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CTBSSP COMMERCIAL TRUCK AND BUS SAFETY SYNTHESIS 18 Older Commercial Drivers: Do They Pose a Safety Risk? Sponsored by the Federal Motor Carrier Safety Administration A Synthesis of Safety Practice

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TRANSPORTATION RESEARCH COMMITTEE* ACRP OVERSIGHT BOARD 2010 EXECUTIVE COMMITTEE* TRANSPORTATION RESEARCH BOARD 2009 EXECUTIVE COMMITTEE CHAIR OFFICERS OFFICERS James Wilding CHAIR: Adib K. Kanafani, Cahill Professor of Civil Engineering, University of California, Berkeley Chair: Michael R. Morris, Independent Director of Transportation, North Consultant Central VICE Texas Council CHAIR: Michael of Governments, R. Morris, Arlington Director of Transportation, North Central Texas Council of Vice Chair: Neil J. Pedersen, Administrator, Maryland State Governments, Highway Administration, Arlington Baltimore VICE CHAIR Executive Director: Robert E. Skinner, Jr., Transportation Research Board EXECUTIVE DIRECTOR: Robert E. Skinner, Jr., Transportation Research Board Jeff Hamiel MEMBERS MinneapolisSt. Paul MEMBERS Metropolitan Airports Commission J. BARRY BARKER, Executive Director, Transit Authority J. of River Barry City, Louisville, Barker, KY Executive Director, Transit Authority of River City, Louisville, KY ALLEN D. BIEHLER, MEMBERS Secretary, Pennsylvania DOT, Harrisburg Allen D. Biehler, Secretary, Pennsylvania DOT, Harrisburg LARRY L. BROWN, James Crites SR., Executive Director, Mississippi Larry DOT, L. Jackson Brown, Sr., Executive Director, Mississippi DOT, Jackson DEBORAH DallasFort H. BUTLER, Executive Worth ViceAirport International President, Planning, and CIO, Deborah Norfolk H. Butler, Southern Executive Corporation, Vice Norfolk, VA President, Planning, and CIO, Norfolk Southern Corporation, WILLIAM A.V. CLARK, Richard Professor, Department of Geography, de Neufville University Norfolk, VA of California, Los Angeles EUGENE A. Massachusetts CONTI, JR., Institute of Technology Secretary of Transportation, North Carolina William A.V.DOT, Clark,Raleigh Professor, Department of Geography, University of California, Los Angeles Kevin C. Dolliole NICHOLASUnisonJ. GARBER, Henry Consulting L. Kinnier Professor, David Department S. Ekern, of Civil Engineering, Commissioner, and Director, Virginia DOT, Center for Transportation Studies, Richmond UniversityJohn of Virginia, K. DuvalCharlottesville Nicholas J. Garber, Henry L. Kinnier Professor, Department of Civil Engineering, University of JEFFREY W. HAMIEL, Beverly Executive Municipal Airport Director, Metropolitan AirportsVirginia, Charlottesville Commission, Minneapolis, MN Kitty Freidheim PAULA J. HAMMOND, Secretary, Washington State DOT, Jeffrey OlympiaW. Hamiel, Executive Director, Metropolitan Airports Commission, Minneapolis, MN Freidheim Consulting Edward A. (Ned) Helme, President, Center for Clean Air Policy, Washington, DC EDWARD A. (NED) Steve HELME, President, Center for Clean Grossman Air Policy, Washington, DC ADIB K. KANAFANI, Cahill Professor Jacksonville Aviation Authority of Civil Engineering,Randell UniversityH. Iwasaki, of Director, California, California Berkeley DOT, Sacramento Tom Jensen SUSAN MARTINOVICH, Director, Nevada DOT, CarsonSusan City Martinovich, Director, Nevada DOT, Carson City National Safe DEBRA L. MILLER, Skies Alliance Secretary, Kansas DOT, Topeka Debra L. Miller, Secretary, Kansas DOT, Topeka Catherine M. Lang Neil J. Pedersen, Administrator, Maryland State Highway Administration, Baltimore SANDRA ROSENBLOOM, Professor of Planning, University of Arizona, Tucson Federal Aviation Administration Pete K. Rahn, Director, Missouri DOT, Jefferson City TRACY L. ROSSER, Vice Gina Marie LindseyPresident, Corporate Traffic, Wal-Mart Stores, Inc., Mandeville, LA Sandra Rosenbloom, Professor of Planning, University of Arizona, Tucson STEVEN T. Los Angeles World SCALZO, Chief Airports Operating Officer, Marine Resources Group, Seattle, WA Carolyn Motz Tracy L. Rosser, Vice President, Regional General Manager, Wal-Mart Stores, Inc., Mandeville, LA HENRY G. (GERRY) SCHWARTZ, JR., Chairman (retired), Hagerstown Regional Airport Rosa Jacobs/Sverdrup Clausell Rountree, Civil, Inc., St. Louis, CEOGeneral MO Transroute International Canada Services, Inc., Manager, BEVERLY A. SCOTT, Richard TuckerGeneral Manager and Chief Executive Officer, Metropolitan Pitt Meadows, BC Atlanta Rapid Transit Authority, Atlanta, GA DAVID SELTZER, Principal, Huntsville InternationalMercator Airport Advisors LLC, Philadelphia, PA Chief Operating Officer, Marine Resources