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

4.1 Relevance to the driving task

In this section

4.1.1. Effect of hearing loss on driving

4.1.2. Considerations for commercial vehicle drivers

4.1.1 Effect of hearing loss on driving

The evidence base regarding hearing loss and driving safely is limited; however, the analysis of the small number of quality studies report that hearing loss has no effect on motor vehicle crash risk.¹ It may be that a loss of hearing is well compensated for since most people who are hard of hearing are aware of their disability and therefore tend to be more cautious and rely more on visual cues and other sensations such as vibrations. Functional hearing is used in the driving task to:

sense alarms, notifications and other auditory cues in the driving environment (e.g. railway crossings, first responder sirens)
sense auditory cues on the state and position of the vehicle from vehicle technology systems (e.g. alarms, warning systems using sound alerts)
compensate for comorbidities or general reduction in functional abilities that may impair driving (e.g. slower reaction times, reduced neck rotation due to musculoskeletal changes)
assist in maintaining general vigilance, alertness and arousal.

See references 1,2,3,4,5,6,7

4.1.2 Considerations for commercial vehicle drivers

While driving ability per se might not be affected by a hearing loss, responsiveness to critical events is an important safety consideration for drivers of commercial vehicles. These drivers therefore require the capacity to ensure safety and the capacity to respond to environmental situations that may involve sirens, rail crossings and emergency signals as well as conditions of the vehicle and roads. It may be challenging to rely solely on vision to compensate for a significant hearing loss in a commercial vehicle. The internal commercial vehicle cabin can place additional attentional, workload and visual demands on drivers for undertaking tasks such as checking multiple displays or monitors and using communication systems. These additional tasks reduce capacity to compensate for a lack of hearing by relying on vision to monitor the external environment.

See references 8,9

Assessing Fitness to Drive

4.1 Relevance to the driving task

In this section

4.1.1 Effect of hearing loss on driving

4.1.2 Considerations for commercial vehicle drivers

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