What is the FMCSA?

The Federal Motor Carrier Safety Administration (FMCSA) is an agency within the Department of Transportation (DOT) whose primary mission is to reduce and prevent crashes, injuries, and fatalities involving large trucks and buses. Formerly a part of the Federal Highway Administration, the FMCSA was established on January 1, 2000. It works cooperatively with federal, state, and local enforcement agencies, the motor carrier industry, labor safety interest groups, and others to ensure safety in motor carrier operations. FMCSA goals include:

  • Strong enforcement of safety regulations
  • Targeting high-risk carriers and commercial motor vehicle drivers
  • Improving safety information systems and commercial motor vehicle technologies
  • Strengthening commercial motor vehicle equipment and operating standards
  • Increasing safety awareness

FMCSA is headquartered in Washington, D.C., and employs more than 1,000 people in all 50 states and the District of Columbia. All FMCSA employees are dedicated to improving the safety of commercial motor vehicles (CMV) and saving lives. The FMCSA's many activities include work to:

  • Develop standards to test and license commercial motor vehicle drivers
  • Collect and disseminate data on motor carrier safety and directs resources to improve motor carrier safety
  • Operate a program to improve safety performance and remove high-risk carriers from the nation's highways
  • Coordinate research and development to improve the safety of motor carrier operations and commercial motor vehicles and drivers
  • Provide states with financial assistance for roadside inspections and other commercial motor vehicle safety programs
  • Promote motor vehicle and motor carrier safety
  • Support the development of unified motor carrier safety requirements and procedures throughout North America
  • Participate in international technical organizations and committees to help share the best practices in motor carrier safety throughout North America and the rest of the world
  • Enforce regulations ensuring safe highway transportation of hazardous materials
  • Maintain a task force to identify and investigate those carriers of household goods which have exhibited a substantial pattern of abuse

If you have questions or would like guidance regarding the Federal Motor Carrier Safety Regulations you can find a local office on their field office phone list

References:

http://www.fmcsa.dot.gov/about/aboutus.htm

Distracted Driving on the Job

Motor vehicle crashes are the leading cause of work-related death. In 2009, motor vehicle accidents accounted for nearly two-fifths of all the fatal work injuries with 1,682 incidents. Among all motor vehicle accidents 16% are attributed to distracted driving. There is no reason to believe the percentage of work-related crashes is not the same or and it could be even higher.

Workers on the road are under many pressures to make calls, text clients, and perform job-related tasks while driving, all of which increase the risk of an accident. According to Oregon Health and Science University:

  • Talking and listening on a cell phone increases the risk of accident by a factor of 1.3 over non-distracted driving
  • Dialing a cell phone by hand increases the risk by 2.8
  • Reading while driving elevates the risk by 3.4.

The risks increase when driving a truck or heavy vehicle:

  • Dialing a cell phone increases the risk of accident by 5.9 times versus non-distracted driving
  • Using or reaching for any electronic device increases the risk by 6.7 times
  • Text messaging increases the risk by a factor of 23.2!

To combat this problem OSHA is launching a multi-pronged initiative that includes:

  • An education campaign for employers, calling on them to prevent occupationally related distracted driving, with a special focus on prohibiting employees from texting while driving
  • An open letter to employers to be posted on OSHA's website and showcase model employer policies and encourage employer and labor associations to communicate OSHA's message
  • Alliances with the National Safety Council and other key organizations as outreach to employers, especially small employers, aimed at combating distracted driving and prohibit texting while driving
  • Special emphasis on reaching younger workers by coordinating with other Labor Department agencies as well as alliance partners and stakeholders
  • Investigation and issuing of citations and penalties where necessary to end the practice when OSHA receives a credible complaint that an employer requires texting while driving.

To help solve this problem OSHA recommends that employers build a "workplace culture of safety" with clear, explicit policies and sound practices and send a clear message to workers and supervisors that your company neither requires nor condones texting while driving.

References:

http://www.jhsph.edu/erc/distracted-driving.html

http://www.cdc.gov/niosh/topics/motorvehicle/

http://stats.bls.gov/news.release/pdf/cfoi.pdf

http://www.cdc.gov/niosh/updates/upd-10-05-10.html

http://www.vtti.vt.edu/PDF/7-22-09-VTTI-Press_Release_Cell_phones_and_Driver_Distraction.pdf

Driving a Bus, More Reason to Pay Attention

Bus fatalities per miles traveled have been steadily dropping in the U.S. since the fatality rate peaked in 1985. In fact, bus-related fatalities per miles traveled have drooped even from 2005. However, bus-related deaths are still an area of serious concern.

