Assessing Fitness to Drive

Table of Contents

Front matter
Foreword
Part A. Fitness to drive principles and practices
1. About this publication
- 1.1. Purpose
- 1.2. Target audience
- 1.3. Scope
- 1.4. Content
- 1.5. Development and evidence base
2. Assessing fitness to drive – general guidance
- 2.1. The driving task
- 2.2. Impact of medical conditions on driving
- 2.3. Assessing and supporting functional driver capacity
3. Roles and responsibilities
- 3.1. Roles and responsibilities of driver licensing authorities
- 3.2. Roles and responsibilities of drivers
- 3.3. Roles and responsibilities of health professionals
4. Licensing and medical fitness to drive
- 4.1. Medical standards for private and commercial vehicle drivers
- 4.2. Considerations for commercial vehicle licensing
- 4.3. Prescribed periodic medical examinations for particular licensing authorisation classes
- 4.4. Conditional licences
- 4.5. Reinstatement of licences or removal or variation of licence conditions
5. Assessment and reporting process – step by step
- 5.1. Steps in the assessment and reporting process
- 5.2. Which forms to use
References and further reading
Part B. Medical standards
Fitness to drive assessment
1. Blackouts
- 1.1. Relevance to the driving task
- 1.2. General assessment and management guidelines
- 1.3. Medical standards for licensing
2. Cardiovascular conditions
- 2.1. Relevance to the driving task
- 2.2. General assessment and management guidelines
- 2.3. Medical standards for licensing
3. Diabetes mellitus
- 3.1. Relevance to the driving task
- 3.2. General assessment and management guidelines
- 3.3. Medical standards for licensing
4. Hearing loss and deafness
- 4.1. Relevance to the driving task
- 4.2. General assessment and management guidelines
- 4.3. Medical standards for licensing
5. Musculoskeletal conditions
- 5.1. Relevance to the driving task
- 5.2. General assessment and management guidelines
- 5.3. Medical standards for licensing
6. Neurological conditions
- 6.1. Dementia
- 6.2. Seizures and epilepsy
- 6.3. Other neurological and neurodevelopmental conditions
7. Psychiatric conditions
- 7.1. Relevance to the driving task
- 7.2. General assessment and management guidelines2,6,7
- 7.3. Medical standards for licensing
8. Sleep disorders
- 8.1. Relevance to the driving task
- 8.2. General assessment and management guidelines
- 8.3. Medical standards for licensing
9. Substance misuse
- 9.1. Relevance to the driving task
- 9.2. General assessment and management guidelines
- 9.3. Medical standards for licensing
10. Vision and eye disorders
- 10.1. Relevance to the driving task
- 10.2. General assessment and management guidelines
- 10.3. Medical standards for licensing
Part C. Appendices
Appendix 1. Regulatory requirements for driver testing
Appendix 2. Forms
Appendix 3. Legislation relating to reporting
Appendix 4. Drivers’ legal BAC limits
Appendix 5. Alcohol interlock programs
Appendix 6. Disabled car parking and taxi services
Appendix 7. Seatbelt use
Appendix 8. Helmet use
Appendix 9. Driver licensing authority contacts
Appendix 10. Specialist driver assessors
Appendix 11. Search Fitness to Drive resources

Help for professionals

For guidance in assessing a patient’s fitness to drive contact your State or Territory driver licensing authority (see Appendix 9 for details). Information is also available from the Austroads website.

Publication information

Assessing Fitness to Drive
First Published 1998
Second Edition 2001
Third Edition 2003
Reprinted 2006
Fourth Edition 2012
Reprinted 2013
Fifth Edition 2016
Reprinted 2017
Sixth Edition 2022

© Austroads Ltd 2022
This work is copyright. Apart from any use as permitted under the Copyright Act 1968, no part may be reproduced by any process without the prior written permission of Austroads.

Publication data
Assessing Fitness to Drive 2022
ISBN: Hardcopy 978-1-922700-17-9; PDF 978-1-922700-21-6
Austroads Publication Number: AP-G56-22

Published by Austroads Ltd
Level 9, 570 George Street
Sydney NSW 2000 Australia
Phone: +61 2 8265 3300
Email: austroads@austroads.com.au
www.austroads.com.au

Austroads 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 herein. Readers should rely on their own skill and judgement to apply information to particular issues.

