CDME Module 2: Vision and Hearing (2025)-Hearing and Vestibular Function and Commercial Vehicle Driver Safety Evidence Report

Hearing and Vestibular Function and Commercial Vehicle Driver Safety Evidence Report

Pdf Summary

The report prepared by the ECRI Institute, in collaboration with MANILA Consulting Group, addresses key questions regarding hearing and vestibular function in relation to commercial motor vehicle (CMV) driver safety. The study is intended to inform the Federal Motor Carrier Safety Administration (FMCSA) in updating its medical standards and fitness-to-drive examination guidelines.<br /><br />**Key Findings:**<br /><br />1. **Hearing and Crash Risk:** <br />   - Current evidence does not clearly indicate whether individuals with hearing impairments (thresholds of 40dB or greater at 500–3,000 Hz) are at increased risk for crashes, specifically among CMV drivers. Existing studies are inadequate due to low quality and non-CMV driver populations.<br /><br />2. **Forced-Whisper Test:**<br />   - This test is viable for screening hearing loss but exhibits high sensitivity and low specificity, indicating it may misidentify individuals with normal hearing as impaired.<br /><br />3. **Vestibular Dysfunction and Crash Risk:**<br />   - No conclusive evidence suggests that vestibular dysfunction increases crash risk among CMV drivers due to a lack of focused studies.<br /><br />4. **Post-Vertigo Driving Safety:**<br />   - Insufficient evidence exists to establish a safe duration for driving post-vertigo episode, due to the absence of relevant studies.<br /><br />5. **Treatments for Ménière’s Disease:**<br />   - Diuretics lack strong support for effectiveness in treating vertigo/hearing loss.<br />   - Betahistine shows moderate evidence for reducing vertigo, but not hearing loss.<br />   - Evidence does not suffice to draw conclusions about diphenidol, intratympanic gentamicin, or endolymphatic sac shunt surgery effectiveness due to insufficient study bases.<br /><br />Overall, this report underscores the necessity for more rigorous research, notably involving CMV drivers, to better ascertain the relationships between hearing and vestibular impairments and driving safety. It suggests cautious interpretation of existing studies and highlights potential areas for future inquiry.

Keywords

ECRI Institute

MANILA Consulting Group

hearing function

vestibular function

CMV driver safety

FMCSA guidelines

crash risk

forced-whisper test

Ménière’s Disease

vestibular dysfunction