  • May 31,2011: A commercial tour bus went off Interstate 95 in Virginia and flipped on its roof before dawn Tuesday, killing four people and injuring many more. The driver was charged with reckless driving and police say fatigue was a factor.
  • March 12, 2011: A bus returning to New York City from a casino overturned on Interstate 95 in the Bronx was sliced in half by the support pole for a large sign. Fourteen people were killed. The NTSB reported the bus was speeding up to 78 mph. The operator, World Wide Travel, was being watched by Federal Motor Carrier Safety Administration officials after being cited five times for "fatigued driving" after previous crashes.
  • March 14, 2011: A privately owned tour bus crashed into a guardrail and a concrete embankment on the New Jersey Turnpike and veered into a drainage ditch on the side of the highway, killing two people and injuring 40 others. The driver was thrown through the windshield and did not survive. The U.S. Department of Transportation's Federal Motor Carrier Safety Administration (FMCSA) declared the Pennsylvania-based bus company Super Luxury Tours, Inc. "an imminent hazard to public safety" and ordered the company to immediately cease all intrastate and interstate transportation services.
  • September 11, 2010: Four people died after a double-decker megabus slammed into the railroad bridge in Salina, NY. The driver had missed a turn and was lost. The driver has been charged with four felony counts of criminally negligent homicide and failure to obey a traffic-control device.

In the North America, about 360 million people travel about 28 billion miles a year on about 30,000 commercial buses. While most of these passengers arrive safely at their destination, about 1,000 of them will be injured and 50 killed in a bus accident. Bus accidents were of such concern that the Federal Motor Carrier Safety Administration conducted a large-scale study of bus accidents in 2009. Among the findings of that study were:

  • Bus crashes were more likely to occur in cities than on cross-country routes
  • Inner-city charter buses were particularly likely to be involved in an accident
  • Causes of these accidents include: other vehicles stopping in a bus lane, abrupt lane changes in front of a bus, pedestrian suddenly crossing in front of a bus, and a bus traveling at an unsafe speed for the weather conditions.

School buses represent the largest form of mass transit in the United States, with about 9 million passengers annually (about double what transit buses transport). School bus accidents make up less than 1% of all motor vehicle accidents, but the number of deaths is still not unsubstantial. Since 1990, 1,450 people have been killed in a school-bus-related accident (some of these were occupants of other vehicles or pedestrians). The most common types of school bus accidents are impacts to the front end of the school bus, right-side impact, and rear impact.

While many things can cause a bus accident, including other drivers and pedestrians, the Federal Motor Carrier Safety Administration concluded that in 15 out of 19 cases, the bus drivers were primarily at fault. Sometimes the fault was that they failed to recognize and respond to a potentially dangerous situation and thus got involved in an avoidable accident. Some bus accidents can be attributed to brake failure, electrical fires, or mechanical problems.

Human factors were involved in 90% of the bus accidents studied by the Federal Motor Carrier Safety Administration. Human factors were considered to blame, even in cases where there other factors were involved, such as dangerous acts by other drivers or pedestrians or poor equipment, if the driver might reasonably have been expected to be able to recognize and compensate for the potential danger.

Bus accidents share much in common with other motor vehicle accidents, in that they often can be traced back to a driver who is distracted, drowsy (sleep-deprived), or impaired (drunk, stoned, high). The reason that bus-related accidents are so appalling is that they affect the lives of all of the passengers, magnifying the damage. For that reason, basic precautions should be taken to help protect the millions of people who rely on bus transportation:

  • Bus drivers must be properly trained and cognizant of safety issues
  • Drowsy driving should be prevented; this may involve enforcement of rules that limit the hours a driver may drive in a day
  • Distracted driving should be prevented by not permitting bus drivers to use cell phones, talk to passengers, or otherwise entertain themselves with anything that takes their focus off the road. This may involve banning cell phones for bus drivers on duty.
  • Periodic random drug screening may be useful to assure that bus drivers do not get behind the wheel when they have used drugs that would impair their ability to drive.

References:

http://abclocal.go.com/wabc/story?section=news/local/new_york&id=8026594

http://www.msnbc.msn.com/id/42045968/ns/us_news-life/t/passengers-bus-driver-drifted-fatal-crash/

http://www.nj.com/news/index.ssf/2011/03/bus_crashes_on_nj_turnpike_in.html

http://www.syracuse.com/news/index.ssf/2010/09/driver_of_megabus_that_struck.html

http://www.fmcsa.dot.gov/about/news/news-releases/2011/Super-Luxury-Tours-Cease-Operations.aspx

Prescription Medication or Heroin – Who Can Say?

