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February 12, 2020
Docket Management Facility
U.S. Department of Transportation
1200 New Jersey Ave., SE
West Building, Ground Floor, Room W12-140
Washington, DC 20590-0001
Regarding: Docket Number: FMCSA-2019-0151, National Association of the Deaf (NAD) Petition for Rulemaking; Hearing Requirement for Commercial Motor Vehicle Drivers
Dear Sir or Madam:
On behalf of the American College of Occupational and Environmental Medicine (ACOEM), I appreciate the opportunity to comment on the Federal Motor Carrier Safety Administration’s call for public comments on the National Association of the Deaf (NAD) petition for rulemaking. The NAD has petitioned to rescind the requirement for interstate drivers of commercial motor vehicles (CMVs) to be able to hear and speak, and to rescind the rule prohibiting the use of interpreters during the administration of the commercial driver’s license (CDL) skills test.
ACOEM, an international society of more than 4,000 occupational physicians and associated professionals, provides leadership to promote optimal health and safety of workers, workplaces, and environments. Occupational and environmental medicine (OEM) is the medical specialty devoted to the prevention and management of occupational and environmental injuries and illnesses. As such, it is the only medical specialty specifically involved in the matching of the worker’s capabilities to the job requirements. OEM physicians work with a broad range of other health-related professionals including colleagues in internal medicine, cardiology, neurology, psychiatry, nephrology, endocrinology, rehabilitation medicine, orthopedics, and other surgical specialties. In addition, OEM physicians work with professionals in the fields of audiology, industrial hygiene, toxicology, occupational health nursing, safety engineering, industrial relations, health physics, ventilation engineering, mechanical engineering, biomechanics, law public policy, and health education.
ACOEM members perform thousands of physical examinations for commercial driver certification. Unlike many other health care professionals, occupational medicine specialists understand the importance of evaluating not just the individual’s current medical condition, but also the job tasks an individual is required to perform and how that condition may impact safe performance of those tasks. Many of our members can relate one or more incidents where a driver, operating under a medical certificate, suffered a serious medical event with disastrous results. These place the driver and the public safety at unnecessary risk. They also pose additional financial and operational burdens on companies.
ACOEM recommends FMCSA deny the NAD’s petition for rulemaking to rescind the requirements for interstate drivers of commercial motor vehicles (CMV) to be able to hear and speak. In addition, ACOEM recommends denying the NAD’s petition to rescind the rule prohibiting the use of interpreters during the administration of the CDL skills test. We support keeping the waiver process in place.
If we benchmark commercial driver requirements in countries such as Australia, Canada, and the United Kingdom, we find that all of them acknowledge that despite the inconclusive evidence, responsiveness to critical events in the driving environment is tremendously important to ensuring safety. Hearing standards in these countries are similar to those in the United States. In these countries, inability to meet the hearing standard either with or without hearing aids does not necessarily disqualify the person from driving in itself. The standards support an individualized assessment and have waiver programs to address the applicants who are able to show that their impairment does not impact safety. This is similar to what FMCSA currently does in the United States.
In 2008, the FMCSA’s Medical Review Board’s Medical Expert Panel published a report on “Hearing, Vestibular Function and Commercial Motor Vehicle Driver Safety.” The Medical Expert Panel was unable to find studies that assessed whether hearing loss is a risk factor for crashes in CMV drivers. Three studies were found which examined crash risk in private driver license holders with hearing loss. None of these studies support that there was an increased crash risk in this population. Additional search of the available scientific literature examining the relationship between hearing loss and crash risk among CMV drivers yields few results. While a 2010 Australian study with 107 drivers showed that hearing impaired drivers’ ability decreases in a complex environment with distractors, other studies showed no safety concerns or increased crash risk. Research does exist showing an association between hearing loss and cognitive decline up to and including dementia. Overall, however, it appears that the number of studies directly examining CMV drivers specifically is few, and results are conflicting. Thus, there is limited data to support either position.
Commercial driving takes place in a complex, multi-sensory environment that requires a sense of hearing. While the evidence-based research regarding increased crash risk in commercial drivers is limited, the practical concerns are readily apparent. With respect to vehicle safety and safe operation, hearing is important for:
- Detection of external warnings – sirens, horns, railroad track bells
- Detection of internal warnings/alerts – malfunction indicators, warnings such as leaving a parking brake engaged, GPS direction alerts, even mundane sounds like leaving a turn signal engaged
- Communication – dispatchers, co-drivers, law enforcement, inspectors, and in the case of bus drivers, passengers
- Detection of vehicle malfunction – brakes grinding, increased engine noise, the flapping of a tire that is beginning to come apart, squealing of belts, a flapping tarp coming loose, etc.
The
Federal Register notice requests public comments on current practices and accommodations from the providers performing tasks such as CDL Training and CDL Skills Test Administration. It also queries the carriers directly regarding concerns about workplace safety.
While there is some redundancy with warning lights or signals that can assist a hearing- impaired driver, it is not possible to develop or engineer practical solutions to entirely replace a driver’s auditory sense. In an environment where split-second reactions to multiple stimuli may be required to avoid a crash, the inability to adequately hear or respond verbally may have disastrous consequences. Teaching would also be challenging in such a situation and could potentially put the trainer and the student driver at risk. It is unclear how any sort of technology or accommodation could potentially mitigate this risk.
In summary, the preponderance of evidence and knowledge of the dynamic work environment would suggest that granting the NAD’s petitions is not advisable. ACOEM does not support granting these petitions and recommends that the safest course of action is to keep the present waiver system in place. This decision should not be left to the individual medical examiner.
Thank you for your consideration of these comments.
Sincerely,
Stephen A Frangos, MD, MPH, FACOEM President
References
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https://austroads.com.au/publications/assessing-fitness-to-drive/ap-g56/hearing-loss-and-deafness/general-assessment-and-managemendtuuxbfn/commercial-vehicle-drivers