Federal Register / Vol. 87, No. 82 / Thursday, April 28, 2022 / Notices 25337 

FOR FURTHER INFORMATION CONTACT: 

Mr. Joe Nye, Civil Engineer, Federal 

Aviation Administration, Northwest 

Mountain Region, Helena Airports 

District Office, 2725 Skyway Drive, 

Suite 2, Helena, MT 59602. 

The request to release Federal 

obligations may be reviewed, by 

appointment, in person at the same 

location. 

SUPPLEMENTARY INFORMATION: The FAA 

invites public comment on the request 

to release Federal obligations of 15.2 

acres at the Billings Logan International 

Airport under the provisions of the Title 

49, U.S.C. Section 47107(h). 

The City of Billings, referred to herein 

as the Sponsor, has requested release 

from the Federal obligations assigned to 

15.2 acres of land acquired under 

Airport Improvement Program Grant 3– 

30–0008–004–1986. The 15.2 acres is 

shown on the Airport’s Exhibit ‘‘A’’ as 

the east most section of Parcel 2A and 

is isolated from the airfield by Highway 

318. 

The Sponsor has completed an 

appraisal for the 15.2 acres of Parcel 2A 

and found that current fair market value 

of the property is $223,000. The 

Sponsor proposes to reimburse the 

federal interest in the 15.2 acres of 

Parcel 2A by reinvesting an amount of 

$200,700 (90% of the current fair market 

value) towards the AIP eligible portion 

of the terminal expansion currently 

underway. 

The Sponsor proposes to sell the 

property to Northwestern Energy for 

expansion of the Northwestern Energy 

Rimrock Substation. The proposed use 

of this property is compatible with other 

airport operations and the Sponsor will 

retain necessary easements to ensure the 

property continues to serve its intended 

purpose of approach protection and 

compatible land use. 

Any person may inspect the request 

in person at the FAA office listed above 

under FOR FURTHER INFORMATION

CONTACT. 

Issued in Helena, Montana on April 25, 

2022. 

William C. Garrison, 

Manager, Helena Airports District Office. 

[FR Doc. 2022–09094 Filed 4–27–22; 8:45 am] 

BILLING CODE 4910–13–P 

DEPARTMENT OF TRANSPORTATION 

Federal Motor Carrier Safety 

Administration 

[Docket No. FMCSA–2021–0182] 

Qualification of Drivers; Exemption 

Applications; Narcolepsy 

AGENCY: Federal Motor Carrier Safety 

Administration (FMCSA), Department 

of Transportation (DOT). 

ACTION: Notice of denial. 

SUMMARY: FMCSA announces its 

decision to deny the application from 

one individual who requested an 

exemption from the Federal Motor 

Carrier Safety Regulations (FMCSRs) 

prohibiting operation of a commercial 

motor vehicle (CMV) in interstate 

commerce by persons with either a 

clinical diagnosis of epilepsy or any 

other condition that is likely to cause a 

loss of consciousness or any loss of 

ability to control a CMV. 

FOR FURTHER INFORMATION CONTACT: Ms. 

Christine A. Hydock, Chief, Medical 

Programs Division, (202) 366–4001, 

fmcsamedical@dot.gov, FMCSA, DOT, 

1200 New Jersey Avenue SE, Room 

W64–224, Washington, DC 20590–0001. 

Office hours are from 8:30 a.m. to 5 

p.m., ET, Monday through Friday, 

except Federal holidays. If you have 

questions regarding viewing materials in 

the docket, contact Dockets Operations, 

(202) 366–9826. 

