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No federal requirements for OSA!?

Posted: Mon Jun 11, 2018 11:48 am
by drjchill
This is in the Spring 2018 edition of ACOEM's CDME Review and I thought I would share. I am a little frustrated that the FMCSA is failing to provide regulations for THEIR program.

"OSA - There remain no requirements from the FMCSA on screening for obstructive sleep apnea (OSA). There is a plan to update the 2015 Bulletin to Examiners by the end of 2018...."

Re: No federal requirements for OSA!?

Posted: Mon Jun 11, 2018 9:19 pm
by Robert Swotinsky MD
I recall two cliches for things that take forever:

- "That would take an act of Congress."

- "It's a federal process."

The physical qualification standards for truck drivers were issued in 1969. They haven't changed. FMCSA has issued FAQs and a Medical Examiners Handbook that offer guidance about certain issues. FMCSA has also been challenged on some of its guidelines, with allegations that Medical Examiners follow the guidelines as if they are regulations (which is true), and the guidelines need to be evidence-based (but there's nonconclusive evidence) and go through the usual regulatory process (which takes forever). So, the (small and underfunded) medical office at FMCSA proceeds conservatively and not much happens. OSA is among the more difficult things to regulate for reasons that most Medical Examiners can understand.

Medical Examiners love standards because they take the Medical Examiner's opinion out of the equation. A busy Medical Examiner probably doesn't go a week without a disqualified and upset driver accusing the ME of making up the rules, and the driver never had this problem with other MEs. What Medical Examiner hasn't had an upset driver complain, "Doc, you're taking away my livelihood!" I suspect for OSA, Medical Examiners will need to make judgment calls (opinions) and face upset drivers for some time to come.

Re: No federal requirements for OSA!?

Posted: Tue Jun 12, 2018 8:25 am
by drjchill
It would seem that the FAA is not having issues in generating "regulations."

Re: No federal requirements for OSA!?

Posted: Fri Sep 06, 2019 9:00 am
by JGraves3
Most of the DOT is RECOMMENDATIONS, ugh. We really need to remember SAFETY first and our name and credentials as the examiners who are passing these individuals.

One question I have is my company will accept a newly found individual with OSA with a 2 week CPAP reading, if within their 45 day pending it is the only thing that time allowed. Is anyone else doing this? Do you believe this is sufficient to pass them for 1 year?

Re: No federal requirements for OSA!?

Posted: Wed Sep 11, 2019 6:44 pm
by Robert Swotinsky MD
The previous post asks about using a 2-week compliance report as sufficient evidence to certify the driver as having controlled OSA and therefore OK for a year. The benefit of this relatively short compliance report is that it allows for a revision of the DOT physical within the 45 day grace limit, after which a completely new DOT physical is required.

The 2008 FMCSA Expert Panel report on obstructive sleep apnea does discuss certifying drivers based on 1-2 weeks of compliance data.
(See ... ns-508.pdf). It discusses certifying the drivers for just 3 months, though. (See page 5 of the Panel report.)