1 / 81

DOT UPDATE FOR EMPLOYERS

DOT UPDATE FOR EMPLOYERS. TIMOTHY LEE, MD, MS MEDICAL DIRECTOR, SENTARA OBICI OCCUPATIONAL HEALTH SERVICES. OBJECTIVES. I Review important DOT changes regarding driver certification process II Update Drug Testing Information III Review “Driver Fatigue” issues. Part I.

dalila
Download Presentation

DOT UPDATE FOR EMPLOYERS

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. DOT UPDATE FOR EMPLOYERS TIMOTHY LEE, MD, MS MEDICAL DIRECTOR, SENTARA OBICI OCCUPATIONAL HEALTH SERVICES

  2. OBJECTIVES • I Review important DOT changes regarding driver certification process • II Update Drug Testing Information • III Review “Driver Fatigue” issues

  3. Part I • Updates regarding driver certification process. • Identify key Dates

  4. IMPORTANT DATES • #1 Jan 30, 2012- Jan 30, 2014 • Must show DOT card to SDLA • SDLA’s = State Driver Licensing Agencies • #2 May 21, 2014 • All ME’s (Medical Examiners) must be certified • Employers MUST use ONLY Certified MEs

  5. New Requirement • Jan 30, 2012 – Jan 30, 2014 • All CDL holders must provide information to their State Driver Licensing Agency regarding the type of commercial motor vehicle operation they drive in or expect to drive in with their CDL. • CDL holders required to have a ”certified” medical status who fail to provide and keep up-to-date their medical examiner’s certificate with their SDLA will become ”not-certified” and they may lose their CDL. • MUST SHOW (ALL) DOT CARDS TO DMV

  6. New Requirement • By May 21, 2014 • All MEs Must be certified • Course and Pass Written Examination • By May 21, 2014 • All Employers Must use ONLY certified MEs; • Cards issued prior to this date are OK

  7. How will I know if my provider is certified? • http://nrcme.fmcsa.dot.gov • Can search by: • Name • City and State • Zip code • Business/Employer Name • National Registry Id #

  8. After this is implemented… • Once a month for EACH driver examiner must transmit to FMCSA: • Name, Date of Birth • Drivers License number and State • Date of Exam • Outcome of exam • Intrastate ??? • Date of driver medical certificate Expiration.

  9. Implications… • Better Standardization • Decreased “Doctor Shopping” • For the first time, a nationwide database • Centralized Over-site • Removal process

  10. Recommendations vs. Regulations • Regulations are laws that MUSTbe followed • Vision- must be at least 20/40 in each eye. • Recommendations are guidelines BUT highly recommended. • Expert Panels/intended as “best practice”

  11. If my driver loses their card, can we contact the National Registry? • Answer: NO

  12. Can the expiration date be extended to the end of the month ? • Driver card has an expiration date of April 15, 2012; • Do we have until the end of the month (before April 30th) to re-certify ?

  13. Do we have until the end of the month to get him re-certified ? • Answer: NO • Card expires at MIDNIGHT on the DATE, MONTH and YEAR written on the certificate.

  14. Review… • DOT Driver must present DOT Card to DMV. • By May 21, 2014, MUST use certified Medical Examiner. • http://nrcme.fmcsa.dot.gov

  15. Part IIDOT DRUG TESTING CHANGES

  16. DOT DRUG TESTING UPDATES • Change in “cut-off” levels • Additional substances for testing • Tests every sample for 6-AM • Metabolite unique to HEROIN

  17. Lower Cut-offs for Amphetamines and Cocaine • DOT projects that the lower cut-off levels for cocaine and amphetamines will produce a 30% increase in laboratory confirmed positive tests for both cocaine and amphetamine/ methamphetamine

  18. IMPORTANT • Safety rep sent an employee in for a routine 5-panel reasonable cause drug test after he had appeared to be unusually drowsy before work. Emp. admitted that he was on pain medications (Vicodin). Has comp policy to report certain prescription meds. • Drug test was MRO’d, came back NEGATIVE.