SUPPLEMENTARY INFORMATION: 

I. Public Participation 

A. Viewing Comments 

To view comments go to 

www.regulations.gov. Insert the docket 

number, FMCSA–2021–0182, in the 

keyword box, and click ‘‘Search.’’ Next, 

sort the results by ‘‘Posted (NewerOlder),’’ choose the first notice listed, 

and click ‘‘Browse Comments.’’ If you 

do not have access to the internet, you 

may view the docket online by visiting 

Dockets Operations in Room W12–140 

on the ground floor of the DOT West 

Building, 1200 New Jersey Avenue SE, 

Washington, DC 20590–0001, between 9 

a.m. and 5 p.m., ET, Monday through 

Friday, except Federal holidays. To be 

sure someone is there to help you, 

please call (202) 366–9317 or (202) 366– 

9826 before visiting Dockets Operations. 

B. Privacy Act 

In accordance with 49 U.S.C. 

31315(b)(6), DOT solicits comments 

from the public on the exemption 

request. DOT posts these comments, 

without edit, including any personal 

information the commenter provides, to 

www.regulations.gov, as described in 

the system of records notice (DOT/ALL– 

14 FDMS), which can be reviewed at 

www.dot.gov/privacy. 

II. Background 

On December 16, 2021, FMCSA 

published a Federal Register notice (86 

FR 71537) announcing receipt of an 

application from one individual with a 

diagnosis of narcolepsy and requested 

comments from the public. The 

individual requested an exemption from 

49 CFR 391.41(b)(8) which prohibits 

operation of a CMV in interstate 

commerce by persons with either a 

clinical diagnosis of epilepsy or any 

other condition that is likely to cause a 

loss of consciousness or any loss of 

ability to control a CMV. The public 

comment period closed on January 18, 

2022, and one comment was received. 

FMCSA has evaluated the eligibility 

of the applicant and concluded that 

granting an exemption would not 

provide a level of safety that would be 

equivalent to, or greater than, the level 

of safety that would be obtained by 

complying with § 391.41(b)(8). A 

summary of the applicant’s medical 

history related to the narcolepsy 

exemption request was discussed in the 

December 16, 2021, Federal Register 

notice and will not be repeated here. 

The Agency considered information 

from the 2009 Evidence Report, 

‘‘Narcolepsy (with and without 

cataplexy) and Commercial Motor 

Vehicle Driver Safety,’’ and the January 

2010 Medical Review Board (MRB) 

recommendation that individuals with 

narcolepsy be ineligible for a 

commercial driver’s license, even with 

treatment. A copy of the Evidence 

Report is included in the docket. 

Narcolepsy is a chronic neurological 

disorder caused by autoimmune 

destruction of hypocretin-producing 

neurons inhibiting the brain’s ability to 

regulate sleep-wake cycles normally. 

Persons with narcolepsy experience 

frequent excessive daytime sleepiness, 

comparable to how individuals without 

narcolepsy feel after 24 to 48 hours of 

sleep deprivation, as well as disturbed 

nocturnal sleep, which is often confused 

with insomnia. See National Institutes 

of Health Narcolepsy Fact Sheet at 

https://www.ninds.nih.gov/Disorders/ 

Patient-Caregiver-Education/FactSheets/Narcolepsy-Fact-Sheet. 

The 2009 Evidence Report, 

‘‘Narcolepsy (with and without 

cataplexy) and Commercial Motor 

Vehicle Driver Safety,’’ addressed 

whether or not individuals with 

narcolepsy are at an increased risk for 

motor vehicle crashes; whether or not 

currently recommended treatments for 


jspears on DSK121TN23PROD with NOTICES1
25338 Federal Register / Vol. 87, No. 82 / Thursday, April 28, 2022 / Notices 

narcolepsy reduce the risk for motor 

vehicle crashes; and the impact of 

various medication therapies for 

narcolepsy on driver safety. 

