The Pre-Registry Commercial Driver Medical Examination: Screening Sensitivity and Certification Lengths for Two Safety-Related Medical Conditions

Stephen Vincent Burks, Jon Eugene Anderson, Bibhudutta Panda, Humza Syed Haider, Rebecca Haider, Dongnan Shi, Yutao Li, Michael Cagle, Denis Ostroushko, Zhining Sun, John Zaharick, Jeffrey Hickman, Erin Mabry, Mark Berger, Charles Czeisler, Stefanos Nikolaos Kales

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Objective:Use independent diagnostic data to analyze the screening effectiveness of the pre-Registry commercial driver medical examination (CDME) for obstructive sleep apnea (OSA), and its sensitivity for hypertension; analyze certification lengths where relevant.Methods:CDME screening results for 1668 drivers were compared to polysomnogram diagnostic test results, and CDME screening results were evaluated for 1155 drivers with at least one insurance claim with a hypertension diagnostic code. Any CDME documentation of the medical condition was considered as detection by screening.Results:CDME sensitivity was 20.7% for moderate OSA (AHI≥15). While sensitivity was 77.5% for hypertension, 93.3% of drivers with Stage 3 hypertension were certified, contrary to Federal Motor Carrier Safety Administration standards.Conclusions:The pre-Registry CDME was ineffective in screening commercial drivers for OSA. Screening was better for hypertension; incorrect certifications were given to many hypertensive drivers.

    Original languageEnglish (US)
    Pages (from-to)237-245
    Number of pages9
    JournalJournal of occupational and environmental medicine
    Volume62
    Issue number3
    DOIs
    StatePublished - Mar 1 2020

    Bibliographical note

    Funding Information:
    Funding: The authors gratefully acknowledge the assistance of the executives and staff of the study firm in acquiring operational and medical data utilized. Financial assistance to the UMN Morris Truckers & Turnover Project has been received from the study firm, the Roadway Safety Institute (the USDOT Region 5 University Transportation Center, which is funded by the USDOT Office of the Assistant Secretary for Research and Tech-nology), and the University of Minnesota Morris. The research also received support from Harvard Catalyst, The Harvard Clinical and Trans-lational Science Center (NIH Award #UL1 RR 025758, financial contri-butions from Harvard University and its affiliated academic health care centers), and support from National Surface Transportation Safety Center for Excellence (Project# 12-UI-017). The content is solely the responsi-bility of the authors and does not necessarily represent the official views of any of the research sponsors.

    Publisher Copyright:
    © 2020 American College of Occupational and Environmental Medicine.

    Keywords

    • commercial driver medical exam
    • commercial motor vehicle
    • commercial motor vehicle operator
    • hypertension
    • motor carrier
    • obstructive sleep apnea
    • polysomnogram
    • truck driver
    • truckload

    PubMed: MeSH publication types

    • Journal Article
    • Research Support, N.I.H., Extramural
    • Research Support, Non-U.S. Gov't
    • Research Support, U.S. Gov't, Non-P.H.S.

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