title: FMCSA's medical review board: five years of progress in commercial driver medical examinations.
abstract: OBJECTIVE
  To revise and update guidance recommendations to the Federal Motor Carrier Safety Administration for evaluating commercial drivers.
  
  
  METHODS
  The Federal Motor Carrier Safety Administration's medical review board has addressed guidance for commercial drivers for the past 5 years. The processes for most topics involve comprehensive literature searches, evidence reports, medical expert panel reports, critique of the literature, testimony, and decision making.
  
  
  RESULTS
  No quality literature evaluating risk of crash among commercial motor vehicle drivers was found for most medical conditions. Little literature was available for crash risk among all drivers. For select conditions, such as seizure disorders, obstructive sleep apnea, and narcolepsy, there is evidence of increased crash risk among the general driving population and evidence-based guidance is now available.
  
  
  CONCLUSIONS
  Detailed guidance from the Medical Review Board is available for assessing commercial drivers with various disorders. Many challenges remain.
authors.affiliation: Rocky Mountain Center for Occupational and Environmental Health, University of Utah, Salt Lake City, Utah 84108, USA. kurt.hegmann@hsc.utah.edu
authors.forename: Kurt T
authors.initials: KT
authors.lastname: Hegmann
authors.forename: Gunnar B J
authors.initials: GB
authors.lastname: Andersson
authors.forename: Michael I
authors.initials: MI
authors.lastname: Greenberg
authors.forename: Barbara
authors.initials: B
authors.lastname: Phillips
authors.forename: Matthew
authors.initials: M
authors.lastname: Rizzo
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000328:Adult; D000368:Aged; D001333:Automobile Driver Examination / Q000706:statistics & numerical data*; D004827:Epilepsy / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009290:Narcolepsy / Q000453:epidemiology; D012306:Risk; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology; D055815:Young Adult