United States Department of Transportation
Federal Motor Carrier Safety Administration
Medical Review Board
Meeting Minutes

The Medical Review Board (MRB) of the U.S. Department of Transportation?s (DOT) Federal Motor Carrier Safety Administration (FMCSA) was convened on April 25, 2007 at the Crowne Plaza, Campbell House, Lexington, Kentucky. The meeting was open to the public.

MRB Members Present:
Dr. Kurt Hegmann, Chairperson
Dr. Gunnar Andersson
Dr. Michael Greenberg, Co-chairperson
Dr. Barbara Phillips
Dr. Matthew Rizzo

FMCSA Staff:
*Larry W. Minor, Director of the Office of Bus and Truck Standards and Operations
Dr. Mary D. Gunnels, Chief, Physical Qualifications Division
Kaye Kirby, Team Leader, Medical Review Board
Pearlie Robinson, Co-Leader, Medical Review Board

*Designated Federal Official

FMCSA Contractors:
Dr. Ellison Wittels, FMCSA Senior Medical Consultant
Stephen Tregear, DPhil, ECRI
Laurie Conly, Manila Consulting Group
John Sheridan, Manila Consulting Group
Maria Soto, Manila Consulting Group

Members of the Public:
Katie Hathaway, American Diabetes Association
Larry Smith, American Diabetes Association

Larry W. Minor, director of the Office of Bus and Truck Standards and Operations, called the fourth public meeting of the MRB to order in his role as DFO.

Dr. Kurt Hegmann, chairperson of the MRB, opened the meeting by stating that the MRB is working on the wording of diabetes guidelines but decided to defer a final vote until its July 26, 2007 meeting in Washington, D.C. He said the MRB expects to address sleep disorders, seizure disorders, and neuromuscular disorders in the fall and will possibly address vision and hearing in 2007 as well.

Stephen Tregear, DPhil of Emergency Care Research Institute was charged by FMCSA with developing an evidence-based research report on ?Cardiovascular Disease (CVD) and Commercial Driving.? His literature search was aimed at identifying studies from which the MRB would develop answers to six key research questions. Click here for key questions.

Dr. Tregear presented the highlights of his report?s findings as well as the recommendations of the Medical Expert Panel (MEP) that reviewed the report. The MEP for cardiovascular disease and driving recommended changes to the current CVD guidelines. Click here to see the changes the MEP recommended.

During final deliberations, the MRB discussed and agreed with the recommendations of the MEP. The MRB recommended using the terms ?medical doctor (MD)" or "doctor of osteopathy (DO) vascular surgeon? rather than ?vascular specialist? as recommended by the MEP and clarified the rate of expansion of thoracic abdominal aneurysms.

The MRB also approved a motion to recommend changes to the exception for the licit use of Schedule II medications. These changes would become a supplement to the Medical Certification Form. Click here to see recommended changes.

During public comment, Larry Smith, a representative of the American Diabetes Association (ADA), asked that the ban on insulin use be lifted because expert opinion shows commercial motor vehicle (CMV) drivers can drive safely while using it. Katie Hathaway, a lawyer for the ADA, asked if the matter would be addressed and if a recommendation would be made at the July 2007 meeting.

Dr. Hegmann said that was a reasonable goal. ?From a personal standpoint, the issues are complex and need careful thought so a good solid evidence-based set of recommendations can be made,? he said.

Disclaimer: FMCSA considers evidence, expert recommendations, and other data; however, all proposed changes to current standards and guidance will be subject to public notice-and-comment and regulatory processes.

Click here to access Medical Expert Panel reports.