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National Standard for Health Assessment of Rail Safety Workers - October 2012

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National Standard for Health Assessment of Rail Safety Workers - October 2012 National Standard for Health www.ntc.gov.au Assessment of Rail Safety Workers October 2012 as amended up to 16 March 2013 National Standard for Health Assessment of Rail Safety Workers - October 2012 for Health Assessment of Rail Safety Workers National Standard Ph: +61 3 9236 5000 National Transport Commission Fax: +61 3 9642 8922 Level 15/628 Bourke Street, [email protected] MELBOURNE VIC 3000 www.ntc.gov.au National Standard for Health Assessment of Rail Safety Workers October 2012 National Transport Commission National Standard for Health Assessment of Rail Safety Workers First published 2004 Second edition 2012 © National Transport Commission National Library of Australia Cataloguing-Publication data: National Standard for Health Assessment of Rail Safety Workers ISBN: 978-1-921604-38-6 Published by National Transport Commission Level 15/628 Bourke Street Melbourne VIC 3000 Australia Phone: +61 3 9236 5000 Fax: +61 3 9642 8922 Email: [email protected] www.ntc.gov.au The National Transport Commission believes this publication to be correct at the time of printing and does not accept responsibility for any consequences arising from the use of information in it. Readers should rely on their own skill and judgement to apply information to particular issues. The National Transport Commission would like to acknowledge VicTrack, the Rail Skills Centre Victoria and Yarra Trams, for supplying images used throughout this publication. An electronic version of this publication is available from the NTC website at: www.ntc.gov.au ii | National Standard for Health Assessment of Rail Safety Workers 2012 Foreword This revised edition of the National Standard for Health Assessment of Rail Safety Workers (the Standard) represents another significant step in the continual improvement of rail safety in Australia. When the Standard was first approved by the Australian Transport Council (ATC) in April 2004, it was the first time that all states and territories adopted a common system of health assessment arrangements for rail safety workers. The approval of the Standard helped rail operators to operate more efficiently within and across state and territory boundaries, helped rail safety workers to maintain sound health and fitness for rail safety work, and provided for equity and portability of medical certification. This revised edition of the Standard ensures that it keeps pace with advances in medical knowledge, continues to be based on an up-to-date understanding of the impact of certain health conditions on safe working performance, and addresses the deficiencies identified in recent rail safety investigations. It should be noted that, in producing this edition of the Standard, it was decided to amalgamate what was previously two volumes into a single volume. This reduces repetition and should make the Standard easier to use. The medical standards have been updated to current best practice using available evidence and specialist medical opinion. Where possible, information has been translated from the commercial vehicle driver standards contained in the recently revised standards for driver licensing, Assessing Fitness to Drive. The Standard is supported by the Guideline for Health Risk Management. This Guideline is not formally part of the Standard, but provides practical guidance and examples to assist rail operators to perform health risk assessments for rail safety workers. This edition of the Standard has been successfully completed with the assistance of industry and government partners. I would like to thank those who have taken time to provide feedback, particularly the numerous medical professionals and transport stakeholders who have provided valuable input in the review process. I would also like to thank the members of the Reference Group. Finally, thanks go to Fiona Landgren and Bruce Hocking from Project Health, along with the following past and present members of the National Transport Commission project team: Lea Morgan, Belinda Irwin, Donna Soo, Claire McCrae, Eliza Murphy, Jeff Potter, Ben Piper, Jane Murray, Kristian Cook and Kate Pearce. Greg Martin PSM Chairman National Transport Commission | iii Contents Foreword iii Acronyms and abbreviations xiii Glossary xiv Part 1: Introduction 1 1 Purpose, scope and structure 1 1.1 Purpose of this Standard 1 1.2 Application and scope of this Standard 2 1.3 Structure of this Standard 2 1.4 Evidence base 3 2 Legislative and program interfaces 3 2.1 Occupational health and safety/work health and safety 3 2.2 Anti-discrimination legislation 4 2.3 Privacy legislation 5 2.4 Drug and alcohol controls 5 2.5 Injury management 6 2.6 Critical incident management 6 2.7 