CDME Module 4: Respiratory-Module 4 Update (READ THIS FIRST)

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The 2022 update of the ACOEM Commercial Driver Medical Examiner Training Program introduces addendums to each module, including Module 4 on respiratory conditions. In this update, there have been no significant changes in respiratory conditions and commercial driver medical certifications. FMCSA does not require screening or follow-up for obstructive sleep apnea (OSA) but references the 2016 Medical Review Board Recommendations for guidance.<br /><br />The FMCSRs also do not include requirements for medical examiners (MEs) to screen commercial motor vehicle (CMV) operators for OSA or refer them for testing. However, if an ME detects a respiratory dysfunction that may interfere with a driver's ability to operate a CMV, the driver may be referred to a specialist for further evaluation. MEs are advised that drivers diagnosed with moderate to severe OSA who fail to adhere to treatment should be disqualified.<br /><br />The 2022 Draft ME Handbook states that there are no specific FMCSRs requirements for waiting periods, maximum certification periods, specific diagnostic procedures or treatment, or specific diagnostic results related to OSA. MEs can refer to the 2016 OSA advisory recommendations for additional guidance.<br /><br />The Medical Review Board meeting aimed to provide guidance on addressing drivers affected by the CPAP machine recall in 2021. The official minutes from the meeting are not yet available, but recommendations from the meeting are expected to be finalized by September 2021.<br /><br />Regarding pulmonary function tests (PFTs) for smokers, the FMCSRs do not require mandatory PFT screening for interstate CMV drivers who smoke. The request for specific medical testing can be made at the ME's discretion to assist with making a physical qualification determination.<br /><br />Overall, this update does not introduce significant changes to respiratory conditions and commercial driver medical certifications but provides important reminders and references to existing guidelines and recommendations.

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Keywords

2022 update

respiratory conditions

commercial driver medical certifications

obstructive sleep apnea

FMCSA

Medical Review Board Recommendations

respiratory dysfunction

moderate to severe OSA

CPAP machine recall

pulmonary function tests