Aircraft Accident Report

SAFETY STUDY
Adopted: February 5, 1990
FATIGUE, ALCOHOL, OTHER DRUGS, AND MEDICAL FACTORS
IN FATAL-TO-THE-DRIVER HEAVY TRUCK CRASHES
VOLUME 1

NTSB Number: SS-90/01
NTIS Number: PB90-917002


SYNOPSIS
For many years, the National Transportation Safety Board has documented the major role played by alcohol and other drug abuse-in causing accidents throughout the U.S. transportation system. The current study focuses an such abuse in accidents involving heavy trucks. The primary purpose in investigating fatal-to-the-driver heavy truck accidents was to assess the role that alcohol and other drugs played in these accidents.

For a one year period, October 1, 1987 through September 30, 1988, the Safety Board investigated every accident in eight States in which a driver of a heavy truck was fatally injured. One hundred and eighty two accident investigations involving 186 heavy trucks were conducted in California, Colorado, Georgia, Maryland, New Jersey, North Carolina, Tennessee and Wisconsin.

Fatal-to-the-driver heavy truck accidents in the eight States represent approximately 25 percent of this type of accident nationwide. While the Safety Board considers this a. significant portion of the total fatal-to-the-driver accidents, it is not a random sample from the annual population of fatally injured truck drivers. However, because of the large sample size and methodology, the Safety Board believes that these accidents are representative of such truck accidents nationwide. The Safety Board does not suggest that fatal-to-the-driver heavy truck accidents are representative of all fatal truck accidents. The accidents are a census of fatal-to-the-driver heavy truck accidents in these States in the year of the study, and their number appears to be consistent with past years. The Safety Board cautions readers to avoid generalizing the results of the analysis of these fatal accidents to either all fatal truck accidents or all truck accidents.

From NTSB toxicological tests, the Safety Board found that 33 percent of the fatally injured drivers tested positive for alcohol and other drugs of abuse. The most prevalent drugs found were marijuana and alcohol (13 percent each), followed by cocaine (9 percent), methamphetamine/amphetamines (7 percent), other stimulants (S percent), and codeine and phencyclidine (PCP) (less than I percent each). Stimulants are the most frequently identified drug class among fatally injured truck drivers.
Fatigue and fatigue-drug interactions were involved in more fatalities in this study than alcohol and other drugs of abuse alone.

In addition, the study found that for the fatally injured drivers:

· The most frequently cited accident probable cause was fatigue (57 drivers or 31 percent) followed by alcohol and other drug use impairment (53 drivers or 29 percent);

· Of the 57 drivers who were fatigued, 19 were also impaired by alcohol and/or other drugs;
· There is a strong association between violation of the Federal hours of service regulations and drug usage;

· Drivers with at least - one suspended or revoked license are more likely than other fatally injured drivers to have used drugs of abuse;

· There is a significant relationship between a driver's prior alcohol and/or other drug offenses and a positive test for drugs of abuse in these accidents. This points up the need for thorough background checks and pre-employment drug tests;

· There is a significant relationship between drug positive test results among professional drivers and a shipment deadline for the load being carried;

· There is a significant relationship between drug positive test results and the type of trucking service provided, truckload (TL) vs. less-than-truckload (LTL). Nearly 42 percent of fatally injured TL carrier drivers tested positive compared with 14 percent of LTL carrier drivers;

· There is a significant relationship between drug positive test results and the day of the week. Saturday, Sunday, and Monday are the days with the highest percentages of drug positive tests;

· While time of day and drug positive tests are not significantly related, 70 percent of the drug positive tests occurred in the following times: 9:00-9:59 am; 1:00-3:59 pm; and 6:00 pm-1:59 am. 1988 FARS data indicates that 48 percent of truck fatal accidents occurred during these times;

· A disproportionately high percentage of drivers who used drugs are single, separated or divorced;

