OSA (obstructive sleep apnea)

The February 2016 report on Significant DOT Rulemakings included an Advanced Notice of Proposed Rule Making (ANPRM) to look at the prevalence of moderate to severe obstructive sleep apnea (OSA) in individuals occupying safety sensitive positions, and the safety and economic impact of regulatory requirement for testing and treating these individuals.   This is jointly being looked at by the FMCSA and FRA (Federal Railroad Administration).  The ANPRM has cleared the White House Office of Management and Budget, and is expected to be published soon in the Federal register.

Background:  After Congress ruled that the FMCSA can not issue new requirements on OSA without going through the formal rule making process, the FMCSA on January 20, 2015 issued a bulletin to medical examiners and in it stated:

 FMCSA’s physical qualification standards and advisory criteria do not provide OSA screening, diagnosis, or treatment guidelines for medical examiners to use in determining whether an individual should be issued a medical certificate..

However, FMCSA reminded examiners that:

49 CFR 391.41 (b) (5) states that individuals who operate in interstate commerce are prohibited from receiving a medical examiner’s certificate if they have an:

“established medical history or clinical diagnosis of a respiratory dysfunction likely to interfere with is or her ability to control and drive a commercial motor vehicle safely”

…and that OSA, depending on its severity may meet the criteria in 49 CFR 391.41 above and alert the examiner that the driver may be at risk for sudden or gradual incapacitation, which should prompt the examiner to refer the driver to a specialist for further evaluation and therapy.

When the OSA ANPRM is published we will continue on the long and contentious path towards actual OSA rulemaking.