|
RX & OTC MEDICATIONS |
FTA
Drug and Alcohol Regulation Updates |
|
Physicians Need Additional Training to Assess Driver Impairment Many transit system employers rely on their employee’s medical practitioners to assess and counsel the employee on the level of impairment associated with their physical condition and use of prescription and over-the-counter medication use. The practice may give transit management a false sense of security as the National Transportation Safety Board (NTSB) has concluded that physicians are not trained to make these assessments. The National Transportation Safety Board (NTSB) publishes articles in its “Lessons Learned" series that cite conclusions and recommendations arising from specific accident investigations and describes the potential benefits for transportation safety. In July, 2005, an article was published entitled “Training Needed to Evaluate Medical Conditions and Ability to Drive Safely.” The article concluded that healthcare professionals need improved awareness and training on the adverse impact serious medical conditions and medications have on many of the nation’s drivers. NTSB found that dozens of people have been killed and injured in accidents in which drivers were impaired due to serious medical conditions or the use of prescription medications that diminished their vision, cognitive, and motor skills. The report concludes that medical professionals need additional training to be adept at recognizing and evaluating medical conditions that may adversely affect a person’s ability to drive. There is no required training for medical students or licensed physicians regarding how to identify, rehabilitate, refer, counsel, and report driving impairment due to medical conditions. The NTSB called for increased course work and continuing education in the area of assessing and counseling medically impaired drivers. Transit employers should be aware of this potential shortcoming and encourage medical practitioners to seek out additional guidance when making fitness-for-duty assessments. The NTSB report cited reference materials that can be used to assist with the assessment process. The NTSB report can be found at http://www.ntsb.gov/publictn/2004/SIR0401.htm. Guide to Assessing Driver Ability The Physician’s Guide to Assessing and Counseling Older Drivers contains a reference list of medical conditions and medications that may impair driving skills for people of all ages. Even though the publication does not address additional requirements associated with Commercial Driver’s Licenses, it provides an up-to-date and comprehensive assessment that physicians can use in assessing a driver’s ability.  The Guide identifies thirteen categories of medical conditions and
medications that may impair driving, including vision, cardiovascular diseases, cerebrovascular diseases, neurologic diseases, psychiatric diseases, metabolic
diseases, musculoskeletal disabilities, peripheral vascular diseases, renal
disease, respiratory diseases, the effects of anesthesia and surgery,
medications, and other conditions. The discussion on medications addresses the level and type of impairment that might result and the potential side effects that might affect driving performance. Consideration is given to dosage and changes over time, particularly after drug initiation and withdrawal. The categories of medications that are addressed include alcohol, anticholinergics, anticonvulsants, antidepressants, antiemetics, antihistimines, antihypertensives, antiparkinsonians, antipsychotics, benzodiazepines, and other sedatives/anxiolytics, muscle relaxants, narcotic analgesics, nonsteroidal anti-inflammatory drugs, and stimulants. The Guide provides recommendations on treating the underlying medical condition to correct problems and prevent further decline, managing the use of medication, advising patients on the risks to safety, recommending driver restrictions, providing additional assessments, counseling drivers, and recommending rehabilitative services. The Guide that was published in 2003 was a collaboration between the American Medical Association (AMA) and the National Highway Traffic Safety Administration (NHTSA) and is available from the NHTSA website at http://www.nhtsa.dot.gov/people/injury/olddrive/OlderDriversBook/. |
Where to Find? ..... Conforming Products List Evidential Breath Testing (EBT) Devices July 29, 2006 Federal Register Vol.71 Pages 37159 - 37162 Primary Topic: Conforming Products List (CPL) Website location: http:// www.dot.gov/ost/dapc/ testingpubs/20040714_ CPL_EBT.pdf Note: This list will be updated periodically. Non-evidential Testing Devices May 4, 2001 Federal Register Vol.66 Pages 22639 - 22640 Primary Topic: Initial Alcohol Screening Devices Note: This list will be updated periodically. The information presented on this page should be used to update Chapter 5 of the revised Implementation Guidelines. |