· The driver's medical condition caused or, contributed to 10 percent of the accidents. Over 90 percent of medical condition related accidents involved some form of cardiac incident. This calls into question the effectiveness of the Federal program to assure the proper medical qualification of commercial vehicle drivers;

· Older drivers are less likely to have tested positive for drugs, but are more likely to have had an incapacitating medical incident;

· Occupant protection issues are the most frequently identified non-causal factors involved in a heavy truck fatal accident (68 of 185); and

· In 115 of the 185 accident involved trucks (62 percent), some management deficiency in oversight of the driver or the proper condition of the vehicle was identified. Deficiencies in oversight of both the driver and the vehicle were identified In 32 of 185 (18 percent) accidents.

The study also reviews: the regulations and legislation governing commercial truck operations; previous relevant research in the field of alcohol and other drug abuse; and the highway accident databases now in existence. The study notes the limitations of those databases as a means with which to assess the scope of the alcohol and other drug abuse problem in heavy truck accidents.

The Safety Board noted that there is also the need for a standardized national set of procedures for conducting alcohol and other drug tests when a fatal heavy truck accident takes place.

As a result of this safety study, recommendations have been issued to: the Department of Transportation, the National Highway Traffic Safety Administration, the Federal Highway Administration, the Department of Health and Human Services, Governors of the States, the National Governors Association, trucking industry trade associations, the International Brotherhood of Teamsters, law enforcement associations, the National Home Study Council, the National Association of Trade and Technical Schools, and the Professional Truck Driver Institute of America.

Recommendations include:

· Review of industry structure, operations, and conditions which may create incentives for drivers to violate hours of service regulations and to use drugs of abuse;

· Establishment of a program to merge different truck databases Into a national commercial truck database to provide information on fatal truck accidents and trucking operations;

· Establishment of a program to standardize post-accident toxicological specimen collection, testing, and reporting for truck accidents;

· Revision of the Fatal Accident Reporting System to include standard drug toxicological test results;

· Improvement of regulations to establish hours of service violations, logbook irregularities, multiple logbooks, and a commercial vehicle operation alcohol offense as a reasonable cause requiring a drug test of the driver;

· Improvement of pre-employment drug and alcohol screening including frequent, unannounced drug testing, for an appropriate period, of drivers with an identified alcohol or other drug abuse problem;

· Improvement of medical screening and disqualification standards;

· Requirements for automated devices to identify commercial drivers who exceed hours of service regulations;

· Establishment of fatigue, alcohol and other drug education campaigns oriented toward commercial drivers;

· Improvement of drug recognition capabilities among law enforcement and other personnel with commercial truck driver oversight responsibilities;

· Development of programs to conduct selective alcohol and other drug enforcement actions including a roadside drug testing demonstration at truck inspection lanes, weigh stations, and/or sobriety checkpoints; and,

· Enactment of State legislation to: establish 0.01 blood alcohol concentration (SAC) as the per se offense level for commercial vehicle operators; require collection of blood samples for toxicological testing of all operators in fatal commercial truck accidents; require employers to perform pre-employment drug tests for all commercial truck drivers, to review applicants' prior history, and to require frequent, unannounced testing, for an appropriate period of drivers with an identified alcohol or other drug abuse problem.

RECOMMENDATIONS

As a result of this safety study, the National Transportation Safety Board made the following recommendations:

to the Department of Transportation:

With the assistance of the Department of Labor, Occupational Safety and Health Administration and the Interstate Commerce Commission, conduct a -detailed review of, and report on, trucking industry structure, operations, and conditions, especially shipping, dispatching, and receiving requirements, shipment broker operations, Just-in-time shipments, and truckload/less-than-truckload operations which may create incentives for drivers to violate hours of service regulations and to use drugs of abuse. (Class II, Priority Action) (H-90-10)

Assess and revise, as appropriate, the reporting and accuracy of existing database elements regarding toxicological tests for DOT operated and supported highway accident databases and trucking operations databases to provide complete and accurate reporting of toxicological tests requested and results obtained. (Class II, Priority Action) (H-90-11)

