Diabetes and Safety-Sensitive Work

For safety-sensitive jobs – such as those involving a firearm or heavy machinery – concern has revolved around whether the worker will become disoriented or incapacitated, according to the American Diabetes Association.

This may be changing in some industries. FMCSA’s recent proposal to ease exemption requirements states that commercial motor vehicle drivers with insulin-treated diabetes mellitus “are as safe as other drivers when their condition is well-controlled.” Drivers with ITDM would be allowed to operate CMVs if they are cleared yearly by a medical examiner listed in the National Registry of Certified Medical Examiners. The risk posed by drivers with controlled diabetes is “very low in general,” the agency states in the rule, which was published in the May 4 Federal Register. FMCSA also believes a yearly doctor visit would allow physicians to promote awareness about hypoglycemia’s effect on driving.


“It’s really great progress,” Paul said. “There’s still plenty of protections. You have to have the treating health care provider provide his or her opinion about qualification. There’s a registry of doctors who have to be certified to provide the Department of Transportation exams. Those are at least two separate medical providers that have to weigh in on the qualification issue or safety issue.”

Similarly, opportunities have expanded for law enforcement officers with diabetes. ACOEM’s National Consensus Guidance for the Medical Evaluation of Law Enforcement Officers states that “blanket bans” of people with diabetes are illegal and inconsistent with medical information. And for firefighters, any disqualification due to diabetes or insulin use must be made on an individual basis.

“The concept is a well-controlled, well-educated, well-motivated diabetic can pretty much do anything,” Samo said.

For pilots, the Federal Aviation Administration states that a history of “diabetes mellitus requiring hypoglycemic medication” is a disqualifying condition, although diabetic pilots who use insulin can apply for a third-class certificate that allows them to fly privately or recreationally. However, the American Diabetes Association wants FAA to change its policy to allow people who treat diabetes with insulin to be medically certified for commercial airline operations.

Additional guidance to clear workers with diabetes for other safety-sensitive jobs would be beneficial, Samo said.

“If someone can be a firefighter and drive an emergency vehicle, why would you say, ‘I’m not going to hire you to drive a forklift in my factory because you’re diabetic,’” Samo said. “It’s irrational. I’d be hard put to think of a job that wouldn’t be able to use the same criteria as the police and fire criteria for other safety-sensitive jobs.”

The above is an excerpt from,”Diabetes and worker safety.” For more information please visit, www.safetyandhealthmagazine.com.

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