With 191 million licensed drivers in the United States and virtually no mechanisms to provide medical oversight of non-commercial drivers, the NTSB is promoting a dozen new safety recommendations related to drivers’ health.

Unlike truckers, drivers of four-wheelers usually don’t have to pass any kind of medical screening – except minimal vision tests – to receive and renew their driver’s licenses. But if safety recommendations from the National Transportation Safety Board become reality, doctors and relatives – and virtually anyone else – would be able to report individual drivers’ medical conditions to state motor vehicle agencies without facing prosecution for privacy violations.

In a public meeting last week, NTSB officials outlined their concerns about drivers with certain medical conditions that the board views as being “incompatible with unrestricted operation of motor vehicles.” The board wants a national system to collect and report information regarding the impact of drivers’ medical conditions on traffic accidents.

At the heart of the board recommendations is the contention that states should enact laws to grant legal immunity to people who inform state motor vehicle agencies about other drivers’ medical conditions. NTSB chairman Ellen Engleman Conners said the data is critical to the process of policy making.

“Safety should never rely on guesswork,” she said.

Medical conditions that the NTSB suggests are of particular danger in driving situations include:

• epilepsy,
• diabetes,
• sleep disorders,
• cardiovascular disease,
• Alzheimer’s Disease,
• arthritis,
• eye diseases, and
• alcoholism.

Currently six states require doctors to report drivers with high-risk conditions. They are Nevada, California, Delaware, New Jersey, Oregon and Pennsylvania.

There are no statistics that show the extent to which having such drivers on the road is a problem, according to the NTSB synopsis of last week’s meeting. However, the NTSB reviewed six wrecks in three states that killed eight and injured 24, including five caused by epileptics having seizures and one by a diabetic who had a blackout, before issuing recommendations.

The board said police need to be trained to spot medically-prompted driving problems and doctors need training in discussing such problems with patients, including raising the issue of whether they should get out from behind the wheel.

The NTSB’s Conners said, however, the board must not overreach.

“We don’t want to say people with diabetes shouldn’t drive,” she said, noting that as many as one in four drivers could have a condition that might trigger concern. “You’re talking about a huge federal action that’s potentially going to reach ... into every patient’s life.”

Dr. Mitchell Garber, the NTSB researcher who presented the report, agreed more data would be helpful, and said states have not taken stronger action to date because they don’t know which medical conditions are dangerous and would make it appropriate to revoke licenses.