Have you heard? If the Federal Motor Carrier Safety Administration (FMCSA) gets its way, truckers – under certain conditions – may have to be screened for sleep apnea to get a green light to hop in the cab.
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Unfortunately, not everyone in the industry agrees this was the right move. The FMCSA had initially proposed this rule, but it first had to be held up by the FMCSA’s Medical Review Board and Motor Carrier Safety Advisory Committee, which it now has done.
What is BMI?
So, what’s the deal here? Will every trucker have to undergo a sleep apnea test? Well, no. The criteria will be based upon a truck driver’s Body Mass Index (BMI). If a trucker has a BMI higher than 40, then they will be flagged for a sleep apnea screening.
BMI is a measure of body fat which is based upon an individual man or woman’s height and weight. While largely accurate, it is not without its limits. In athletes, for instance, who may weigh more because of muscle, rather than fat, BMI can be deceiving. It may also underestimate fat in older people who have lost muscle mass over time.
The BMI chart reads as:
- < 18.5 = Underweight
- 5 – 24.9 = Normal weight
- 25 – 29.9 = Overweight
- > 30 = Obese
Considering a reading above 30 is considered obese, some argue that requiring a sleep apnea test at 40 is not an overly onerous burden. Others claim that the FMCSA is using far too strict guidelines in how they determine who gets a test.
When a Test is Required
Some point to the Federal Aviation Administration (FAA) when advising the FMCSA on how to proceed. The FAA prohibits using BMI as a sole factor when issuing flight cards. The FAA once even wanted to do exactly what the FMCSA is proposing to do, but ended up reversing course.
For truckers who have a BMI over 40, the FMCSA would force them to get a 90-day medical certification. During the 90 days, they would have to either do an at-home or in-lab sleep study. If they receive a positive diagnosis, they would then have to begin treatment, again within the 90-day period.
In situations where a truck driver tests out with a BMI higher than 33, they would be subject to screening if they meet three other qualifiers. One such example of three other qualifiers includes being male and being over the age of 42 – neither of which are statistics in short supply within the trucking industry. For a postmenopausal female truck driver aged 42 or older, a flag for high blood pressure or a history of diabetes or heart disease might trigger a test.
If a trucker is diagnosed with moderate or severe sleep apnea, their medical certification can last no longer than a year. This replaces the standard two-year certification window for those who don’t suffer from sleep apnea.
Other Changes
While much of the FMCSA’s original idea came through the advisory board’s final analysis, there were some changes made to the criteria surrounding when a truck driver should be immediately disqualified.
A driver could be disqualified if they:
- Are reporting excessive sleepiness while behind the wheel
- Are involved in an accident related to falling asleep while driving
- Have been seen by someone else sleeping while operating a commercial motor vehicle
- Are not in compliance with existing sleep apnea treatment guidelines
A medical examiner could also disqualify a truck driver if they deem said driver to be high risk. They would then be out of service until they can get treatment, and would be required to be treated for two weeks before they can get behind the wheel.
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Of course, many in the industry are not happy with this ruling. While some say it goes a long way to increasing truck driver safety and overall wellness, others say it is an intrusion that leaves a ton of unanswered questions, not-the-least-of-which being who foots the bill when a truck driver has to be removed from the road and sent for testing. In the end, only time will tell how this shakes out.