On October 1, 2010 the DOT (U.S. Department of Transportation) made some changes to their drug testing requirements. One of these changes is the addition of 6-Acetylmorphines or 6-AM to the list. 6-AM is a short-lived metabolite of heroin. It is produce in the body only from heroin and not from other opiates like codeine or morphine. Therefore, the presence of 6-AM in a specimen would be a clear indication of heroin use...or would it?

While it is true that 6-AM is a metabolite resulting only from heroin use, it is also an impurity present in the manufacture of legitimately prescribed opiates such as Oxycontin®, Vicodin®, morphine, and others. This impurity is not known to pose any harm to the patient taking the prescribed drug, but it may be detected by drug tests. This was not an issue until the DOT initiated its new, more sensitive test for 6-AM.

There is no way in the lab to differentiate if 6-AM is present because of appropriately prescribed pain medication or because of heroin use. However, when 6-AM shows up on a drug test, the donor and his or her employer should care about where it came from!

The American Association of Medical Review Officers (AAMRO) has put out an alert regarding a potential problem with the new requirement to test for 6-Acetylmorphines as an indicator for heroin use. The Federal Transit Administration (FTA) does not seem to agree. Here is what the FTA said in Drug and Alcohol Regulation Updates, Issue 42, Summer 2010:

"An additional test for 6-Acetylmorphines (6-AM) will be conducted for opiate positives above the initial test cutoff concentration of 2000 ng/mL. The 6-AM test is a definitive marker for heroin use. There is no legitimate medical explanation for 6-AM positive tests. The MRO must confer with the laboratory to determine if there was confirmed morphine below 2000 ng/mL."

This is a case where the various agencies are contradicting each other. The DOT says that 6-AM is a definitive marker for heroin and no other medical explanation can be entertained. The Food and Drug Administration (FDA), on the other hand, says that 6-AM is an impurity in the manufacture of a variety of controlled substances which may be legitimately prescribed.

The AAMRO says that the presence of this impurity will present, "A significant technical issue for MRO verification of 6-AM in DOT and HHS [Health and Human Services] urine tests." They say this problem will arise because "6-AM is present in very low levels in pharmaceutical morphine preparations."

At very low levels, this 6-AM might not be detected. But for people with prescriptions for high-strength opioid pain killers, it might be possible for levels of 6-AM to be detected that exceed established thresholds.

Laboratories involved with monitoring opioids have known about "process impurities" for a long time, but workplace drug testing lab have never had to deal with it.

The current regulations do not address this problem. This could become a serious "technical issue" for companies who find out certain employees are "heroin users" and for those employees who lose their jobs because they were taking prescription pain killers.

According to the AAMRO, the best course of action in the case of 6-AM detection in a donor who is taking a prescription opioid pain killer:

  • The Medical Review Officer (MRO) should follow current guidelines, taking care to address safety concerns
  • The MRO should contact the appropriate regulatory body for additional guidance
  • The MRO should ethically discuss the possibility of "process impurities" with the donor.

References:

http://www.aamro.com/docs/news/27.pdf

http://en.wikipedia.org/wiki/Monoacetylmorphine

http://transit-safety.volpe.dot.gov/drugandalcohol/Newsletters/issue42/pdf/Issue42.pdf

http://arthritisinsight.com/medical/meds/opiates.html

http://www.fsijournal.org/article/S0379-0738%2898%2900074-7/abstract

Who is the MRO?

When a company creates their safety program under the United States Department of Transportation (DOT) regulations one vital spot to fill is that of the Medical Review Officer (MRO). While the Designated Employer Representative (DER) receives test results from the drug and alcohol testing agency and enforces whatever actions are necessary according to the company's drug and alcohol policy, he or she relies on the MRO's medical expertise.

The MRO used by the company as its medical expert must be a licensed physician (Doctor of Medicine or Osteopathy) in the United States, Canada or Mexico. MROs can perform their duties for employers outside of their licensing state or province. The MRO can be an employee of the company or belong to an agency hired by the employer, but the MRO must not have an affiliation with the testing laboratory nor be a part of the process for choosing a testing lab or service.

The MRO acts as an independent and impartial assurer of the accuracy and integrity of the drug testing process. MROs provide a quality assurance review of the drug testing process for the specimens under their authority. They are also responsible to ensure the timely flow of test results and other information from the testing service to the employer, and they protect the confidentiality of the drug testing information.

