Last September the Federal Motor Carrier Safety Administration issued new blood pressure guidelines for medical examiners. Although not adopting a specific B/P level, the FMCSA issued guidelines to be used when physically qualifying Commercial Drivers.

What does this mean? Effective September 30, 2004 medical examiners must begin using new physical examination forms which recommend Stage 1 blood pressure concern at 140/90. In the past, blood pressure at or below 160/90 was considered acceptable. Under the new guidelines, the individual medical examiner must consider whether treatment is necessary at a level over 140/90.

49 CFR, 391.41(b)(6) states "has no current clinical diagnosis of high blood pressure likely to interfere with his/her ability to operate a commercial motor vehicle safely;". The new guidelines leave the judgment of whether a drivers blood pressure is likely to interfere with his/her ability to safely operate a commercial vehicle, up to the medical examiner.

Applied practically, employers of commercial drivers must review the new physical examination forms carefully. If the driver's B/P is over 140/90 but the medical examiner has qualified the driver for two years, then the driver is qualified for two years. If the driver's B/P is over 140/90 and the medical examiner has qualified the driver for only one year, then the driver is only qualified for one year.

The good news. FMCSA will no longer cite employers for drivers with elevated blood pressures. The decision as to whether a specific blood pressure level affects an individual's safety, is left up to the medical examiner.

The bad news. The guidelines are subjective on the part of the medical examiner. There will be conflicting medical judgments as to whether an individual is qualified or not. Not having a mandated B/P level will cause some confusion for both medical examiners and employers. Additionally, medical examiners may use either physical form until September 30, 2004. Until then you may have drivers qualified under two different set of guidelines.

The new guidelines will more than likely place some drivers, who were fine under the old standard, into a B/P monitoring category. Additionally, FMCSA won't be looking solely at the medical examiner if they find a driver with severely elevated B/P. The employer has a general responsibility to ensure its drivers are physically qualified. Just because the medical examiner certified a driver with B/P of 200/120 doesn't mean FMCSA is going to let the employer off the hook.

Another area to consider is litigation. Although you may have a driver who meets regulatory compliance, can elevated B/P cost you in Court? Companies should establish a policy of their own to address this issue. There is nothing in the regulations prohibiting you from adopting more stringent requirements.