FORT LAUDERDALE, Fla. — A fiery 2019 Florida interstate crash that killed five children from a Louisiana church headed to Walt Disney World was caused by a truck driver who hid his long medical history becoming incapacitated and losing control of his semi, investigators said in a report released Thursday.

The National Transportation Safety Board said Steve Holland, 59, had heart disease and other medical conditions when his truck slammed through the center divider on Interstate 75 near Gainesville on Jan. 3, 2019, and into the church van, but for years had failed to report them when he received the health certificate needed to renew his license.

The report said Holland’s medical history probably would not have prevented him from getting his certificate, but it probably would have been for less than the maximum two years that he received.

In the month before the crash, Holland had been treated by doctors for a persistent cough and weakness and had told another driver he had been suffering from chest pains, but he kept driving, the report said. His autopsy said heart disease was a contributing factor to his death, but the report says it is uncertain what medical issue caused him to lose control.

Holland was heading north, carrying mail from South Florida to Georgia for Eagle Express when he lost control about 3:40 p.m. on a clear, dry highway. His truck veered to the left, smashing into a car and pushing both through the center guardrail.

The truck then smashed into a southbound van carrying 12 adults and children from the Avoyelles House of Mercy, a Pentecostal church in Marksville, Louisiana. The children were on winter break and were less than two hours from Disney World. Holland’s truck then smashed head on into another truck, also killing that driver. Several children and Holland were thrown from their vehicles, with the trucks erupting in flames.

A fifth car, unable to avoid the chaos, sped through and hit people who were thrown from the van, the highway patrol said. In addition to the seven deaths, at least eight others were injured, some seriously.

Authorities identified the dead children as Joel Cloud and Jeremiah Warren, both 14; Cara Descant, 13; Briena Descant, 10; and Cierra Bordelan, 9. Church officials did not immediately respond late Thursday to a call and Facebook message seeking comment.

The report says Holland had suffered a heart attack and had undergone bypass surgery in 2010, had high blood pressure and numerous other conditions.

But after receiving only one-year certificates in 2012 and 2013 because of his mounting health issues, Holland in 2014 began falsifying that information on the questionnaire drivers fill out during their health examinations, answering “no” to specific questions about those conditions, investigators said. He also started seeing different doctors who were not familiar with his history. His last examination was 11 months before the crash.

Investigators said there were no mechanical defects to his truck, a 2016 Freightliner, that would have caused the crash. Eagle Express is a division of 10 Roads Express. The Carter Lake, Iowa, company did not immediately respond to an email message late Thursday.

Court records show Holland received numerous tickets between 2000 and 2014 in Florida, Pennsylvania, Ohio, Indiana and Virginia for violations such as speeding, driving an unsafe vehicle, driving an overloaded vehicle and not carrying proof of insurance.