4.3 Medical standards for licensing
Requirements for unconditional and conditional licences are outlined in the following table.
Medical standards for licensing – hearing Health professionals should familiarise themselves with the information in this chapter and the tabulated standards before assessing a person’s fitness to drive. | ||
|---|---|---|
| Condition | Private standards (Drivers of cars, light rigid vehicles or motorcycles unless carrying public passengers or requiring a dangerous goods driver licence – refer to definition in Table 3) | Commercial standards (Drivers of heavy vehicles, public passenger vehicles or requiring a dangerous goods driver licence – refer to definition in Table 3) |
| Hearing loss | There is no hearing standard for private vehicle drivers. Refer to section 4.2. General assessment and management guidelines. | Compliance with the standard should be clinically assessed initially. If the initial clinical assessment indicates possible hearing loss, the person should be referred for audiometry. A person is not fit to hold an unconditional licence:
A conditional licence may be considered by the driver licensing authority subject to periodic review*, taking into account the nature of the driving task and information provided by an ENT specialist or audiologist** as to whether:
If the standard is not able to be met with a hearing aid, further individualised assessment should be offered. A conditional licence may be considered by the driver licensing authority subject to periodic review* taking into account:
* Stable conditions may not require periodic review. ** Refer to section 4.2. General assessment and management guidelines. *** In some cases, noise amplification as a result of wearing hearing aids may lead to driver distraction and may warrant individualised assessment to determine fitness to drive without the hearing aid (refer to section 4.2. General assessment and management guidelines). |
IMPORTANT: The medical standards and management guidelines contained in this chapter should be read in conjunction with the general information contained in Part A of this publication. Practitioners should give consideration to the following:
Licensing responsibility
The responsibility for issuing, renewing, suspending or cancelling a person’s driver licence (including a conditional licence) lies ultimately with the driver licensing authority. Licensing decisions are based on a full consideration of relevant factors relating to health and driving performance.
Conditional licences
For a conditional licence to be issued, the health professional must provide to the driver licensing authority details of the medical criteria not met, evidence of the medical criteria met, as well as the proposed conditions and monitoring requirements. The presence of other medical conditions While a person may meet individual disease criteria, concurrent medical conditions may combine to affect fitness to drive – for example, hearing, visual or cognitive impairment (refer to Part A section 2.2.7. Older drivers and age-related changes and section 2.2.8. Multiple medical conditions).
The nature of the driving task
The driver licensing authority will take into consideration the nature of the driving task as well as the medical condition, particularly when granting a conditional licence. For example, the licence status of a farmer requiring a commercial vehicle licence for the occasional use of a heavy vehicle may be quite different from that of an interstate multiple combination vehicle driver. The examining health professional should bear this in mind when examining a person and when providing advice to the driver licensing authority.
Reporting responsibilities
Patients should be made aware of the effects of their condition on driving and should be advised of their legal obligation to notify the driver licensing authority where driving is likely to be affected. The health professional may themselves advise the driver licensing authority as the situation requires (refer to section 3.3 and step 6).
References and further reading
- Charlton, J.L., Di Stefano, M., Dow, J., Rapoport, M.J., O’Neill, D., Odell, M., Darzins, P., & Koppel, S. Influence of chronic Illness on crash involvement of motor vehicle drivers: 3rd edition. Monash University Accident Research Centre Reports 353. Melbourne, Australia: Monash University Accident Research Centre. (2021).
- Green, K. A., McGwin, G. & Owsley, C. Associations between visual, hearing, and dual sensory impairments and history of motor vehicle collision involvement of older drivers. Journal of the American Geriatrics Society 61, 252–257 (2013).
- McCloskey, L. W., Koepsell, T. D., Wolf, M. E. & Buchner, D. M. Motor vehicle collision injuries and sensory impairments of older drivers. Age and Ageing 23, 267–273 (1994).
- Picard, M. et al. Could driving safety be compromised by noise exposure at work and noise-induced hearing loss? Traffic Injury Prevention 9, 489–499 (2008).
- Dow, J., Gaudet, M. & Turmel, E. Crash rates of Quebec drivers with medical conditions. Annals of advances in automotive medicine. Association for the Advancement of Automotive Medicine. Annual Scientific Conference 57, 57–66 (2013).
- Vivoda, J. M. et al. The Influence of Hearing Impairment on Driving Avoidance Among a Large Cohort of Older Drivers. Journal of Applied Gerontology (2021) doi:10.1177/0733464821999223.
- Australian Transport Safety Bureau. Level crossing collision between The Ghan Passenger Train (1AD8) and a Road-Train Truck: ATSB Transport Safety Investigation Report 2006/015. (Australian Transport Safety Bureau, 2008).
- Songer, T. et al. Hearing disorders and commercial motor vehicle operators (Final Report FHWA-MC-93-004. (1992).
- Campbell, J. et al. Human factors design guidance for driver-vehicle interfaces (Report No. DOT HS 812 360). www.nhtsa. gov (2016).