Group, Seattle, WA Steven T. Scalzo, DANIEL SPERLING, Professor of Civil Engineering and Environmental Henry G. (Gerry) Science and Policy; Schwartz, Director, Jr., Chairman Institute (retired), of Transportation Jacobs/Sverdrup Studies; Civil, Inc., St. Louis, MO EX and Interim OFFICIO Director, MEMBERS Energy Efficiency Center, University of California, Davis C. Michael Walton, Ernest H. Cockrell Centennial Chair in Engineering, University of Texas, Austin KIRK T. STEUDLE, Director, Michigan DOT, Lansing Linda S. Watson, CEO, LYNXCentral Florida Regional Transportation Authority, Orlando Sabrina Johnson DOUGLAS U.S. Environmental W. STOTLAR, Protectionand President Agency CEO, Con-Way,SteveInc., Williams, Ann Arbor, MI Chairman and CEO, Maverick Transportation, Inc., Little Rock, AR Richard Marchi C. MICHAEL WALTON, Ernest H. Cockrell Centennial Airports Council International--North America Chair in Engineering, University of Texas, Austin Laura McKee EX OFFICIO MEMBERS EX OFFICIO MEMBERS Air Transport Association of America Thad Allen (Adm., U.S. Coast Guard), Commandant, U.S. Coast Guard, Washington, DC Henry Ogrodzinski PETER H. APPEL, Administrator, Research and Innovative National Association of State Aviation Officials Technology Peter H. Appel,Administration, Administrator,U.S.DOT Research and Innovative Technology Administration, U.S.DOT J. RANDOLPH BABBITT, Melissa Sabatine Administrator, Federal Aviation J. Randolph Babbitt, Administration, U.S.DOT Administrator, Federal Aviation Administration, U.S.DOT REBECCA M. BREWSTER, American AssociationPresident of Airport and COO, American Executives Rebecca M. Brewster, Transportation President Research and COO, Institute, American Smyrna, GA Transportation Research Institute, Smyrna, G Robert E. Skinner, President GEORGE BUGLIARELLO, Jr. George Emeritus and University Bugliarello, Professor, PresidentInstitute Polytechnic Emeritus ofand NewUniversity Professor, York University, Polytechnic Institute of New York Brooklyn; Transportation Research Board University, Brooklyn; Foreign Secretary, National Academy of Engineering, Washington, DC Foreign Secretary, National Academy of Engineering, Washington, DC ANNE S. FERRO, Administrator, Federal Motor Carrier Safety JamesAdministration, E. Caponiti, Acting Deputy Administrator, Maritime Administration, U.S.DOT U.S.DOT SECRETARY LEROY GISHI, Chief, Division of Transportation, Bureau Cynthia of IndianDouglass, Acting Affairs, U.S. Deputy Administrator, Department Pipeline of the Interior, and Hazardous Washington, DC Materials Safety Christopher W. Jenks Administration, U.S.DOT Washington, DC EDWARD R. HAMBERGER, President Transportation Research Board and CEO, Association of American Railroads, JOHN C. HORSLEY, Executive Director, American Association LeRoyof Gishi, StateChief, Division Highway of Transportation, and Transportation Bureau Washington, Officials, of Indian Affairs, DC U.S. Department of the Interior, DAVID T. MATSUDA, Deputy Administrator, Maritime Administration, U.S.DOT Washington, DC Edward R. Hamberger, President and CEO, Association of American Railroads, Washington, DC VICTOR M. MENDEZ, Administrator, Federal Highway Administration, U.S.DOT John C. Horsley, Executive Director, American Association of State Highway and Transportation WILLIAM W. MILLAR, President, American Public Transportation Association, Washington, DC Officials, Washington, DC ROBERT J. PAPP (Adm., U.S. Coast Guard), Commandant, U.S. Coast Guard, U.S. Department of Homeland Security, Washington, DC Rose A. McMurry, Acting Deputy Administrator, Federal Motor Carrier Safety Administration, U.S.DO CYNTHIA L. QUARTERMAN, Administrator, Pipeline and Hazardous Ronald Medford,Materials Acting Safety DeputyAdministration, U.S.DOTHighway Traffic Safety Administration, Administrator, National PETER M. ROGOFF, Administrator, Federal Transit Administration, U.S.DOTU.S.DOT DAVID L. STRICKLAND, Administrator, National Highway Traffic Victor Safety Administration, M. Mendez, Administrator,U.S.DOT Federal Highway Administration, U.S.DOT JOSEPH C. SZABO, Administrator, Federal Railroad Administration, U.S.DOT William W. Millar, President, American Public Transportation Association, Washington, DC POLLY TROTTENBERG, Assistant Secretary for Transportation Peter M. Policy, Rogoff,U.S.DOT Administrator, Federal Transit Administration, U.S.DOT ROBERT L. VAN ANTWERP (Lt. Gen., U.S. Army), Chief of Engineers Joseph C. Szabo,and Commanding Administrator, General, Federal U.S. Administration, Railroad Army Corps of U.S.DOT Engineers, Washington, DC Polly Trottenberg, Assistant Secretary for Transportation Policy, U.S.DOT Robert L. Van Antwerp (Lt. Gen., U.S. Army), Chief of Engineers and Commanding General, U.S. Army Corps of Engineers, Washington, DC *Membership as of July 2010. *Membership as of October 2009. *Membership as of October 2009.

