Monday, July 21, 2008

CNN does another Hatchet Job on the trucking industry

Medically unfit truckers still on the road, safety study shows

Hundreds of thousands of tractor-trailer and bus drivers in the United States carry commercial driver's licenses, and some of those drivers have suffered seizures, heart attacks or unconscious spells, according to a new U.S. safety study obtained by The Associated Press

There are "hundreds of thousands" of CDL holders and "some of those drivers" have medical problems. Well, how many is some? I'm not sure if this is a poorly written sentence or if the writer is trying to pull a fast one.

According to to the FMCSA there are varying estimates of the number of truck drivers on the road. The CDLIS system, which holds information on current and former CDL holders in all 50 states, has 11.4 million entries. Federal Estimates of the number of people currently working as truck drivers range from 2.9 million to 4.8 million. So there's more than "hundreds of thousands" of CDL drivers out there.

Truckers violating federal medical rules have been caught in every state, according to a review by the AP of 7.3 million commercial driver violations compiled by the Transportation Department in 2006, the latest data available. Texas, Maryland, Georgia, Florida, Indiana, Pennsylvania, Illinois, Michigan, Alabama, New Jersey, Minnesota and Ohio were states where drivers were sanctioned most frequently for breaking medical rules, such as failing to carry a valid medical certificate. Those 12 states accounted for half of all such violations in the United States

Once again we have a pseudostatistic. We are told medical violations are part of 7.3 million violations, but we are not told how big of a part they are. Are they one percent or twenty percent? "Failing to carry a valid medical certificate" can encompass everything from not having the paper CDL physical on your person (not a big deal) to actually not having a current physical (a big deal). You can't renew your CDL without a current medical certificate so folks without one are not going to be doing that forever. Many states also will void your CDL if they don't have a current cert on file for you (one copy goes to the carrier, one to the State, and one to the driver). Being in possession of a piece of plastic that says "CDL" on the front doesn't necessarily mean that you really have a CDL (just like you can still possess a driver's license even though it is suspended).

Now to the case studies:
A Virginia trucker with a prosthetic leg from a farm accident more than 10 years ago is permitted to drive tanker trucks until at least 2012, even though he doesn't have the proper federal paperwork required for amputees. Virginia revoked the medical license for the official who approved him to drive over charges the official was caught illegally distributing controlled substances.
Well, he's probably going to be driving after that too. The scam is that in order to be certified with a prosthetic you have to demonstrate 2 years of safe operation of a Commercial Motor Vehicle with a prosthetic (which you can't legally do without a valid medical certificate). Shades of M.C. Escher.

George Albright Jr., 61, smashed his 70,000-pound tractor-trailer into congested traffic on Interstate 70 in June 2006, killing four women in a Ford sedan about 30 miles east of Columbia, Mo. Albright's employer agreed earlier this year to pay $18 million in a settlement. A Missouri jury acquitted Albright this month on four counts of second-degree involuntary manslaughter, after his lawyers argued in court that a diabetic episode "put him in an altered state of consciousness." Albright wasn't injured.
If the diabetes is controlled without insulin, he's legal. Obviously if he was indeed having a diabetic episode he wasn't managing his diabetes. The medical examiner under any conceivable system is only going to see the driver every so often. If we are going to allow diabetics to operate CMVs we are going to have to depend on them managing their own condition.

The driver of a 15-passenger "Tippy Toes" day-care bus traveling 63 mph on Interstate 240 in Memphis, Tenn., in April 2002 crashed into a bridge, killing the driver and four of the six children aboard. The National Transportation Safety Board said the driver, Wesley B. Hudson, 27, fell asleep, "quite likely due to an undiagnosed sleep disorder." Investigators said children sometimes had to wake up Hudson, whom the NTSB described as obese and a marijuana user.
A 15 passenger van does not require a CDL. According to the NTSB report Mr Hudson did not have a CDL (PDF, page 5). He had a regular Tennessee license with a "for hire" (taxi) endorsement. Indeed, one of the unimplemented recommendations of the governor's commission that investigated the tragedy was to require child care transport workers to have a CDL. But the AP doesn't let any of this stand in the way of a good story.

The dog that didn't bark in this story is the fact that there are no health requirement for operators of RVs, no matter their weight or size, and that states often allow farms and other intrastate operators of trucks to follow much less rigorous standards.

Also left out is the fact that the CDL physical is nothing more than a basic physical. The doctor making the decision about whether or not to certify the driver only has the driver's answers to the health questionnaire, their direct observation, and a urine test to go on. The physician does not have access to the driver's medical records.

A question of incentives for CDL medical examiners might be raised. The article mentions efforts to avoid "doctor shopping" by drivers, but what about carriers? The physical is paid for by the company, which will usually contract with a doctor to perform the exams. It might seem that a "picky" doctor could be at risk for work being sent elsewhere. I don't know that that is a realistic concern for most of the doctors out there, but there probably are a few conflicted physicians on the margins.