Develop a program to merge elements concerning commercial vehicle operations of the separate DOT operated and supported highway accident databases. These elements should include, but not be limited to, driver history, carrier, vehicle and roadway characteristics, hazardous materials transportation, and alcohol and other drug involvement. (Class II, Priority Action) (H-90-12)

With the assistance of the Department of Health and Human Services, the States, the American Academy of Forensic Sciences, the National Safety Council Committee on Alcohol and Other Drugs, and other organizations as appropriate, standardize procedures for postaccident toxicological specimen collection, chain of custody, testing, and reporting among the States for accidents involving medium and heavy trucks. (Class II, Priority Action) (H-90-13)

Establish, with the Department of Health and Human Services and other organizations as appropriate a postaccident alcohol and other drug analytic test plan for tests to be conducted on a wide range of impairing drugs with results reported at state-of-the-art sensitivity levels. (Class II, Priority Action) (H-90-14)

Provide funding incentives, guidance and assistance to the States to obtain complete toxicological tests and report results (including drug tests requested) to DOT on all vehicle operators involved in fatal commercial vehicle accidents. (Class II, Priority Action) (H-90-15)

to the National Highway Traffic Safety Administration:

Revise the Fatal Accident Reporting System to include standardized drug toxicological tests requested in each fatal accident and results, both single and multiple drug, which would include an estimating system similar to that now use to estimate national alcohol involvement in fatal accidents. (Class II, Priority Action) (H-90-16)

to the Federal Highway Administration:

Require pre-employment alcohol and other drug tests on all drivers of commercial trucks with a gross vehicle weight rating of 10,000 pounds and above as a condition of employment. (Class II, Priority Action) (H-90-17)

Amend 49 CFR 391.21 Application for employment and 391.23 Investigations and inquiries to include a complete review of alcohol and other drug abuse treatment history prior to employment as a commercial truck driver. (Class II, Priority Action) (H-90-18)

Require commercial truck driver applicants with a prior history of drug and/or alcohol abuse to. complete a certified treatment program and obtain a physician's evaluation of substance abuse and dependency. (Class II, Priority Action) (H-90-19)

Require close supervision, including frequent, unannounced drug testing, for an appropriate period, of commercial truck drivers with an identified alcohol or other drug abuse problem. Such testing should be sufficiently frequent to create the likelihood of detection if the person uses drugs of abuse. (Class II, Priority Action) (H-90-20)

Disseminate safety information to national, State, an-i local police agencies, public service and safety agencies, professional truck driver groups and individual truck drivers, regarding: the effects of fatigue, alcohol and other drug use; the interaction of alcohol, drugs and fatigue; the prevalence of drug and alcohol abuse among professional commercial vehicle operators; and, methods of minimizing conditions which lead to commercial vehicle operators driving while fatigued. (Class II, Priority Action) (H-90-21)

Establish a demonstration project(s) to deter the use of alcohol and other drugs by drivers of medium and heavy trucks that includes alcohol and other drug testing at special roadside sobriety check-points, truck inspection lanes, and truck weigh stations. (Class II, Priority Action) (H-90-22)

Establish and fund a program to train instructors to provide drug recognition expert training to Federal agency inspectors/ investigators, police, and other public service personnel with commercial truck and truck driver oversight responsibilities. (Class II, Priority Action) (H-90-23)

Amend 49 CFR 391.43 to require more extensive and frequent state of the art cardiac screening tests and examinations of older commercial truck drivers (age 40 and above) and for all commercial drivers with cardiac conditions. Commercial drivers with a cardiac history or condition should be disqualified until cleared by a competent medical authority. (Class II, Priority Action) (H-90-24)

Develop a clear set of medical standards for cardiac risk assessment and require physicians to use them in qualifying older commercial truck drivers and for commercial drivers with cardiac conditions. Medical certification should include medical state of the art cardiac risk factors. (Class II, Priority Action) (H-90-25)

