Federal Motor Carrier Safety Administration's Medical Standards Update and Development Program: Development and Findings of Systematic Reviews of the Best-Available Evidence

To make an effective and robust policy decision about the risks associated with allowing individuals with certain medical conditions to drive a commercial motor vehicle (CMV), relevant stakeholders must understand the mechanisms by which a hazard interacts with driving performance, the probability that such an event will occur, and what potential harms are associated with the occurrence of such an event. Systematically gathering and scientifically analyzing the kind of information is referred to as risk assessment. Phase 1 of the Risk-Based Regulatory Decision Making Framework used by the Federal Motor Carrier Safety Administration (FMCSA), as part of the Medical Standards Update and Development Program, involves conducting systematic reviews of the best available evidence pertaining to the impact of various medical conditions on driver safety. Each systematic evidence review provides both qualitative and quantitative summaries of information relevant to a series of key questions posed by FMCSA as it undertakes to review, revise, and develop new fitness-for-duty regulations and guidance to medical examiners. The purpose of this presentation is to discuss the processes involved in creating systematic reviews of the best-available evidence pertaining to the impact of various medical conditions on driver safety. We will also identify the medical conditions found through these systematic reviews to be associated with an increased risk of motor vehicle crash and discuss the magnitude of risk and strength of evidence for motor vehicle crash risk associated with these diseases/disorders.