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ASSESSING FITNESS to DRIVE for Commercial and Private Vehicle Drivers

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ASSESSING FITNESS to DRIVE for Commercial and Private Vehicle Drivers ASSESSING FITNESS TO DRIVE for commercial and private vehicle drivers MEDICAL STANDARDS FOR LICENSING AND CLINICAL MANAGEMENT GUIDELINES A resource for health professionals in Australia Publication date to be set 1 AUSTROADS Austroads' purpose is to: promote improved Australian and New Zealand transport outcomes provide expert technical input to national policy development on road and road transport issues promote improved practice and capability by road agencies promote consistency in road and road agency operations Austroads membership comprises the six state and two territory road transport and traffic authorities, the Commonwealth Department of Infrastructure and Regional Development, the Australian Local Government Association, and NZ Transport Agency. Austroads is governed by a Board consisting of the chief executive officer (or an alternative senior executive officer) of each of its eleven member organisations: Roads and Maritime Services New South Wales Roads Corporation Victoria Department of Transport and Main Roads Queensland Main Roads Western Australia Department of Planning, Transport and Infrastructure South Australia Department of State Growth Tasmania Department of Transport Northern Territory Territory and Municipal Services Directorate Australian Capital Territory Commonwealth Department of Infrastructure and Regional Development Australian Local Government Association New Zealand Transport Agency. The success of Austroads is derived from the collaboration of member organisations and others in the road industry. It aims to be the Australasian leader in providing high quality information, advice and fostering research in the road transport sector. NATIONAL TRANSPORT COMMISSION The National Transport Commission is an inter-governmental agency charged with improving the productivity, safety and environmental performance of Australia's road, rail and intermodal transport system. As an independent statutory body, the NTC develops and submits reform recommendations for approval to the Transport and Infrastructure Council, which comprises federal, state and territory transport, infrastructure and planning ministers. The NTC also plays an important role in implementation planning to ensure reform outcomes are realised on the ground, as well as coordinating, monitoring, evaluating and maintaining the implementation of approved reforms. NTC's vision Australia's prosperity and community livability is enhanced by the movement of people and goods. NTC's mission To champion and facilitate changes that improve productivity, safety and environmental outcomes. NTC's role To develop national regulatory and operational reform and implementation strategies for road, rail and intermodal transport. 2 ENDORSEMENTS These standards are endorsed by: *Medical College endorsement to be included in due course* 3 ACKNOWLEDGEMENTS Setting these standards involved extensive consultation across a wide range of stakeholders, including regulators, employers, and health professionals. The National Transport Commission and Austroads gratefully acknowledge all contributors including the members of the Maintenance Advisory Group and Older Driver/Multiple Medical Conditions Working Group, and the project team and consultants. In particular, the contributions of various health professional organisations and individual health professionals are recognised as invaluable to the review process. MAINTENANCE ADVISORY GROUP Austroads Ms Cheryl Richey Department of Planning, Transport and Infrastructure South Australia Ms Jean Phillips Department of Transport and Main Roads Queensland Ms Trudy Struber Roads and Maritime Services New South Wales Ms Mary Drewett Transport for New South Wales Ms Irene Siu VicRoads Ms Marilyn Di Stefano Ms Robyn Seymour Australian College of Rural and Remote Medicine Dr Ken Mackey Australasian Faculty of Occupational and Environmental Medicine Dr Bruce Hocking Royal Australian College of General Practitioners Dr Nigel Stocks Victorian Institute of Forensic Medicine Associate Professor Morris Odell Australian Trucking Association Ms Louise Bilato Mr Bill McKinley OLDER DRIVER/MULTIPLE MEDICAL CONDITIONS WORKING GROUP VicRoads Ms Fiona Morris Royal Australian College of General Practitioners Dr Nigel Stocks Occupational Therapy Australia Dr Angela Berndt Associate Professor Stacey George Professor Carolyn Unsworth Monash University of Accident Research Centre Associate Professor Judith Charlton Dr Sjaan Koppel 4 Victorian Institute of Forensic Medicine Associate Professor Morris Odell Alzheimer's Australia Ms Jenny Philipp DIABETES WORKING GROUP Australian Diabetes Society Dr Stephen Twigg Diabetes Australia Ms