On Mother’s Day in 1999, Custom Bus Charters’ bus driver Frank Bedell veered off a highway near New Orleans, killing 22 passengers and injuring 20 others. Just 10 hours before this trip, Bedell was treated at a local hospital for “nausea and weakness.” He had been treated at least 20 times in the 21 months prior to the accident, and 10 of those times involved hospitalization for “life-threatening” heart and kidney disease. You can read more about this horrific crash, which remains one of the nation’s deadliest bus crashes, at NOLA.com: Loopholes let sick man drive, safety board says. Also of interest: Breaking the law went with the job.
This accident brought the issue of the medical competence of commercial drivers to the public attention in a dramatic way. In its subsequent report of the accident after the investigation, The National Transportation Safety Board (NTSB) determined that “…the probable cause of this accident was the driver’s incapacitation due to his severe medical conditions and the failure of the medical certification process to detect and remove the driver from service. Other factors that may have had a role in the accident were the driver’s fatigue and the driver’s use of marijuana and a sedating antihistamine.
The incident and investigation prompted NTSB to issue Safety Recommendations revolving around medical certification of commercial drivers.
How are we doing today?
Nearly a decade later, how are these safety measures designed to protect the public from medically unsafe commercial drivers working out? Not too well, according to a recent investigative report by News21, which was published by MSNBC in the article Truckers fit to drive — if a chiropractor says so: “From 2002, when the recommendations were made, through 2008, the last year for which data is available, there were at least 826 fatal crashes involving medically unqualified or fatigued drivers, according to a News21 analysis of the FMCSA Crash Statistics database.”
The article paints a scary portrait of a driver medical certification program that is pretty broken. Truck drivers can pop into roadside clinics to pick up certifications issued after a cursory examination by almost any health professional. And that’s a good scenario – drivers can also download online certificates and fill them out themselves or ignore the requirement entirely. Forgeries are a common occurrence. Being caught without a certificate might result in a slap-on-the-wrist fine. While there have been calls for a national registry for medical certification of commercial drivers, the idea has made little progress. It will probably take the next big incident to ignite public outrage to motivate any change.
For a resource on current regulations, see the US Department of Transportation Motor Carrier Safety Administration’s Medical Programs, which includes medical regulations and notices, including drug and alcohol testing.
The News21 story on commercial drivers is the third part in a series of four articles that deal with transportation and public safety. Here are the others:

Part 1: Driving While Tired: Safety officials are slow to react to operator fatigue:
“NTSB does not track fatigue-related highway accidents on a regular basis. But in 1993, the board commissioned a study expecting to learn about the effects of drugs and alcohol on trucking accidents. Investigators studied all heavy-trucking accidents that year and made an unexpected discovery: Fatigue turned out to be the bigger problem. NTSB Crash investigators said driver fatigue played a key role in a bus accident in Utah in 2008 that killed nine people returning from a ski trip.
The study found 3,311 heavy truck accidents killed 3,783 people that year, and between 30 percent and 40 percent of those accidents were fatigue-related.”
Part 2: Video in the cockpit: Privacy vs. safety
In 200, the NTSB added a recommendation for video recorders to be installed in commercial and charter planes to its “most wanted” list. Pilot unions and other groups have lobbied this safety measure. See this story’s sidebar article: Shhhh! Your pilot is napping
Part 4: Outsourcing safety: Airplane repairs move to unregulated foreign shops
“More maintenance has moved overseas. Airlines are not required to use regulated repair shops. Foreign repair stations can go five years between inspections, and even then are often tipped off that inspectors are coming. Manuals are in English, but not all the workers read English. Drug tests of workers are illegal in some countries.
A News21 analysis of Federal Aviation Administration data showed that about 15,000 accidents or safety incidents in all aviation travel can be attributed at least in part to inferior maintenance or repairs since 1973, when the FAA started keeping such records. In these accidents at least 2,500 people died and 4,200 were injured.”
Most wanted list: transportation safety improvements
The NTSB keeps a most wanted list of transportation safety improvements, in which it makes recommendations for critical safety improvements for various transportation sectors. Recommendations are designed to improve public safety and save lives, but many have been on the list for years. In some cases, individual states may have requirements, but these recommendations are national in scope. While issues on the “most wanted list” are pending, individual employers might use the list as best practice guidance for safety programs to limit exposure both for workers compensation and other liability issues that might arise from commercial transportation accidents.
You can find more reports on transportation and public safety at News21, “a national initiative led by 12 of America’s leading research universities with the support of two major foundations” with a purpose of furthering in-depth and investigative reporting. In 2010, one of the main areas of focus has been Breakdown: Traveling Dangerously in America.