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COMMERCIAL TRUCK AND BUS SAFETY SYNTHESIS PROGRAM CTBSSP Synthesis 18 Older Commercial Drivers: Do They Pose a Safety Risk? A Synthesis of Safety Practice Consultants GENE BERGOFFEN MaineWay Services, Inc. with JOHN F. BROCK Windwalker Corporation and LOREN STAPLIN TransAnalytics, LLC S ubscriber C ategories Motor Carriers Public Transportation Safety and Human Factors Research Sponsored by the Federal Motor Carrier Safety Administration TRANSPORTATION RESEARCH BOARD WASHINGTON, D.C. 2010 www.TRB.org

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COMMERCIAL TRUCK AND BUS SAFETY SYNTHESIS PROGRAM CTBSSP SYNTHESIS 18 Safety is a principal focus of government agencies and private-sector organiza- Project MC-18 tions concerned with transportation. The Federal Motor Carrier Safety Admin- ISSN 1544-6808 istration (FMCSA) was established within the Department of Transportation ISBN: 978-0-309-14314-1 on January 1, 2000, pursuant to the Motor Carrier Safety Improvement Act of Library of Congress Control Number 2010925482 1999. Formerly a part of the Federal Highway Administration, the FMCSA's primary mission is to prevent commercial motor vehicle-related fatalities and injuries. Administration activities contribute to ensuring safety in motor carrier 2010 National Academy of Sciences. All rights reserved. operations through strong enforcement of safety regulations, targeting high-risk carriers and commercial motor vehicle drivers; improving safety information systems and commercial motor vehicle technologies; strengthening commercial COPYRIGHT INFORMATION motor vehicle equipment and operating standards; and increasing safety aware- ness. To accomplish these activities, the Administration works with federal, state, Authors herein are responsible for the authenticity of their materials and for and local enforcement agencies, the motor carrier industry, labor, safety interest obtaining written permissions from publishers or persons who own the copy- groups, and others. In addition to safety, security-related issues are also receiving right to any previously published or copyrighted material used herein. significant attention in light of the terrorist events of September 11, 2001. Cooperative Research Programs (CRP) grants permission to reproduce mate- Administrators, commercial truck and bus carriers, government regula- rial in this publication for classroom and not-for-profit purposes. Permission is tors, and researchers often face problems for which information already exists, given with the understanding that none of the material will be used to imply TRB, either in documented form or as undocumented experience and practice. This AASHTO, FAA, FHWA, FMCSA, FTA, or Transit Development Corporation information may be fragmented, scattered, and underevaluated. As a conse- endorsement of a particular product, method, or practice. It is expected that those quence, full knowledge of what has been learned about a problem may not be reproducing the material in this document for educational and not-for-profit uses brought to bear on its solution. Costly research findings may go unused, valu- able experience may be overlooked, and due consideration may not be given to will give appropriate acknowledgment of the source of any reprinted or repro- recommended practices for solving or alleviating the problem. duced material. For other uses of the material, request permission from CRP. There is information available on nearly every subject of concern to commer- cial truck and bus safety. Much of it derives from research or from the work of practitioners faced with problems in their day-to-day work. To provide a system- NOTICE atic means for assembling and evaluating such useful information and to make it available to the commercial truck and bus industry, the Commercial Truck and The project that is the subject of this report was a part of the Commercial Truck Bus Safety Synthesis Program (CTBSSP) was established by the FMCSA to and Bus Safety Synthesis Program conducted by the Transportation Research undertake a series of studies to search out and synthesize useful knowledge from Board with the approval of the Governing Board of the National Research Coun- all available sources and to prepare