ct now to prepare for... New Commercial Driver Rules
By focusing on wellness, drivers can avoid licensing delays, medical expenses
By William Ferguson, M.D.
There are at least two reactions to pending changes in the Federal Motor Carrier Safety Administration regulations for commercial drivers set to take effect May 2014.
The 3 million commercial drivers affected, as well as the companies they work for, can either take evasive action to avoid the repercussions of increased scrutiny of driver's health, or ignore the consequences looming ahead and keep on trucking.
Once in place, a national database of commercial drivers will be used to track individuals and catch health problems that may otherwise have gone untreated. The goal is to identify drivers whose health may put them at increased risk for drowsy driving, which is attributed to 50,000 commercial driving crashes a year.
Rather than wait for the new regulations to take effect, I'm advising drivers and businesses act now by focusing on wellness. Drivers who are overweight can try to lose those extra pounds by eating healthy and exercising, and by getting screened for sleep apnea, diabetes and heart disease, conditions that are the focus of the new safety guidelines.
The road ahead
Commercial drivers already need a medical examination every two years, but starting in 2014, those check-ups will have to be performed by a specially licensed physician trained to screen for sleep apnea, diabetes and heart disease. Drivers with a body mass index higher than 35 (a man who is 5’10” and weighs 245 pounds has a BMI of 35) will automatically be issued a temporary license, pending the outcome of a test to evaluate whether he has a condition called sleep apnea. If a driver is diagnosed with sleep apnea, he must complete treatment for the condition, usually wearing a specialized mask that keeps his airway open during sleep. In order to comply with treatment, a person must wear the airway support mask at least 70 percent of the time for at least 4 hours each night and have it documented by a physician. Then a one-year license can be issued.
Because sleep apnea is a condition that is caused by obesity, one of the best forms of treatment is weight loss. In people with sleep apnea, the airway collapses during sleep, causing a person to stop breathing and triggering an alarm-like response that interrupts sleep. Lack of quality sleep not only affects how a person feels when he wakes up, but these interruptions caused by sleep apnea are also linked to hypertension, or high blood pressure, and hardening of the arteries, or heart disease.
While only a small percentage of crashes are actually caused by heart disease, it is responsible for a significant number of driver deaths and fatal crashes, according to the Safety Administration.
Who pays for the additional medical treatment and screenings? In most cases, it's the driver who bears the cost. My colleague at The Corvallis Clinic Occupational Medicine Department Christopher Swan, M.D., puts it this way. How many pounds do you need to lose for your BMI to be less than 35? Now calculate how much each of those pounds is worth in terms of actual dollars.
Depending on insurance coverage, a hospital sleep study can cost as much as $1,900. Although home tests that measure oxygen levels during the night are acceptable and available at a fraction of the cost of a sleep lab study, significant savings are still possible by losing weight and avoiding the need to be screened for sleep apnea, not to mention the multiple trips to the doctor for licensing.
Serving up solutions
Drive down any interstate or highway and you'll be inundated with advertising for a lifestyle that is at the heart of the problem. Let's face it, commercial drivers don't typically eat well on the road.
For starters, temptation is everywhere. Giant cheeseburgers on fast-food billboards. Free steak dinners with fuel fill-up at truck stops. Pictures of trailer-sized orders of french fries on commercial trucks themselves.
Truck drivers also tend to have an irregular eating schedule, they don't get a lot of exercise, and many of them smoke. So it may not be surprising that there's been little response in the trucking industry to the pending regulation changes. I know of only a few businesses that are doing anything at all to prepare.
From an occupational medicine doctor's perspective, that's the wrong approach.
You wouldn’t ignore the flashing caution lights warning of a sharp turn ahead. So why would you ignore the warnings about obesity and the health risks it poses? If you or your workforce need help losing weight, there are many new medically proven methods that a doctor can recommend.
There will be people who attempt to do an end-run around the new rules, but eventually, they’ll be the ones who have to jump through the extra hoops of increased regulation. A better solution is not to procrastinate and to save yourself time and money by acting now to address these real health and safety concerns.
Dr. Ferguson is an occupational medicine physician at The Corvallis Clinic at Walnut Boulevard in Corvallis. He can be reached at 541-753-1786.
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