Bus and truck drivers should be required to undergo more stringent physical examinations, according to the federal National Safety Transportation Board (NTSB), linking recent crashes to drivers with heart problems, kidney disease, and poorly controlled diabetes. In its final report on a 1999 bus crash that killed 22 people in New Orleans, the NTSB said the federal government should make sure that doctors who perform the examinations know the demands of driving a truck or bus, learn how health problems can affect drivers’ performances, and be able to find out if an applicant failed an earlier exam. The exams are given once every two years. In addition, the board said, doctors and others who have concerns about a driver’s health should be able to tell state and federal transportation officials without the risk of being sued. Despite being hospitalized 10 times in the 20 months prior to the accident for heart and kidney disease, the driver in the New Orleans crash was repeatedly cleared to renew his commercial license and doctors never reported his health problems to state or federal officials. Three months after the crash, the driver died of a heart attack. The NTSB blamed the crash on the driver’s poor health and the failure of the doctors to try to take him off the road. The board also recommended setting up a system to allow a prospective employer to find out whether an applicant has failed a drug test, and renewed its suggestions for bus-design standards that would protect occupants more effectively in crashes.