documented reports on current practices in cil. Such approval reflects the Governing Board's judgment that the program the subject areas of concern. Reports from this endeavor constitute the CTBSSP concerned is appropriate with respect to both the purposes and resources of the Synthesis series, which collects and assembles the various forms of information National Research Council. into single concise documents pertaining to specific commercial truck and bus The members of the technical committee selected to monitor this project and safety problems or sets of closely related problems to review this report were chosen for recognized scholarly competence and with The CTBSSP, administered by the Transportation Research Board, began in early 2002 in support of the FMCSA's safety research programs. The pro- due consideration for the balance of disciplines appropriate to the project. The gram initiates three to four synthesis studies annually that address concerns in opinions and conclusions expressed or implied are those of the research agency the area of commercial truck and bus safety. A synthesis report is a document that performed the research, and, while they have been accepted as appropri- that summarizes existing practice in a specific technical area based typically ate by the technical panel, they are not necessarily those of the Transportation on a literature search and a survey of relevant organizations (e.g., state DOTs, Research Board, the National Research Council, or the Federal Motor Carrier enforcement agencies, commercial truck and bus companies, or other organiza- Safety Administration of the U.S. Department of Transportation. tions appropriate for the specific topic). The primary users of the syntheses are Each report is reviewed and accepted for publication by the technical panel practitioners who work on issues or problems using diverse approaches in their according to procedures established and monitored by the Transportation individual settings. The program is modeled after the successful synthesis pro- Research Board Executive Committee and the Governing Board of the National grams currently operated as part of the National Cooperative Highway Research Program (NCHRP) and the Transit Cooperative Research Program (TCRP). Research Council. This synthesis series reports on various practices, making recommendations The Transportation Research Board, the National Research Council, and the where appropriate. Each document is a compendium of the best knowledge Federal Motor Carrier Safety Administration (sponsor of the Commercial Truck available on measures found to be successful in resolving specific problems. and Bus Safety Synthesis Program) do not endorse products or manufacturers. To develop these syntheses in a comprehensive manner and to ensure inclu- Trade or manufacturers' names appear herein solely because they are considered sion of significant knowledge, available information assembled from numerous essential to the clarity and completeness of the project reporting. sources, including a large number of relevant organizations, is analyzed. For each topic, the project objectives are (1) to locate and assemble docu- mented information (2) to learn what practice has been used for solving or alleviating problems; (3) to identify all ongoing research; (4) to learn what problems remain largely unsolved; and (5) to organize, evaluate, and document the useful information that is acquired. Each synthesis is an immediately useful document that records practices that were acceptable within the limitations of the knowledge available at the time of its preparation. Published reports of the The CTBSSP is governed by a Program Oversight Panel consisting of indi- viduals knowledgeable in the area of commercial truck and bus safety from a COMMERCIAL TRUCK AND BUS SAFETY SYNTHESIS PROGRAM number of perspectives--commercial truck and bus carriers, key industry trade associations, state regulatory agencies, safety organizations, academia, and are available from: related federal agencies. Major responsibilities of the panel are to (1) provide Transportation Research Board general oversight of the CTBSSP and its procedures, (2) annually select syn- thesis topics, (3) refine synthesis scopes, (4) select researchers to prepare each Business Office synthesis, (5) review products, and (6) make publication recommendations. 500 Fifth Street, NW Each year, potential synthesis topics are solicited through a broad indus- Washington, DC 20001 try-wide process. Based on the topics received, the Program Oversight Panel selects new synthesis topics based on the level of funding provided by the and can be ordered through the Internet at: FMCSA. In late 2002, the Program Oversight Panel selected two task-order http://www.national-academies.org/trb/bookstore contractor teams through a competitive process to conduct syntheses for Fiscal Years 2003 through 2005. Printed in the United States of America