While MROs are responsible for reviewing the Federal Drug Testing Custody and Control Form (CCF) to determine whether there is a problem that would cause the test to be cancelled, they are not responsible for the internal chain of custody at the testing laboratory.

If lab results show a confirmed positive, adulterated, substituted, or invalid result, the MRO determines whether there is a legitimate medical cause for these results. One such medical cause might be a legally prescribed medication. MROs investigate, as needed, and may be involved in correcting problems and notifying the appropriate parties when assistance is needed. For example, MROs may determine when tests with questionable results must be repeated, if cutoff rates for certain substances are too high, or if the testing facility is not handling specimens according to protocol. The role of the MRO is, in part, to provide feedback to employers, collection sites, and laboratories, regarding performance issues. All this must be in compliance with DOT regulations, especially 49 CFR Part 40.

In the effort to combat substance abuse in the workplace accuracy and integrity are paramount. The highest medical standards must be maintained.The MRO is the key to making this happen.

References:

http://www.dot.gov/ost/dapc/NEW_DOCS/part40.html

No Texting Allowed

"Every single time someone takes their focus off the road — even if just for a moment — they put their lives and the lives of others in danger," said U.S. Transportation Sectretary Ray LaHood. "Distracted driving is unsafe, irresponsible, and, in a split second, its consequences can be devastating. There's no call or email so important that it can't wait." During the 2010 National Distracted Driving Summit, LaHood announced new anti-distracted driving regulations affecting drivers who transport hazardous materials, commercial truck and bus drivers, and rail operators.

Last year's proposal to ban texting while driving by commercial bus and truck drivers is now law. In fact, in many places in the United States texting while driving is illegal, whether or not one is a commercial driver. This issue seems to have grabbed the attention of the public and the media. Even Oprah Winfrey has weighed in with her No-Phone-Zone campaign.

A study was done by the Highway Loss Data Institute (HLDI), an affiliate of the Insurance Institute for Highway Safety, in order to see if crashes were reduced by banning all drivers from texting while driving. Surprisingly, the HLDI found that accidents actually increased in three out of the four states where texting was banned.

"Texting bans haven't reduced crashes at all. In a perverse twist, crashes increased in 3 of the 4 states we studied after bans were enacted," stated Adrian Lund, president of both HLDI and the Insurance Institute for Highway Safety. "It's an indication that texting bans might even increase the risk of texting for drivers who continue to do so despite the laws."

The reason for the increase is likely explained by simple noncompliance with the law. In a survey, 45% of 18-24 year-old drivers admitted to texting while driving despite the ban. Why then would the number of crashes increase after a ban is put into effect, instead of remaining steady? Probably because texters try to hide their illegal activity by holding the electronic device low, out of sight. This could increase the risk because it takes the driver's eyes away from the road longer than when the device is held at windshield-level.

Research from Federal Motor Carrier Safety Administration (FMCSA) reveals that when drivers send and receive text messages they take their eyes off the road for about an average of 4.6 seconds out of every 6 seconds. At 55 miles per hour a vehicle may travel further than a football field's length during that 4.6 seconds. Drivers who text while driving increase their chances of having an accident 20 times more than drivers who are not distracted.

While younger drivers who do not hold commercial licenses may still text behind the wheel even when it is prohibited by law, it is not clear whether this noncompliance extends to older or commercial drivers. These laws may levy fines of up to $2,750 on commercial truck and bus drivers caught texting while driving; it may be that such penalties should extend to non-commercial drivers as well.

Compliance is clearly an issue in creating distraction-free drivers. Meanwhile, everyone on the road—including those who never text or talk on a cell phone—should be aware that not all drivers are equally focused! While commercial bus and truck drivers must not allow themselves to get distracted while driving, they should be aware that many non-commercial drivers might not be as safety conscious.

References:

http://www.distraction.gov/files/for-media/2010.09.22-sec-lahood-remarks-2010summit.pdf

http://www.distraction.gov/

http://ehstoday.com/safety/news/dot-anncounces-distracted-driving-regulations-09222/

http://www.oprah.com/oprahshow/Oprahs-Message-About-Distracted-Driving-No-Phone-Zone-Video

http://www.iihs.org/news/rss/pr092810.html

http://www.irponline.org/irp/DocumentDisplay.aspx?id={C5058A87-0FF2-4A72-BD7F-E1D961399B8B}