How Healthy Are Truckers?

What it takes for a commercial driver to pass the government physical.

A truck. Click image to expand
A truck

Members of the House of Representatives discussed the health of the nation’s commercial truck drivers on Thursday. The congressional hearing comes after a government investigation identified several truckers who suffer from conditions that should have disqualified them from working on the road. How healthy do you have to be if you want to become a truck driver?

Healthy enough not to collapse at the wheel. Among other things, you can’t suffer from epilepsy, extremely high blood pressure, or acute cardiovascular diseases. Any bus or truck driver who crosses state lines must obtain a fitness certificate (PDF) signed by a medical examiner in order to get a commercial drivers’ license. (The certificate must be renewed at least once every two years.) In total, there are 13 categories of medical conditions that can disqualify a driver. Some, like an amputated hand, might impair normal operation of a vehicle, while others, like heart disease, run the risk of causing sudden death or another medical event that causes a driver to lose control.

Some of the government’s health requirements are very clear-cut: If you suffer from seizures or can’t meet vision or hearing standards, you will almost certainly be disqualified. Diabetics who require insulin treatments are also passed over, although the Federal Motor Carrier Safety Administration has created a program that allows some patients to apply for an exemption. The medical examiner must evaluate patients with other conditions—with the help of advisory guidelines—on a case-by-case basis. For example, the examiner is expected to determine whether a driver’s cardiovascular disease is likely to cause heart failure. Patients with somewhat elevated blood pressure can stay behind the wheel as long as they receive frequent checkups, although they are immediately disqualified if their reading ever rises above 180/110.

The government report (PDF) released this week listed several recent cases in which drivers with severe medical conditions ended up causing fatal accidents. In 2005, for example, a truck driver who had been diagnosed with sleep apnea killed a woman and her infant son in Kansas by crashing into their SUV. (The driver had kept his condition hidden from a medical examiner.) In another case, a trucker who had forged his medical certificate caused a fatal accident in New York after he suffered a seizure.

Of course, if you don’t drive beyond your home state, you aren’t required to get the federal certification. Many states have similar requirements for their own truck and bus drivers, but they are sometimes a little less strict than the federal rules—see, for example, this shorter form (PDF) required for Massachusetts school-bus drivers. And while the medical requirements have recently become the subject of heightened concern, they are nothing new: The federal government was granted the authority to require medical exams in the 1930s.

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Explainer thanks Natalie Hartenbaum of the American College of Occupational and Environmental Medicine and Kurt Hegmann of the Federal Motor Carrier Safety Administration Medical Review Board and the University of Utah.