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THE NATIONAL ACADEMIES Advisers to the Nation on Science, Engineering, and Medicine The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. On the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Charles M. Vest is president of the National Academy of Engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the ser- vices of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, on its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine. The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy's purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Acad- emy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Charles M. Vest are chair and vice chair, respectively, of the National Research Council. The Transportation Research Board is one of six major divisions of the National Research Council. The mission of the Transportation Research Board is to provide leadership in transportation innovation and prog- ress through research and information exchange, conducted within a setting that is objective, interdisciplinary, and multimodal. The Board's varied activities annually engage about 7,000 engineers, scientists, and other transportation researchers and practitioners from the public and private sectors and academia, all of whom contribute their expertise in the public interest. The program is supported by state transportation departments, federal agencies including the component administrations of the U.S. Department of Transportation, and other organizations and individuals interested in the development of transportation. www.TRB.org www.national-academies.org

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CTBBSP OVERSIGHT COMMITTEE CRP STAFF FOR CTBSSP SYNTHESIS 18 CHRISTOPHER W. JENKS, Director, Cooperative Research Programs CHAIR CRAWFORD F. JENCKS, Deputy Director, Cooperative NORM LITTLER Research Programs American Bus Association NANDA SRINIVASAN, Senior Program Officer EILEEN P. DELANEY, Director of Publications MEMBERS LAMONT BYRD CTBSSP SYNTHESIS STAFF International Brotherhood of Teamsters STEPHEN R. GODWIN, Director for Studies and Special B. SCOTT CLAFFEY Programs Great West Casualty Company JON M. WILLIAMS, Program Director, IDEA and CHRISTOPHER CREAN Synthesis Studies Peter Pan Bus Lines, Inc. DONNA VLASAK, Senior Program Officer ALESSANDRO "ALEX" GUARIENTO DON TIPPMAN, Editor MV Transportation, Inc., Plano, TX DEMISHA WILLIAMS, Senior Program Assistant STEPHEN A. KEPLER DEBBIE IRVIN, Program Associate Commercial Vehicle Safety Alliance BRENDA LANTZ North Dakota State University DEAN NEWELL Maverick Transportation LLC DAVID OSIECKI American Trucking Associations, Alexandria, VA E. JAN SKOUBY Missouri DOT CARI SULLIVAN Two Men and a Truck International, Inc. TOM WEAKLEY OwnerOperator Independent Drivers Association Foundation GREER WOODRUFF J.B. Hunt Transport Services, Inc. CHRISTOPHER ZEILINGER Community Transportation Association of America FMCSA LIAISON ALBERT ALVAREZ MARTIN WALKER FHWA LIAISON Michael S. "Mike" Griffith John C. Nicholas APTA LIAISON GREG HULL AASHTO LIAISON LEO PENNE TRB LIAISON CHARLES W. NIESSNER RICHARD PAIN

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FOREWORD Administrators, commercial truck and bus carriers, government regulators, and researchers often face problems for which information already exists, either in documented form or as undocumented experience and practice. This information may be fragmented, scattered, and underevaluated. As a consequence, full knowledge of what has been learned about a problem may not be brought to bear on its solution. Costly research findings may go unused, valuable experience may be overlooked, and due consideration may not be given to recommended practices for solving or alleviating the problem. There is information available on nearly every subject of concern to commercial truck and bus safety. Much of it derives from research or from the work of practitioners faced with problems in their day-to-day jobs. To provide a systematic means for assembling and evaluating such useful information and to make it available to the commercial truck and bus industry, the Commercial Truck and Bus Safety Synthesis