FMCSA concedes, President signs bill requiring formal OSA rulemaking

This month the FMCSA conceded to mounting pressure from several trucking industry trade organizations and backed away from its goal of issuing guidance on OSA screening parameters to DOT physicians. The pressure from industry stakeholders prompted action from within the US House of Representatives. This action seems to have been well timed as, in a rare momentary display of bi-partisanship, the measure sped its way through both chambers of congress.

Before the bill had a chance to make it through and to the President’s desk for final approval the FMCSA caved to mounting pressure of public opinion. The FMCSA has issued a statement agreeing to hold off on the release of any guidance on screening parameters for OSA and will instead embark on the full formal rule making process. The President signed the measure to solidify the requirement.

Industry stakeholders may have inadvertently caused themselves some additional stress as the guidance was meant as the second part of the FMCSA’s goal of addressing sleep apnea in the trucking industry. The first part, to cite within the medical examiner’s handbook that OSA was a serious condition that required attention and screening, was reviewed, accepted and lauded by industry groups. However, without this guidance on HOW to screen drivers who may need a sleep test DOT physicians will now find themselves on their own. DOT Physicians are required to utilize their medical judgment and may not be able to avoid liability if they ignore the suggested guidelines or the medical communities own guidelines (which are more stringent than those proposed by the FMCSA).

We may see more confusion than benefit from this ruling in the coming months.

FMCSA, OSA guidance comes under fire

The FMCSA came under attack this month by several trucking industry trade organizations. The industry stakeholders have all come together against the proposed guidance on obstructive sleep apnea. They have found many allies in their representatives in the US House and are seeking a bill that limits the ability of the FMCSA to act unilaterally toward their DOT physicians. The bill proposes that the FMCSA be required to undergo the full rulemaking process and procedures, including public comment and budgetary and effectiveness analysis.

To read the full text of the bill and to track its progress please click here

FMCSA to release guidance to DOT physicians in 2012

The FMCSA, who has already enacted the requirement for all DOT Physicians to participate to their new registry in May 2012, has confirmed this week that they will be issuing the newest set of screening protocols for Obstructive Sleep Apnea (OSA) no later than the end of 2012. This statement was first made at the ATA meeting in Kansas City and later confirmed by Anne Ferro, administrator of the FMCSA, as well as several others within the organization.

The new guidelines will be in line with the recommendations previously released this year by the joint meetings of the MRB and MCSAC. We have already seen some early adoption from DOT Physicians enacting these guidelines and will most likely see a dramatic increase in adherence as we get closer to the end of the year.

The formal release of this interim set of guidelines is said to mark the beginning of a broader process towards the formulation of an official regulation on sleep apnea within the trucking industry. Trucking officials have eluded to the fact that the final regulation will be of a stricter nature than this interim set of guidelines and will include requirements of the trucking companies themselves; such as having a formalized program in place to educate drivers, test and treat drivers as necessary, address any problems and regularly verify and report driver compliance.

FMCSA releases/retracts/delays OSA recommendation notice

The FMCSA has released and now subsequently retracted the announcement of the newly established pending DOT Physician Recommendations on the handling of Obstructive Sleep Apnea in the Trucking Industry. Sources have confirmed that the retraction of this release has been purely based on timing and that the industry should expect to see a similar release concerning Sleep Apnea in trucking later on this year.

We are told to anticipate that the final content of the recommendation is likely to conform entirely to the previously released recommendations of the joint meetings of the MRB/MCSAC published earlier this year.

Joint MRB/MCSAC Committee Releases Finalized Report

This month the joint committee meetings of the Medical Review Board (MRB) and the Motor Carrier Safety Advisory Committee (MCSAC) have released their final report on FMCSA Task 11-05. This task dealt with the formulation of an interim set of guidelines for DOT Physician personnel to address the issue of sleep apnea in the trucking industry. These guidelines are expected to be reviewed and released by the FMCSA later this year.

According to estimates of the DOT Statisticians cited during the joint committee’s own meetings this interim set of guidelines will effectively require a sleep test of almost 30% of the currently licensed CDL driving population. If positive, drivers must be treated on a PAP therapy device and be able to demonstrate compliance with treatment going forward.

The formal release of this interim set of guidelines is said to mark the beginning of a broader process towards the formulation of an official regulation on sleep apnea within the trucking industry. Trucking officials have eluded to the fact that the final regulation will be of a stricter nature than this interim set of guidelines and will include requirements of the trucking companies themselves; such as having a formalized program in place to educate drivers, test and treat drivers as necessary, address any problems and regularly verify and report driver compliance.