Provide for criminal penalties for physicians who deliberately qualify commercial truck drivers with serious medical .conditions in spite of contradictory medical evidence and for physicians, commercial drivers, and others who falsify the medical examiner's certificate. (Class II, Priority Action) (H-90-26)

Improve the medical examination form in 49 CFR 391.43 to ensure that the examining physician is aware of truck operation risk factors and of the physical and other stress producing requirements of commercial truck operation. Provide for a means for physicians to acknowledge that they understand the rigors of commercial truck operation and that the driver being examined is qualified for such commercial truck operations. The physician should also certify that he understands the penalties for deliberate and/or false statements on the medical certificate and for medical certificate falsification. (Class II, Priority Action) (H-9017)

Require automated/tamper-proof on-board recording devices such as tachographs or computerized logs to identify commercial truck drivers who exceed hours of service regulations. (Class II, Priority Action) (H-90-28)

As part of the FHWA on-going study of fatigue and loss of alertness among commercial vehicle operators, investigate the interactions of fatigue and drug usage. (Class II, Priority Action) (H-90-29)

Revise 49 CFR Parts 391 and 395 to establish driver hours of service violations, logbook irregularities, or the presence of multiple logbooks as a reasonable cause requiring a drug test of the driver. Amend the regulations and provide notice to drivers of these revised regulations. (Class II, Priority Action) (N-90-30)

Revise 49 CFR Parts-391 and 392 to establish violation of the commercial vehicle operation alcohol offense (49 CFR 392.4, 392.5) as a reasonable cause requiring a drug test of the driver. Amend the regulations and provide notice to drivers of these revised regulations. (Class II, Priority Action) (H-90-31)

Amend 49 CFR Part 392 and 395 to prohibit employers, shippers, receivers, brokers, or drivers from accepting and scheduling a shipment which would require that the driver exceed the hours of service regulations in order to meet the delivery deadline (similar to current regulations regarding schedules which would require the driver to exceed the speed limit [49 CFR 392.61). In conjunction with the Interstate Commerce Commission, provide for operating certificate and financial penalties appropriate to the offense. (Class II, Priority Action) (H-90-32)

to the Department of Health and Human Services:

Assist the Department of Transportation, the States, the American Academy of Forensic Sciences, the National Safety Council Committee on Alcohol and Drugs, and other organizations as appropriate, in standardizing procedures for postaccident toxicological specimen collection, chain of custody, testing, and reporting among the States for accidents involving medium and heavy trucks. (Class II, Priority Action) (N-90-33)

Establish, with the Department of Transportation and other organizations as appropriate, a postaccident alcohol and other drug analytic test plan for tests to be conducted on a wide range of impairing drugs with results reported at state-of-the-art sensitivity levels. (Class II, Priority Action) (H90-34)

to the American Trucking Associations, Regular Common Carrier Conference, the Private Carrier Conference, the National Private Truck Council, the National Tank Truck Carriers, the Owner-Operator Independent Drivers Association, the Shippers National Freight Claim Council, the Commercial Vehicle Safety Alliance, and the International Brotherhood of Teamsters:

Actively promote and encourage your members to use or support: pre-employment tests for alcohol and other drugs; driver violation history checks; and alcohol or other drug abuse treatment history checks. (Class II, Priority Action) (H-9035)

Encourage your membership to participate in alcohol and other drug education and information programs aimed at commercial drivers. (Class II, Priority Action) (H-90-36)

Encourage your membership to participate in education and public information programs regarding: scheduling and its impact on driver fatigue; and the effects of alcohol and other drug use; and, the interaction of drugs and fatigue. (Class II, Priority Action) (H-90-37)

to the International Association of Chiefs of Police, the Commercial Vehicle Safety Alliance, and the International Association of Directors of Law Enforcement Standards and Training:

Disseminate to your members information regarding the prevalence of alcohol -and other drug use/abuse and fatigue among professional commercial truck drivers. (Class II, Priority Action) (H-90-38)