The evidence report reviewed studies 

from the available literature and 

evaluated outcomes on measures of 

Excessive Daytime Sleepiness (EDS), 

cataplexy, event rate, measures of 

cognitive and psychomotor function, 

and driving performance. The currently 

available direct and indirect evidence 

supports the contention that drivers 

with narcolepsy are at an increased risk 

for a motor vehicle crash when 

compared to otherwise similar 

individuals who do not have the 

disorder. The direct evidence from three 

crash studies conducted of non-CMV 

drivers showed that individuals with 

narcolepsy are at an increased risk for 

a crash compared to individuals who do 

not have narcolepsy. The indirect 

evidence from studies of driving tests 

and driving simulation examined factors 

associated with simulated driving 

outcomes such as driving performance, 

tracking error, fewer correct responses, 

and more instances of going out of 

bounds compared to healthy controls. 

While there are limitations in the 

quality of the studies that examined 

direct crash risk, both the direct and 

indirect studies showed a strong effect 

size and statistical significance. The 

American Academy of Sleep Medicine 

(AASM) and the European Federation of 

Neurological Societies recommend 

modafinil as the first treatment option 

and methylphenidate as the second 

treatment option. The AASM also 

recommends amphetamine, 

methamphetamine, or 

dextroamphetamine as alternative 

treatments. During literature searches, 

no studies that directly examined the 

impact of treatment with modafinil, 

armodafinil, sodium oxybate (used with 

narcolepsy with cataplexy), or antidepressants on crash risk or driving 

performance were identified. Therefore, 

conclusions regarding treatment with 

these medications on crash risk and 

driving performance could not be made. 

Currently available evidence suggests 

that amphetamines and/or 

methylphenidate are effective in 

improving symptoms of EDS in 

individuals with narcolepsy (quality of 

studies range from ‘‘moderate to low’’). 

However, these improvements do not 

result in levels of daytime sleepiness 

that can be considered to be normal in 

the vast majority of individuals. 

Therefore, conclusions regarding to the 

impact of treatment with amphetamines, 

methylphenidate, or other related 

stimulant drugs on cognitive and 

psychomotor function among 

individuals with narcolepsy could not 

be made. 

In January 2010, the FMCSA’s MRB 

recommended that individuals with 

narcolepsy be ineligible for a 

commercial driver’s license, even with 

treatment. 

Discussion of Comments 

FMCSA received one comment in this 

proceeding from a private citizen who 

did not support granting an exemption 

in the interest of public safety and the 

applicant’s well-being. The commenter 

cites that the applicant’s medical 

provider states that the applicant’s 

current treatment has proven effective 

and that treatment continues without 

explicit determination by the medical 

provider that the current regimen has 

sufficiently remedied the applicant’s 

medical condition such that it would 

not interfere with the ability to drive a 

CMV in the future. FMCSA 

acknowledges the commenter’s concern. 

When evaluating a medical exemption 

application request, FMCSA considers 

the applicant’s relevant medical 

information, however the Agency does 

not make a decision to grant or deny a 

medical exemption solely on the basis 

of an applicant’s medical 

documentation. 

III. Basis for Exemption Determination 

Under 49 U.S.C. 31136(e) and 

31315(b), FMCSA may grant an 

exemption from the FMCSRs for no 

longer than a 5-year period if it finds 

such exemption would likely achieve a 

level of safety that is equivalent to, or 

greater than, the level that would be 

achieved absent such exemption. 

The Agency’s decision regarding this 

exemption application is based on an 

individualized assessment of the 

applicant’s medical information, 

available medical and scientific data 

concerning narcolepsy, and any relevant 

public comments received. 

IV. Conclusion 

The Agency has determined that the 

available medical and scientific 

literature and research provides 

insufficient data to enable the Agency to 

conclude that granting this exemption 

would achieve a level of safety 

equivalent to, or greater than, the level 

of safety maintained without the 

exemption. Therefore, the following 

applicant has been denied an exemption 

from the physical qualification 

standards in § 391.41(b)(8): 

Sheila Bennett (TN) 

The applicant has, prior to this notice, 

received a letter of final disposition 

regarding their exemption request. The 

decision letter fully outlined the basis 

for the denial and constitute final action 

by the Agency. The name of the 

individual published in this notice 

summarizes the Agency’s recent denials 

as required under 49 U.S.C. 31315(b)(4). 