Program (CTBSSP) was established by the Federal Motor Carrier Safety Administration (FMCSA) to undertake a series of studies to search out and synthesize useful knowledge from all available sources and to prepare documented reports on current practices in the subject areas of concern. Reports from this endeavor constitute the CTBSSP Synthesis series, which collects and assembles information into single concise documents pertaining to specific commercial truck and bus safety problems. The CTBSSP, administered by the Transportation Research Board, was authorized in late 2001 and began in 2002 in support of the FMCSA's safety research programs. The program initiates several syn- thesis studies annually that address issues in the area of commercial truck and bus safety. A synthesis report is a document that summarizes existing practice in a specific technical area based typically on a literature search and a survey of relevant organizations (e.g., state DOTs, enforcement agencies, com- mercial truck and bus companies, or other organizations appropriate for the specific topic). The primary users of the syntheses are practitioners who work on issues or problems using diverse approaches in their individual settings. This synthesis series reports on various practices; each document is a compendium of the best knowl- edge available on measures found to be successful in resolving specific problems. To develop these syn- theses in a comprehensive manner and to ensure inclusion of significant knowledge, available information assembled from numerous sources is analyzed. For each topic, the project objectives are (1) to locate and assemble documented information; (2) to learn what practices have been used for solving or alleviating problems; (3) to identify relevant, ongoing research; (4) to learn what problems remain largely unsolved; and (5) to organize, evaluate, and document the useful information that is acquired. Each synthesis is an immediately useful document that records practices that were acceptable within the limitations of the knowledge available at the time of its preparation. PREFACE This synthesis provides a knowledge base regarding age-related changes in the basic functional abilities needed to drive safely that can assist industry and labor practitioners in promoting safer commercial By Donna L. Vlasak operations. Managers of bus and truck fleets, academic and trade association researchers, and federal and Senior Program Officer state agency officials with responsibility for developing effective regulatory and incentive programs may Transportation find this report useful. Research Board The synthesis team conducted a literature review about changes in medical (functional) fitness to drive that affect older drivers generally, and older commercial drivers, specifically. Although research data on older drivers and older drivers in general was found to be broad, findings for older commercial drivers appeared to be limited. One 1995 study proved useful to this synthesis study. As surveys with carriers and others in the trucking industry regarding older drivers' information yielded a low response rate, in-person telephone inter- views were conducted with six carriers to gather more detailed information from industry safety managers. Gene Bergoffen, MaineWay Services, Inc.; John F. Brock, Windwalker Corporation; and Loren Sta- plin, TransAnalytics, LLC, collected and synthesized the information and wrote the report. The Com- mercial Truck and Bus Safety Synthesis Program Oversight Committee members are acknowledged on the preceding page. This synthesis is an immediately useful document that records the practices that were acceptable within the limitations of the knowledge available at the time of its preparation. As progress in research and practice continues, new knowledge will be added to that now at hand.

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Contents 1 SUMMARY 3 CHAPTER ONE INTRODUCTION Background, 3 Objectives and Scope, 3 5 CHAPTER TWO LITERATURE REVIEW Introduction, 5 Medical Conditions and Older Driver Safety, 5 Medication Use and Safety Concerns Among Older Drivers, 8 Age-Related Functional Deficits That Predict Crash Risk, 10 Strategies to Maintain Safety with an Aging Driver Population, 17 21 CHAPTER THREE TRUCK CARRIER INDUSTRY Large Truck Crash Causation Study, 21 Industry's View, 21 22 CHAPTER FOUR CONCLUSIONS General Findings on Older Drivers, 22 General Findings on Older Commercial Drivers, 22 Summary, 22 Conclusions, 23 24 REFERENCES

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