October 17, 2016 10:00 AM, EDT

Two FMCSA Advisory Boards to Meet Next Week

Two Federal Motor Carrier Safety Administration advisory boards will meet Oct. 24 to discuss recommendations for agency guidelines on how to diagnose and treat truck driver obstructive sleep apnea.

FMCSA’s Motor Carrier Safety Advisory Committee and Medical Review Board also will be given an update on the agency’s Driver Health and Wellness Initiative.

MCSAC also will meet Oct. 25 to complete its review of the agency's regulatory guidance, and MRB will meet that same day to discuss how to incorporate recently issued warnings from the Food and Drug Administration on narcotics and benzodiazepines.

In August, MRB recommended a slate of sleep apnea guidelines that would require truck drivers to take costly diagnostic sleep studies if they have a body mass index of 40 or higher, have experienced excessive fatigue or sleepiness while driving, or have been in a sleep-related crash.

MRB issued updated recommendations during a two-day session Aug. 22-23 to help the agency formulate a proposed rule that would offer clear guidelines for medical examiners to diagnose and treat moderate to severe obstructive sleep apnea.

Larry Minor, FMCSA’s associate administrator for policy, said after the meeting that if the agency does issue a proposal, it would not come until sometime next year after a new administration is in place in Washington.

The board also recommended that drivers at risk for apnea may be issued conditional 90-day medical certifications pending sleep study and treatment, if diagnosed with apnea.

In addition, the board said that a driver with a body mass index of 33 to 40 should be required to take sleep studies if he or she has three of 11 factors that range from hypertension and type 2 diabetes to a male neck size greater than 17 inches and a history of stroke, or coronary artery disease.

MCSAC offered the recommendations in response to a joint FMCSA and Federal Railroad Administration advance notice of proposed rulemaking March 8. Neither agency is certain whether an apnea rule will be adopted, but each is exploring the possibility, but are excepting comments on the ANPRM through Oct. 19.

On Aug. 31, FDA announced that it has found that the growing combined use of opioid medicines with benzodiazepines or other drugs that depress the central nervous system has resulted in serious side effects, including slowed or difficult breathing and deaths.

Opioids are used to treat pain and cough; benzodiazepines are used to treat anxiety, insomnia, and seizures.

“In an effort to decrease the use of opioids and benzodiazepines, or opioids and other depressants, together, we are adding boxed warnings, our strongest warnings, to the drug labeling of prescription opioid pain and prescription opioid cough medicines, and benzodiazepines,” FDA said.