Larry W. Minor, 

Associate Administrator for Policy. 

[FR Doc. 2022–09016 Filed 4–27–22; 8:45 am] 

BILLING CODE 4910–EX–P 

DEPARTMENT OF TRANSPORTATION 

Federal Motor Carrier Safety 

Administration 

[Docket No. FMCSA–1998–4334; 

FMCSA–1999–6156; FMCSA–1999–6480; 

FMCSA–2001–10578; FMCSA–2002–11714; 

FMCSA–2002–12844; FMCSA–2003–15892; 

FMCSA–2003–16564; FMCSA–2004–17984; 

FMCSA–2004–18885; FMCSA–2005–21254; 

FMCSA–2005–21711; FMCSA–2005–22194; 

FMCSA–2005–22727; FMCSA–2005–23238; 

FMCSA–2006–24015; FMCSA–2006–24783; 

FMCSA–2007–0017; FMCSA–2007–27897; 

FMCSA–2008–0021; FMCSA–2008–0174; 

FMCSA–2008–0231; FMCSA–2008–0266; 

FMCSA–2008–0292; FMCSA–2009–0011; 

FMCSA–2009–0154; FMCSA–2009–0206; 

FMCSA–2009–0291; FMCSA–2009–0303; 

FMCSA–2010–0372; FMCSA–2010–0385; 

FMCSA–2011–0102; FMCSA–2011–0124; 

FMCSA–2011–0140; FMCSA–2011–0275; 

FMCSA–2011–0299; FMCSA–2011–0324; 

FMCSA–2011–0325; FMCSA–2011–0365; 

FMCSA–2011–0366; FMCSA–2011–0378; 

FMCSA–2011–0379; FMCSA–2011–0380; 

FMCSA–2011–26690; FMCSA–2012–0279; 

FMCSA–2012–0338; FMCSA–2013–0022; 

FMCSA–2013–0026; FMCSA–2013–0027; 

FMCSA–2013–0028; FMCSA–2013–0165; 

FMCSA–2013–0166; FMCSA–2013–0167; 

FMCSA–2013–0168; FMCSA–2013–0169; 

FMCSA–2013–0170; FMCSA–2013–0174; 

FMCSA–2014–0002; FMCSA–2014–0003; 

FMCSA–2014–0004; FMCSA–2014–0010; 

FMCSA–2014–0296; FMCSA–2014–0298; 

FMCSA–2015–0048; FMCSA–2015–0049; 

FMCSA–2015–0052; FMCSA–2015–0053; 

FMCSA–2015–0055; FMCSA–2015–0056; 

FMCSA–2015–0070; FMCSA–2015–0071; 

FMCSA–2015–0072; FMCSA–2015–0344; 

FMCSA–2015–0345; FMCSA–2015–0347; 

FMCSA–2015–0348; FMCSA–2015–0350; 

FMCSA–2015–0351; FMCSA–2016–0024; 

FMCSA–2016–0033; FMCSA–2016–0209; 

FMCSA–2016–0377; FMCSA–2017–0017; 

FMCSA–2017–0019; FMCSA–2017–0024; 

FMCSA–2017–0026; FMCSA–2017–0028; 

FMCSA–2018–0006; FMCSA–2018–0007; 

FMCSA–2018–0008; FMCSA–2018–0010; 

FMCSA–2018–0012; FMCSA–2019–0008; 

FMCSA–2019–0009; FMCSA–2019–0010; 

FMCSA–2019–0013; FMCSA–2019–0015; 

FMCSA–2019–0017; FMCSA–2019–0018; 

FMCSA–2019–0019; FMCSA–2020–0005; 

FMCSA–2020–0006] 

Qualification of Drivers; Exemption 

Applications; Vision 

AGENCY: Federal Motor Carrier Safety 

Administration (FMCSA), Department 

of Transportation (DOT). 


jspears on DSK121TN23PROD with NOTICES1