Encourage your members to provide training In drug recognition for those personnel with commercial truck and truck driver enforcement and oversight responsibilities. (Class II, Priority Action) (H-90-39)

to the National Governors Association:

Coordinate development of national programs for State implementation of standardized testing for alcohol and other drugs. (Class II, Priority Action) (H-90-40)

Develop a program for the reporting of all accident toxicological results to the national commercial truck database system. (Class II, Priority Action) (H-90-41)

to the Governors of the 50 States, the Commonwealth of Puerto Rico, the Virgin Islands, and the Territories:

Enact legislation or issue regulations to require the collection of blood samples for alcohol and other drug toxicological testing from all vehicle operators involved in fatal commercial truck accidents. (Class II, Priority Action) (H-90-42)

Report alcohol and other drug toxicological tests requested and results obtained in fatal accidents to the Fatal Accident Reporting System operated by the National Highway Traffic Safety Administration. (Class II, Priority Action) (H-90-43)

Require intrastate motor carriers in your State to:

· Perform pre-employment alcohol and other drug tests for all applicants seeking to work as drivers of commercial trucks weighing over 10,000 pounds GVWR; (Class II, Priority Action) (H-90-44)

· Review the alcohol/drug abuse treatment history of all applicants seeking work as commercial truck drivers; (Class II, Priority Action) (H-90-45)

· Obtain proof that applicants seeking work as commercial truck drivers, who have had a history of alcohol/drug abuse, have successfully completed a certified treatment program and obtained a physician's evaluation of substance abuse and dependency; (Class II, Priority Action) (H-90-46)

· Require close supervision, including frequent unannounced drug testing, for an appropriate period, of commercial truck drivers with an identified alcohol or other drug abuse problem. Such testing should be sufficiently frequent to create the likelihood of detection if the person uses drugs of abuse. (Class II, Priority Action) (H-90-47)

· Require automated/tamper-proof on-board recording devices such as tachographs or computerized logs to identify commercial truck drivers who exceed hours of service regulations. (Class II, Priority Action) (H-90-48)

Disseminate safety information to commercial truck drivers in your State regarding the effects of fatigue, alcohol and other drug use, and the interaction of drugs and fatigue. (Class II, Priority Action)( H-90-49)

Provide drug recognition expert training to personnel in State and local police agencies and in other public safety/law enforcement agencies who have commercial truck and truck driver enforcement and oversight responsibilities. (Class II, Priority Action) (H-90-50)

Develop a coordinated statewide program to conduct selective alcohol and other drug enforcement operations at times and locations of high levels of truck accidents -- specifically at times of high incidence of commercial truck accidents involving alcohol and/or other drugs. (Class II, Priority Action) (H-90-51)

Adopt revised Federal regulations or establish State regulations requiring medical certification of commercial truck drivers and for more extensive and frequent, state of the art cardiac screening tests and examinations of older commercial truck drivers (age 40 and older) And for commercial drivers with cardiac conditions. (Class II, Priority Action) (H-90-52)

Enact legislation or adopt regulations, as appropriate, to define the alcohol concentration level that constitutes driving a commercial motor vehicle under the influence at the lowest possible level consistent with the capability of testing equipment to measure any ingested alcohol. (Class II, Priority Action) (H-90-53)

Enact legislation to establish 0.01 percent (the practical scientific level which allows for instrument sensitivity and individual differences).as the per se offense blood alcohol concentration for operators of commercial vehicles in your State. (Class II, Priority Action) (H-90-54)

to the National Association of Trade and Technical Schools, the National Home Study Council, and the Professional Truck Driver Institute of America:

Encourage your membership to disseminate information to the commercial trucking industry and commercial vehicle operators regarding:

the effects of fatigue, alcohol and other drug use;

the interaction of alcohol, drugs and fatigue;

· the differences between truck driver perception of fatigue and the actual onset of fatigue;
 

methods of minimizing conditions which lead to commercial vehicle operators driving while fatigued. (Class II, Priority Action) (H-90-55)