Evidence Report: Stroke and Commercial Motor Vehicle Driver Safety

Of all occupations in the United States, workers in the trucking industry experience the third highest fatality rate, accounting for 12 percent of all worker deaths. About two thirds of fatally injured truck workers are involved in highway crashes. According to statistics from the U.S. Department of Transportation (DOT), there were 4,932 fatal crashes involving a large truck in 2005 for a total of 5,212 fatalities. In addition, there were 137,144 non-fatal crashes; 59,405 of these were crashes that resulted in an injury to at least one individual (for a total of 89,681 injuries). The purpose of this evidence report is to address several key questions posed by the Federal Motor Carrier Safety Administration (FMCSA). Each of these key questions was developed by the FMCSA so that the answers to these questions would provide information that would be useful in updating its current medical examination guidelines. The three key questions addressed in this evidence report are: Key Question 1: Are individuals who have experienced a stroke at an increased risk for a motor vehicle crash (crash risk or driving performance)? Key Question 2: If so, can neuropsychological testing of individuals who have experienced a stroke predict crash risk? Key Question 3: Among individuals who have experienced a TIA (transient ischemic event), what is the risk of experiencing a future stroke?