MRB/MCSAC Joint Committee begins work on Sleep Apnea Guidelines

Members of the Medical Review Board (MRB) and the Motor Carrier Safety Advisory Committee (MCSAC) as well as a panel of industry experts have begun to gather in a series of meetings originally slated for earlier this year. These meetings are specifically intended to examine the needs for changes to the current requirements of all DOT physical examinations.

One of the key issues being addressed is the formulation of a new set of interim guidelines on how Sleep Apnea is addressed within the trucking industry. In the coming months this group will be releasing their final recommendations that, if approved, will be used as the new regulatory standard by which all DOT Physicians screen CDL drivers.

NTSB Cites Sleep Apnea Among its "Most Wanted" List of New Regulations

Recently the NTSB has published a listing of their ‘Most Wanted’ new regulations it would like to see the FMCSA establish within the trucking industry. Several of these will come as no surprise to anyone within the trucking industry and include things like highway safety concerns, hours of service and accident prevention. But a growing amount of regulatory energy and attention is being paid to driver health and wellness issues during their certification and time on the road.

Found within the list of all of these potentially new regulatory directions is a strong desire to see a formal regulation toward trucking companies on a baseline for addressing the issue of Obstructive Sleep Apnea within their fleets. The NTSB has previously voiced the view that screening along a certain standard is not good enough by itself and would like to have any final regulation address the company’s involvement in education, treatment, assistance and compliance reporting.

The NTSB highlighted the need for a regulation addressing Obstructive Sleep Apnea in the trucking industry back in 2009. This new resurgence of attention being placed on the topic by the NTSB is likely to expedite any planned action by the FMCSA.

FMCSA Schedules Joint Meeting of MRB/MCSAC to Address Sleep Apnea

In the coming months the Medical Review Board (MRB) and the Motor Carrier Safety Advisory Committee (MCSAC) will be addressing the topic of Obstructive Sleep Apnea (OSA) within the trucking industry. The discussions, currently slated to begin in August of this year, will include several driver health and wellness topics highlighted by the FMCSA with a particular emphasis paid to OSA.

The group appears to be working on the first of a two part process announced that is aimed at addressing the issue of OSA in the trucking industry. This first part will try to establish a new set of screening guidelines for all DOT Physicians to utilize during the physical process to highlight the need for a sleep test within the driving population. The second part of the process, which will begin shortly after the guidelines are completed, is aimed at the formulation of an official regulation on sleep apnea within the trucking industry.

Trucking officials have eluded to the fact that the final regulation will be of a stricter nature than this interim set of guidelines and will include requirements of the trucking companies themselves; such as having a formalized program in place to educate drivers, test and treat drivers as necessary, address any problems and regularly verify and report driver compliance.

Movement on Sleep Apnea in Trucking will be pushed to 2011

According to recent reports of the FMCSA, the board is pushing back its expected discussions on Obstructive Sleep Apnea (OSA) in the trucking industry to sometime in the future of 2011. The discussion on OSA, which was said to be coming by the end of the year, has been pushed back to allow the group to finalize existing programs and focus on their current regulatory efforts.

The group has cited the need to address and finalize existing issues within the CSA program, EOBRs and Hours of Service regulations before it will begin any work on OSA. Sleep Apnea is still seen by the FMCSA as one of the most important in a list of new regulations addressing driver health and wellness coming in 2011.

NTSB Urges Action from FMCSA on Obstructive Sleep Apnea Regulation

In a strongly worded letter, dated October 20, 2009, the NTSB has urged the FMCSA towards action regarding the need for a regulation addressing the issue of Obstructive Sleep Apnea (OSA) within the trucking industry. The group has specifically cited the FMCSA’s own research, the advice of their own Medical Review Board from 2008 as well as several other data sources to suggest that not only is a regulation on OSA warranted but severely needed within the trucking industry.

MRB Issues Recommendations on OSA in Trucking Industry

The Medical Review Board (MRB) of the FMCSA has issued its latest recommendations on the topic of Obstructive Sleep Apnea (OSA) within the trucking industry. Industry leaders have said the recommendations contained within their report point to the need for increased regulatory oversight on this issue as well as a broader regulatory position on how to address, treat and demonstrate compliance with such oversight.