Prevention Book

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DOT ExaminationAka: Department of Transportation Examination

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  1. Absolute disqualifying conditions for certification
    1. Diabetes Mellitus requiring Insulin Therapy
      1. Other Diabetes Mellitus management not excluded
        1. Diet control
        2. Oral Hypoglycemic control
      2. Other management must result in good glucose control
        1. Certify for one year at a time to ensure monitoring
    2. Seizure disorder
      1. Does not include childhood Febrile Seizures
      2. No isolated Seizure in last 5 years
      3. No multiple Seizures in last 10 years
      4. No medications
      5. Refer questionable cases to Neurology
    3. Significant Hearing Loss
      1. Hearing Aid may be worn
      2. Screening with whispered voice
        1. Negative if heard at 5 feet in at least one ear
      3. Audiogram Evaluation (indicated for positive screen)
        1. Average Hearing Loss at 500, 1000, and 2000 Hz
          1. Calculate for better ear
          2. Add values together and divide by three
        2. Qualification requires 40 decibel average or less
    4. Significant Vision Loss
      1. Vision correction may be used
      2. Visual Acuity must be at least 20/40 in each eye
      3. Field of vision must be 70 degrees in each eye
      4. Color vision must recognize red, green and amber
  2. Special Circumstances with Possible Disqualification
    1. Extremity loss or Impairment
      1. Examples
        1. Amputation
        2. Fused or immobile knee or hip
        3. Partial limb paralysis
      2. Unqualified unless waiver received
        1. Waiver obtained by Director of Motor Carriers
    2. Cardiovascular disease with risk of Syncope or CHF
      1. Asymptomatic and isolated arrhythmia may be ok
      2. Cardiology evaluation recommended
        1. Myocardial Infarction or Angina
        2. Cardiac arrhythmia
          1. Tachycardia
          2. Bradycardia
      3. Consider additional testing
        1. Holter Monitoring
        2. Exercise Stress Test
    3. Significant Respiratory Disease
      1. Spirometry indicated for significant symptoms
      2. Spirometry findings requiring oxygenation assessment
        1. Forced Expiratory Volume (FEV1) <65% of predicted
        2. Forced Vital Capacity (FVC) <60% of predicted
        3. FEV1 to FVC ration <65% of predicted
      3. Oxygenation assessment
        1. Arterial Blood Gas (ABG) indicated for O2 Sat <92%
        2. Disqualifying Arterial Blood Gas values
          1. PaO2 <65 mmHg
          2. PaCO2 >45 mmHg
    4. Uncontrolled Hypertension
      1. Initial Blood Pressure (may take several readings)
        1. Disqualifying Blood Pressure: 181/105 or higher
        2. Temporary Certification (3 months): 161/91 or over
        3. Full Two year certification: 160/90 or lower
      2. Treated Hypertension (if disqualified above)
        1. Consider sudden collapse risk if end organ damage
        2. Certify for only one year at a time
    5. Disorders that alter driving ability or judgment
      1. Disqualification per physician assessment
      2. Examples
        1. Musculoskeletal, neurologic or vascular disease
        2. Psychiatric illness
          1. Judgment or reality perception affected
          2. Reaction time affected
          3. Psychotropic medications altering consciousness
        3. Consciousness altering substance use
          1. Schedule I Drug (e.g. Amphetamine, Narcotic)
          2. Current Alcoholism
            1. Consider Substance Abuse counselor assessment
  3. Resources
    1. Federal Highway Administration
      1. http://www.fhwa.dot.gov
    2. DOT Regulations
      1. http://www.acoem.com/dot/dotregs.html
  4. References
    1. Pommerenke (1998) Am Fam Physician 58(2):415

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