Psychometric testing 6 2.8 Employee assistance programs 6 2.9 Fatigue management 6 2.10 Health promotion 7 3 Responsibilities and relationships 7 3.1 Rail transport operators 8 3.2 Contractors 8 3.3 Rail safety workers 8 3.4 Health professionals 8 3.5 The role of medical specialists 9 Part 2: The health risk management system 11 4 Risk management approach 11 5 Features of the health risk management system 12 5.1 Risk categorisation of rail safety workers 13 5.2 Health assessments matched to risk categories 14 5.2.1 Safety Critical Worker Health Assessments (Categories 1 and 2) 14 5.2.2 Track Safety Health Assessment (Category 3) 16 5.2.3 Task-specific requirements 16 5.2.4 Functional and practical assessments 16 5.2.5 Drug and alcohol screening 17 iv | National Standard for Health Assessment of Rail Safety Workers 2012 5.3 Timing and frequency of health assessments 18 5.3.1 Pre-placement or change of risk category health assessments 18 5.3.2 Periodic health assessments 18 5.3.3 Triggered health assessments 19 5.4 Standard reporting framework 20 5.4.1 Fit for Duty Unconditional 20 5.4.2 Temporarily Unfit for Duty 20 5.4.3 Fit for Duty Conditional 20 5.4.4 Fit for Duty Subject to Review 20 5.4.5 Fit for Duty Subject to Job Modification 21 5.4.6 Permanently Unfit for Duty 21 6 Risk assessment and categorisation process 22 6.1 Step 1: Define the context 22 6.2 Step 2: Identify rail safety tasks 24 6.3 Step 3: Analyse tasks 25 6.4 Step 4: Identify and describe local safety controls 25 6.5 Step 5: Analyse and categorise tasks 25 6.6 Step 6: Identify task-specific health equirementsr 27 6.6.1 Colour vision risk assessment 27 6.6.2 Hearing risk assessment 29 6.6.3 Musculoskeletal requirements 30 6.7 Step 7: Risk control 30 6.8 Step 8: Confirm health assessment equirementsr 31 6.8.1 Occupational health, safety and welfare 31 7 Appointing and authorising health professionals 31 7.1 Who may perform health assessments 31 7.2 Criteria for appointing Authorised Health Professionals 31 8 Administrative systems 33 8.1 Health assessment database 33 8.2 Privacy laws 33 8.2.1 Privacy policy 33 8.2.2 Primary purpose 33 8.2.3 Information disclosure 33 8.2.4 Maintenance and storage of information 34 8.2.5 Interstate considerations 34 8.3 Health assessment forms 34 8.3.1 Request and Report Form 34 8.3.2 Worker Notification and Health Questionnaire 34 National Transport Commission | v 8.3.3 Record for health professional 35 8.3.4 Risk assessment template 35 8.4 Worker identification 36 8.5 Communication with workers 36 8.5.1 Before the assessment 36 8.5.2 After the assessment 36 8.6 Communication with the Authorised Health Professional 36 8.6.1 Before the assessment 36 8.6.2 Supporting information 37 8.6.3 After the assessment 37 8.7 Portability of a health assessment report 37 9 Quality control 38 9.1 General requirements 38 9.2 Nature and extent of quality control system 38 9.3 Audit points 39 Part 3: Procedures for conducting health assessments 41 10 Appointment, documentation and requests for tests 41 11 Orienting the worker 42 12 The examination 42 12.1 History including health questionnaire 43 12.2 Clinical assessments relevant to the worker’s risk category 43 12.2.1 Hearing 43 12.2.2 Vision 44 12.2.3 Musculoskeletal capacity 44 12.2.4 Cardiovascular 44 12.2.5 Biometrics/sleep 45 12.2.6 Substance misuse 45 12.3 Interpretation of the examination findings 45 12.3.1 General considerations 45 12.3.2 Cardiac Risk Score/level 46 12.3.3 Psychological health 46 12.3.4 Sleep 46 12.3.5 Substance misuse 47 12.3.6 Temporary conditions 47 12.3.7 Undifferentiated illness 47 12.3.8 Complex conditions and conditions not covered in this Standard 47 12.3.9 Drugs and Safety Critical Work 48 vi | National Standard for Health Assessment of Rail Safety Workers 2012 13 Additional tests and referral 49 13.1 Functional and practical assessments 49 13.2 Neuropsychological tests 50 13.3 Specialist referral 50 14 Reporting to the employer 50 15 Record keeping 51 16 Informing and counselling the worker 51 17 Communicating with the worker’s general practitioner and other health professionals 52 Part 4: Medical criteria for safety critical worker health assessments (Categories 1 and 2) 55 18 Conditions causing sudden incapacity or loss of situational awareness 55 18.1 Blackouts 55 18.1.1 Relevance to Safety Critical Work 55 18.1.2 General assessment and management guidelines 55 18.1.3 Medical criteria for Safety Critical Workers 55 18.2 Cardiovascular conditions 59 18.2.1 Relevance to Safety Critical Work 59 18.2.2 General assessment and management guidelines 59 18.2.3 Medical criteria for Safety Critical Workers 66 18.3 Diabetes 82 18.3.1 Relevance to Safety Critical Work 82 18.3.2 General assessment and management guidelines 82 18.3.3 Medical criteria for safety critical workers 86 18.4 Neurological conditions 88 18.4.1 Dementia 89 18.4.2 Seizures and epilepsy
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