  19. Thoughts… • How did he “pass” the test? • Was Vicodin in his system? • What are the implications for safety? • What is in place to help protect safety?

  20. Remember… • More people abuse “prescription” drugs than “illegal” dugs. • Recommendation: Include all drugs in company policy, legal AND illegal AND over-the-counter; • For safety sensitive employees, “must report all drugs that may impair one’s ability to safely perform their job; this includes but is not limited to all medications whose label states “may cause drowsiness, dizziness etc…”

  21. Take home message… • Routine DOT drug tests DO NOT pick up “synthetic” opiates such as Vicodin, Percocet etc. • DOT drug tests pick up • Morphine • Codeine • 6- AM • If unsure, discuss with your Occ Heath provider!

  22. What new substance(s) were added to DOT Drug Testing? • A. Spice • B. Ecstasy • C. Bath Salts • D. All of the above

  23. What new substance(s) were added to DOT Drug Testing? • A. Spice • B. Bath Salts • C. Ecstasy • D. All of the above

  24. The New Craze…

  25. Spice, K-2 • DEA listed the major components in Spice and K-2 as Schedule I illicit drugs in December 2010 • No medical or licit use for the compounds found in K-2/Spice • Use is not detected in drug test for marijuana • Several laboratories have developed assays to detect Spice/K-2 in urine. • Has not been added to DOT drug panel

  26. What Next? >>> Bath Salts?? Mephedrone (4-MMC) is a drug that blends amphetamine and cathinone structures together to create a hybrid psychedelic stimulant. Cathinone is the psychostimulant that powers the drug khat, a plant that is grown in Africa and smuggled to the United States. Mephedrone has obvious addictive potential. Appears to cause an amphetamine-like effects, including symptoms of paranoia, anorexia, and hyper-vigilance.

  27. Bath Salts & Plant Food--Mephedrone Ivory Wave, Red Dove, and Vanilla Sky are the more common forms of these products. Nominally marketed and sold as bath salts, these substances are not intended for human consumption. Are packaged as bath salts and are relatively easy to prepare and ingest to get high. The white bath powders can be snorted or smoked. Preparation is quite similar to preparation of powdered methamphetamine or cocaine for "snorting." 4-MMC also appears as a product in certain brands of foreign made plant food. Coming from Russia and Cameroon, these substances are typically packaged in small plastic baggies for individual use. They are prepared and snorted in a fashion identical to ingestion of cocaine and methamphetamine.

  28. Bath Salts

  29. ANSWER TO QUESTION… C. ECSTASY

  30. CURRENT DOT PANEL Marijuana (THC) Cocaine Amphetamines Amphetamine Methamphetamine MDMA MDA MDEA Opiates Codeine Morphine 6-AM (heroin) Phencyclidine (PCP)

  31. Part III“FATIGUE”: IMPLICATIONS FOR THE WORKPLACE

  32. First Fatality From Falling Asleep at the Wheel Thag Anderson becomes the first fatality as a result of falling asleep at the wheel.

  33. “Fatigue” and WORK • 1993- Nat. Commission on sleep disorders Research: • - Over 70 Million workers are “overly tired” • - Est. $ “fatigue” related workplace accidents is between $50-100 BILLION/year • - “Fatigued” workers are at least 2X as likely to have an accident

  34. “FATIGUE” RELATED DISASTERS • The Exxon Valdez • Chernobyl/Three Mile Island • The Challenger Disaster

  35. Memorable Fatigue Moments from the Recent Past • Accident at Three Mile Island nuclear power plant- • Destruction of Unit 2 reactor and release of radioactive gases and water into the environment • Nuclear meltdown at Chernobyl - • 300 deaths, $13 billion in economic disruption, increased cancer rates and birth defects • Release of poisons from Union Carbide in Bhopal- • 2,800 deaths, 20,000 cases of respiratory and eye damage, and $3 billion in immediate costs • Grounding of the Exxon Valdez - • 1400 miles of shoreline contaminated, over $8 billion in direct costs

