Chronic obstructive pulmonary disease (COPD) is not a single disease, but a group
of medical conditions characterized by chronic reduction of maximal expiratory flow
most often caused by:
- Chronic bronchitis.
Most drivers with COPD have a combination of chronic bronchitis and emphysema. COPD
has an insidious onset. The driver may have substantial reduction in lung function
prior to developing dyspnea on exertion. The cardinal symptoms are:
- Chronic cough.
- Sputum production.
- Dyspnea on exertion.
As the disease progresses, these symptoms can become incapacitating. In the majority
of cases, cigarette smoking is a primary etiologic factor.
Certification/Recertification — Chronic Obstructive Pulmonary Disease
No recommended time frame
You should not certify the driver until etiology is confirmed and treatment has
been shown to be adequate/effective, safe, and stable.
Maximum certification — 2 years
Recommend to certify if:
As the medical examiner, you believe that the nature and severity of the medical
condition of the driver is stable and does not endanger the health and safety of
the driver and the public.
Recommend not to certify if:
The driver has:
- Hypoxemia at rest.
- Chronic respiratory failure.
- History of continuing cough with cough syncope.
Obvious difficulty breathing in a resting position is an indicator for additional
pulmonary function tests.
If the forced expiratory volume in the first second of expiration (FEV1)
is less than 65% of that predicted, arterial blood gas measurements should be evaluated.
NOTE: Smokers have a high incidence of COPD, yet individuals may
have a significant reduction in lung function without symptoms. Spirometry should
be performed in all smokers over the age of 35 years.
The driver should have follow-up dependent upon the clinical course of the condition
and recommendation of the treating healthcare provider.
The complete text of the medical conference reports can be accessed from FMCSA Medical Reports.