CDME Module 8: Drug Abuse & Alcoholism-ME Handbook

Pdf Summary
The FMCSA Medical Examiner Handbook outlines guidelines for medical professionals assessing commercial drivers' physical qualifications to ensure they meet federal standards (49 CFR 391.41). The handbook aligns with the Federal Motor Carrier Safety Administration’s goal of reducing crashes, injuries, and fatalities involving large trucks and buses by ensuring that only medically fit drivers are certified to operate commercial motor vehicles (CMVs).<br /><br />Key aspects covered include:<br /><br />1. **Vision and Hearing**: Drivers must have 20/40 visual acuity in each eye, 70 degrees peripheral vision, and pass a forced whisper hearing test at 5 feet, with specific provisions for those needing federal exemptions.<br /><br />2. **Cardiovascular Health**: Conditions like myocardial infarction, angina, and hypertension are strictly evaluated. Stage 3 hypertension (>180/110) disqualifies until controlled. The tolerance and effectiveness of anti-hypertensive treatments are also checked.<br /><br />3. **Respiratory Health**: Conditions such as asthma, COPD, and severe allergies are considered, with assessments on disease stability, treatment effectiveness, and potential impact on cognitive and motor functions.<br /><br />4. **Neurological Disorders**: Includes assessments for epilepsy, seizures, cognitive functions, and headaches. Active epilepsy generally disqualifies a driver.<br /><br />5. **Diabetes Mellitus**: Insulin-dependent drivers can apply for federal exemptions. Stable glucose levels and regular review by specialists are required.<br /><br />6. **Musculoskeletal Disorders**: Conditions affecting vehicle control are evaluated, and Skill Performance Evaluations (SPE) may be required for fixed deficits.<br /><br />7. **Psychological Disorders**: Disorders such as depression and schizophrenia must be stable and not impair driving abilities.<br /><br />8. **Substance Abuse**: Prohibition on controlled substances and alcohol abuse, with mandatory regular testing and participation in treatment programs.<br /><br />9. **Medication Use**: Scrutiny on medications that could impair driving, ensuring drivers use necessary medications safely and effectively.<br /><br />Drivers must undergo regular biennial medical examinations or more frequent follow-ups for specific conditions. Medical certifications are valid for up to two years, with documentation of the examination process and driver limitations. This comprehensive approach ensures only qualified individuals operate CMVs, enhancing roadway safety.
Asset Caption
Pages 201 – 212
Keywords
FMCSA
Medical Examiner Handbook
commercial drivers
physical qualifications
vision and hearing
cardiovascular health
respiratory health
neurological disorders
diabetes mellitus
substance abuse