  36. Causative Factors in These and Other Accidents • All occurred in the early morning hours when fatigue levels were high - CIRCADIAN • Sleepiness and circadian disruptions (from shift work) were significant factors • Equipment, mechanical, or procedural errors often initiated the fateful chain of events – DECISION MAKING • At TMI, maintenance workers had closed auxiliary valves; at Chernobyl, a nonstandard procedure was being conducted • However, the fatigue-related decrements in reaction time and judgement ultimately created the disaster- REACTION TIME/JUDGEMENT • Obvious Courses of action were overlooked, mistakes were made, and standard safety procedures were ignored

  37. Fatigue Degrades Performance and Mental Abilities • Accuracy and timing degrade • Lower standards of performance become acceptable • Attentional resources are difficult to divide • The ability to integrate information is lost • Everything becomes more difficult to perform • Social interactions decline • The ability to logically reason is impaired • Attention wanes • Attitude and mood deteriorates • Involuntary lapses into sleep begin to occur

  38. INTERESTING RESEARCH FINDINGS

  39. Fatigued drivers are poor self-assessors !!! Driver’s stated self assessments of their levels of alertness DID NOT correlate with objective measures of performance.

  40. MICROSLEEP • Brief, uncontrolled and spontaneous episodes of physiologic sleep • Significant performance reductions sufficient to create safety risks before & after a microsleep • Usually no subjective awareness

  41. Fatigue Costs Everyone • Half of adults say sleepiness degrades quality of life (poorer mood, energy, health, and family relations) • NHTSA reports driver drowsiness causes 100,000 accidents, 1,500 fatalities, 71,000 injuries, and $12.5 billion a year in monetary losses • Sleepy personnel cost employers $18 billion annually in lost productivity

  42. How has the DOT attempted to deal with driver fatigue?

  43. Federal Motor Carrier Regulations • 49 CFR 392 • 392.3 Ill or fatigued operator • No driver shall operate a motor vehicle, and a commercial motor carrier shall not require or permit a driver to operate a commercial motor vehicle, while the driver’s ability or alertness is so impaired, • or so likely to become impaired, through fatigue, illness, or any other cause, as to make it unsafe for him/her to begin or continue to operate the commercial motor vehicle.

  44. How has the DOT attempted to deal with driver fatigue? • Hours-of-Service (HOS) Limitations (in handout) • Obstructive Sleep Apnea

  45. Fatigue is More of a Problem Now than Ever Before • Most living creatures rely on the natural day/night cues to govern their activity and rest cycles • However, in 1883 the electric light changed that by extending the work day (and increasing production) • In the past century, Americans have reduced their sleep time by 20% (from 9 down to 7 hours a night) • Since 1969, we have added 158 hours a year to our working and commuting time • Over 25 million people now routinely engage in shift work (and many of these are in the military)

  46. MYTHS ABOUT FATIGUE • FALSE: “As long as I’m awake, I’m OK to drive” Being “awake” does not mean that your cognitive performance, judgment or reaction time is not affected by lack of sleep. Performance starts to decline after 15-16 hours of continued alertness. • FALSE: “It doesn’t matter when I drive after being up for 24 hours. The period of most limited attention span after being awake for 24 hours is between 6 a.m. and 11 a.m. • FALSE: “I can learn to get by on less sleep” You cannot change how much sleep you need. It is a physiologic need, genetically determined • FALSE “I can tell when I’m too tired to work” Many studies have shown that individuals have little insight into their level of sleepiness. The more tired you are, the less accurate is your perception of how sleepy you really are!

  47. holdemqueen@hotmail.com

  48. CAUSES OF FATIGUE • Inadequate Sleep • Sleep disorders • Sleep apnea • Loud snoring, pauses in breathing

  49. CAUSES OF FATIGUE • Medications • Even OTC (Benadryl) • Medication side effects • Medical conditions: • Thyroid disorders • Anemia • Psychiatric • Diabetes

More Related