About Austroads and the NTC

Austroads

Austroads is the collective of the Australian and New Zealand transport agencies, representing all levels of government. Austroads’ purpose is to support its member organisations to deliver an improved Australasian road transport network. To succeed in this task, Austroads undertakes leading-edge road and transport research which underpins its input to policy development and published guidance on the design, construction and management of the road network and its associated infrastructure. Austroads also supports its members to achieve consistency and improvements in the application of registration and licensing practices, processes and systems.

National Transport Commission

The NTC is a national land transport reform agency that supports Australian governments to improve safety, productivity and environmental outcomes, provide for future technologies and improve regulatory efficiency.

The NTC has a legislative requirement to develop, monitor and maintain uniform or nationally consistent regulatory and operational arrangements for road, rail and intermodal transport.

As a key contributor to the national reform agenda, the NTC is accountable to Commonwealth, state and territory ministers who are responsible for transport and infrastructure and make up membership of the Infrastructure and Transport Ministers’ Meeting (ITMM). The NTC works closely with ITMM’s advisory body, the Infrastructure and Transport Senior Officials’ Committee, which includes the heads of Commonwealth, state and territory agencies.

Acknowledgements

Setting these standards involved extensive consultation across a wide range of stakeholders including regulators, employers and health professionals. The NTC and Austroads gratefully acknowledge all contributors including the members of the Advisory Group, the Medicinal Cannabis Working Group, the project team and consultants. In particular, the contributions of various health professional organisations and individual health professionals are invaluable to the review process.

Advisory Group

Derise Cubin, Access Canberra
Rebecca Wilson, Access Canberra
Bill McKinley, Australian Trucking Association
Dr Ramu Nachiappan, Australian College of Rural and Remote Medicine
Adam Cameron, Department for Infrastructure and Transport
Scott Swain, Department for Infrastructure and Transport
Amie Buisman, Department of Transport (WA)
Karen Webb, Department of State Growth
A/Prof. Sjaan Koppel, Monash University Accident Research Centre
Andreas Blahous, National Heavy Vehicle Regulator
Emily Hicks, Office of Road Safety
Parik Lumb, Road Safety Commission
Prof. Nigel Stocks, Royal Australian College of General Practitioners
Lee Cheetham, Transport for NSW
Irene Siu, Transport for NSW
Yessenia Pineda-De Leon, Transport and Main Roads
Fiona Morris, Department of Transport (Vic)
Dr Marilyn DiStefano, Department of Transport (Vic)
Dr Sanjeev Gaya, Victorian Institute of Forensic Medicine

Medicinal Cannabis Working Group

Dr Shruti Navathe, Access Canberra
David Sutton, Department for Infrastructure and Transport
Scott Swain, Department for Infrastructure and Transport
Sharon Wishart, Department of Transport (Vic)
Tim Umbers, Department of Transport (Vic)
Amie Buisman, Department of Transport (WA)
Sussan Osmond, Department of Transport and Main Roads
Prof. Iain McGregor, Lambert Initiative for Cannabinoid Therapeutics, USYD
Dr Tamara Nation, National Institute of Integrative Medicine
A/Prof. Vicki KotsirilosNICM, University of Western Sydney
Adelaide Jones, Office of Road Safety
Prof. Edward Ogden, St Vincent’s Hospital Melbourne
Prof. Yvonne Bonomo, St Vincent’s Hospital Melbourne
Sally Millward, Transport for NSW
Dr Sanjeev Gaya, Victorian Institute of Forensic Medicine

Contributing health professional organisations

The following organisations contributed substantially to the review process:

Australian and New Zealand Association of Neurologists
Australian Diabetes Society
Australasian Sleep Association
Cardiac Society of Australia and New Zealand
Cognitive Dementia and Memory Service
Epilepsy Society of Australia
Occupational Therapy Australia
Optometry Australia
Orthoptics Australia
Stroke Society of Australasia
The Royal Australian and New Zealand College of Ophthalmologists
The Royal Australian and New Zealand College of Psychiatrists.

Endorsements

These standards are endorsed by:

Australasian Faculty of Occupational and Environmental Medicine
Australasian Faculty of Rehabilitation Medicine
Australasian Sleep Association
Australian and New Zealand Association of Neurologists
Australian College of Rural and Remote Medicine
Australian Diabetes Society
Cardiac Society of Australia and New Zealand
Occupational Therapy Australia
Royal Australian College of Physicians.

Accepted Clinical Resource

Royal Australian College of General Practitioners

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 publishing. 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 healthcare 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.