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Transportation Agencies Withdraw Proposed Obstructive Sleep Apnea Rule

An advance notice of proposed rulemaking on obstructive sleep apnea (OSA) has been withdrawn by the Federal Motor Carrier Safety Administration (FMCSA) and the Federal Railroad Administration. A withdrawal notice was published today in the Federal Register.

The rule, Evaluation of Safety Sensitive Personnel for Moderate-to-Severe Obstructive Sleep Apnea, was proposed in response to OSA-related transportation incidents and crashes. OSA can cause unintended sleep episodes and affect attention, concentration, situational awareness and memory.

Under current regulations, OSA is defined as a “respiratory dysfunction.” When it is considered severe enough to be likely to interfere with safe operation, a qualified medical examiner may exercise his or her clinical judgment when deciding whether to issue a medical certificate to a driver, and for how long. Successfully treated drivers with OSA may regain their “medically-qualified-to-drive” status.

According to the notice, the FMCSA will consider an update to its January 2015 Bulletin to Medical Examiners and Training Organizations Regarding OSA, which addresses physical qualifications and related advisory criteria. Medical Review Board recommendations issued a year ago would be used as a basis for the update.

In the notice, medical examiners are reminded that there are no FMCSA rules related to screening, diagnosis and treatment of OSA in commercial drivers. “This does not mean that evaluating whether a driver is at risk of having OSA or that ensuring compliance with treatment is no longer important – just that there are no formal requirements from FMCSA,” reports Natalie Hartenbaum, M.D., M.P.H., president and chief medical officer of OccuMedix and expert on transportation-related medical issues.