Renza Scibilia Australian Diabetes Educators Association Ms Toni Rice Mr Brett Fenton Australian College of Rural and Remote Medicine Dr Ken Mackey Department of Planning, Transport and Infrastructure South Australia Ms Jean Phillips HEARING WORKING GROUP Consultant audiologist Dr Ross Dineen Deaf Australia Mr Kyle Miers Deaf Victoria Melissa Lowrie Roads and Maritime Services New South Wales Ms Mary Drewitt Australian Trucking Association Mr Alex Stojanovic VISION WORKING GROUP Royal Australian and New Zealand College of Ophthalmologists Dr Paul Beaumont Dr Michael Delaney Mr Gerhard Schlenther University of NSW, Discipline of Orthoptics Hon. Research Associate Neryla Jolly Optometry Australia Mr Luke Arundel NATIONAL TRANSPORT COMMISSION Ms Belinda Irwin Mr Paul Davies Ms Tania Wilson CONSULTANTS - Project Health Dr Bruce Hocking Ms Fiona Landgren 5 CONTRIBUTING HEALTH PROFESSIONAL ORGANISATIONS The following organisations contributed substantially to the review process: Australian and New Zealand Association of Neurologists Australian Diabetes Educators Association Australian Diabetes Society Australasian Sleep Association Cardiac Society of Australia and New Zealand Epilepsy Society of Australia Occupational Therapy Australia Optometry Australia Royal Australian and New Zealand College of Ophthalmologists Royal Australasian College of Physicians – Chapter of Addiction Medicine Royal Australasian College of Physicians – Australasian Faculty of Occupational and Environmental Medicine CONTRIBUTING CONSUMER HEALTH ORGANISATIONS Alzheimer's Australia Deaf Australia Deaf Victoria Diabetes Australia LEGAL DISCLAIMER These licensing standards and management guidelines have been compiled using all reasonable care, based on expert medical opinion and relevant literature, and Austroads believes them to be correct at the time of printing. However, neither Austroads nor the authors accept responsibility for any consequences arising from their application. Health professionals should maintain an awareness of any changes in health care and health technology that may affect their assessment of drivers. Health professionals should also maintain an awareness of changes in the law that may affect their legal responsibilities. Where there are concerns about a particular set of circumstances relating to ethical or legal issues, advice may be sought from the health professional's medical defence organisation or legal advisor. Other queries about the standards should be directed to the relevant driver licensing authority. 6 FOREWORD *To be developed* 7 CONTENTS PART A: GENERAL INFORMATION 1. About this publication 13 1.1 Purpose 13 1.2 Target audience 13 1.3 Scope 13 1.4 Content 14 1.5 Development and evidence base 15 2. Principles of assessing fitness to drive 16 2.1 The driving task 16 2.2 Medical conditions and driving 18 2.3 Assessing and supporting functional driver capacity 22 3. Roles and responsibilities 25 3.1 Roles and responsibilities of driver licensing authority 26 3.2 Roles and responsibilities of drivers 27 3.3 Roles and responsibilities of health professionals 27 4. Licensing and medical fitness to drive 30 4.1 Medical standards for private and commercial vehicle drivers 30 4.2 Considerations for commercial vehicle licensing 30 4.3 Prescribed periodic medical examinations for particular licensing / authorisation classes 32 4.4 Conditional licences 32 4.5 Reinstatement of licences or removal or variation of licence conditions 34 5. Assessment and reporting process – Step by step 35 5.1 Which forms to use 38 5.2 Steps in the assessment and reporting process 38 PART B: MEDICAL STANDARDS 1. Blackouts 43 1.1 Relevance to the driving task 43 1.2 General assessment and management guidelines 43 1.3 Medical standards for licensing 43 2. Cardiovascular conditions 47 2.1 Relevance to the driving task 47 2.2 General assessment and management guidelines 47 2.3 Medical standards for licensing 52 8 3. Diabetes mellitus 66 3.1 Relevance to the driving task 66 3.2 General assessment and management guidelines 66 3.3 Medical standards for licensing 69 4. Hearing loss and deafness 74 4.1 Relevance to the driving task 74 4.2 General assessment and management guidelines 74 4.3 Medical standards for licensing 76 5. Musculoskeletal conditions 78 5.1 Relevance to the driving task 78 5.2 General assessment and management guidelines 78 5.3 Medical standards for licensing 80 6. Neurological conditions 82 6.1 Dementia 83 6.2 Seizures and epilepsy 89 6.3 Other neurological and neurodevelopmental conditions 103 7. Psychiatric conditions 113 7.1 Relevance to the driving task 113 7.2 General assessment and management guidelines 114 7.3 Medical standards for licensing 115 8. Sleep disorders 118 8.1 Relevance to the driving task 118 8.2 General assessment and management guidelines 118 8.3 Medical standards for licensing 121 9. Substance
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