there aren’t other ways to getting a better nights sleep…) but there were 26.5 million prescriptions filled last year in the United States alone! Ambien-related arrests and accidents are expected to be on the rise! -So watch out for the mid-Westners!

   [Here is a good one]: In Washington state, officals counted 78 impaired-driving arrests in which Ambien was the factor, last year. Up from 56 cases in 2004. Some of Washington’s zombie-like drivers said they took the pill while behind the wheel so that it would kick in by bedtime!-

“Wow, that’s a really bad idea,” said sleep special Dr. Brook Judd, as assistant professor on medicine. “These newer sleep medications have a rapid onset so people can get to sleep quickly. You shouldn’t take them until you are really ready to go to bed.” >Don’t doctors pound this into patients heads when they are getting evaluated for these kind of things (drugs)?

  Several cases also involved drivers using alcohol with Ambien -a combination that magnigies the drowsy- lifeless effects of this drug.  A spokeswoman for the Food & Drug Admin told the newspaper that the agency is aware of the reports of people driving while sleepwalking, but said that the drug’s current warning lable states, …Should not be used with alcohol and in some cases could cause sleepwalking or hallucinations, which were adequate. Users are advised not to drive or operate machinersy while taking the drug. > So whats wrong with this picture? We have warning labels for a reason…right?

  Laura J. Liddicoat, the forensic toxicology supervisor at Wisconcin’s state lab, resented six cases of Ambien drivers at a meeting of the American Academy of Forensic Scientisits, including a man who crashed into two cars and drover a curb. This was all news to him when he came to in the police station!

😉

 

drowsy-driver.jpg   People with obstructive sleep apnea have a markedly increased risk of severe motor vehicle crashes involving personal injury. The study of 800 people with sleep apnea and 800 with a nighttime breathing disorder found that patients with sleep apnea were twice as likely as people without sleep apnea to have a car crash, and three to five times as likely to have a serious crash involving personal injury. Overall, the sleep apnea group had a total of 250 crashes over three years, compared with the 123 crashes in the group without sleep apnea.

  drowsyy-driver-deterent.jpg While many previous studies have shown that sleep apnea patients are not increased risk of car crashes, this study is the first to look at the severity of those crashes. Upon comparison, many of the sleep apnea patients’ crashes involved personal injury, but that some patients had fairly mild sleep apnea were at increased risk car crashes. Based on those findings, it is now considered driving risk when deciding on treatments for patients with mild sleep apnea.

  tired-sleepy-driver.gif The study is the biggest one to combine validated sleep apnea diagnosis through an overnight sleep study called polysonography, with data from insurance records to verify motor vehicles crashes and their severity. In obstructive sleep apnea, the upper airway narrows, or collapses, during sleep. Periods of apnea end with a brief partial arousal that may disrupt sleep hundreds of times throughout the night. Obesity is a major risk factor for sleep apnea            

snoring-smiling-face.jpg This study also found that while in the general population men have more vehicle crashes than women, among sleep apnea patients, men and women actually crash at a similar rate. Although, the issue of treatment is not addressed by this study, data from other groups suggest that crashes related to sleep apnea are preventable.


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