By LEE BOWMAN
Scripps Howard News Service
March 30, 2009
But it will be nearly three years before federal and state safety officials -- pulling over buses and trucks for roadside inspections -- can quickly verify that operators are medically fit to drive.
And even when a national database of medical certificates is up and running in 2012, police and regulators may not be sure that a legitimate medical examination has been done or that drivers have told examiners the truth about their medical history.
Scripps reporters earlier this month found several instances where medically unfit drivers had caused fatal crashes. The driver in one fatal Ohio crash had 27 different prescription drugs in his cab, although none were detected in his blood. His medical certificate had expired just a week earlier.
The National Highway Traffic Safety Administration reported in 2007 that truck drivers' heart attacks or other physical impairments were responsible for some 4,000 serious truck crashes from April 2001 through December 2003, while another 5,000 were caused by drivers falling asleep. Researchers estimate that more than 28 percent of all truckers suffer from sleep apnea to some degree.
"Are there people out there who should not be on the road? Absolutely, we see them all the time," said Dr. Richard O'Desky, an Akron, Ohio, occupational-medicine specialist who is one of the nation's leading experts on trucker health and safety. He says among the most common conditions are heart disease, serious neurological problems and sleep disorders that make nodding off behind the wheel near-certain.
Federal investigators last year reported that more than 560,000 operators holding current commercial driver's licenses were also receiving full medical-disability payments from the government.
And last summer, congressional investigators reported that one out of three medical certificates examined at roadside stops could not be verified -- either the doctors who signed the certificates could not be found or they denied ever conducting an exam claimed by a driver.
Under current law, commercial drivers are required to carry a copy of their medical certificate with them as proof of having passed the exam. But state regulators have no way to verify the information on the document in real time. In Ohio, for instance, commercial driver's licenses are issued by the Bureau of Motor Vehicles, but medical certification is handled by the state Public Utilities Commission.
"We have no means to verify a certificate when we have a driver stopped alongside the road for an inspection," PUC official Milan Orbovich told the WEWS television station in Cleveland. "We have a big level of concern."
Federal officials say that out of 3.4 million roadside inspections in 2007, there were more than 145,000 citations issued to drivers who did not have a copy of their medical certificate, more than 42,000 who had expired certificates and another 4,300 with improper certificates.
Blank medical-certificate cards are easily downloaded from government Web sites, and there are no safeguards to keep a driver from filling out his or her own medical papers. They can pick a doctor's name from the phone book, sign the certificate themselves and look up the medical provider's license number online.
"They're paper. I mean, somebody with a pen, a good eye and steady hand could change numbers," O'Desky said. "Does it happen every day? Not in our practice. But it happens enough that it's become a problem."
Under rules adopted in January, the Federal Motor Carrier Safety Administration will require drivers to send a copy of their medical certificates to state driver-licensing agencies. Those agencies will then merge the medical information on an electronic record in the national commercial-driver-license database. The three-year delay is needed to give state DMVs time to set up new recordkeeping and storage systems, officials say.
"This will make things simpler and easier for drivers -- simpler and easier for law-enforcement officers," said Duane DeBruyne, a spokesman for the FMCSA.
Problems with federal systems to ensure medical fitness aren't unique to truckers and bus operators. For decades, the Federal Aviation Administration has had in place a database of medical certificates for the nation's more than 600,000 pilots. The FAA requires regular exams as often as every six months to be done by one of 40,000 trained examiners, but disqualified pilots still slip through.
Recent audits found that up to 10 percent of pilots who died in accidents between 1993 and 2003 were taking drugs for psychotropic, neurological or cardiovascular conditions that were not reported on their medical certificates.
The Transportation Department anticipates that a newly trained and certified cadre of 40,000 medical examiners should be enough to follow the medical conditions of some 4.4 million active interstate commercial-vehicle drivers who will need to be checked at least every two years.
For commercial drivers and pilots alike, "to a great extent, the medical-certification process relies on applicants' honesty in disclosing his or her medical history, especially about possibly disqualifying medical conditions," Transportation Department Inspector General Calvin Scovel told lawmakers last summer.
Investigators have found that some examiners either don't know or chose to ignore that some conditions, such as deafness or missing limbs, are disqualifying for commercial drivers.
The FMCSA has just proposed rules to set up the registry of trained examiners, who will be required to get regular updates on what the driving implications are for various medical problems. Drivers won't have to start using the new examiners until at least two years after the registry is set up.
But once it's in place, the system will make it much harder for drivers to either falsify exams or "doctor shop" for examiners who will pass over problems that should keep them from behind the wheel of 80,000-pound rigs. Each examiner would also be required to send the government an electronic report on each exam he or she does, providing a crosscheck that an operator has been found medically sound to drive.
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