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Assessing Fitness to Drive
AP-G56-17
Principles of assessing fitness to drive
Assessing and supporting functional driver capacity

Assessing Fitness to Drive

Table of Contents

Endorsements
Acknowledgements
Legal disclaimer
Foreword
Part A: General Information
1. About this publication
- 1.1 Purpose
- 1.2 Target audience
- 1.3 Scope
- 1.4 Content
- 1.5 Development and evidence base
2. Principles of assessing fitness to drive
- 2.1 The driving task
- 2.2 Medical conditions and driving
- 2.3 Assessing and supporting functional driver capacity
3. Roles and responsibilities
- 3.1 Roles and responsibilities of driver licensing authority
- 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 Which forms to use
  - 5.1.1 When conducting an assessment at the request of a driver licensing authority
  - 5.1.2 When assessing fitness to drive in the course of patient treatment
- 5.2 Steps in the assessment and reporting process
Part B: Medical standards
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
  - 2.3.1 Medical criteria
  - 2.3.2 Conditional licences and periodic review
3. Diabetes mellitus
- 3.1 Relevance to the driving task
  - 3.1.1 Effects of diabetes on driving
  - 3.1.2 Evidence of crash risk
- 3.2 General assessment and management guidelines
- 3.3 Medical standards for licensing
  - 3.3.1 Diabetes treated by glucose-lowering agents other than insulin – private drivers
  - 3.3.2 Recommendation and review of conditional licences for commercial vehicle drivers
4. Hearing loss and deafness
- 4.1 Relevance to the driving task
  - 4.1.1 Effect of hearing loss on driving
  - 4.1.2 Considerations for commercial vehicle drivers
- 4.2 General assessment and management guidelines
  - 4.2.1 Commercial vehicle drivers
  - 4.2.2 Private vehicle drivers
- 4.3 Medical standards for licensing
5. Musculoskeletal conditions
- 5.1 Relevance to the driving task
  - 5.1.1 Effects of musculoskeletal conditions on driving
  - 5.1.2 Evidence of crash risk
- 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
  - 6.3.1 General assessment and management guidelines
  - 6.3.2 Medical standards for licensing
7. Psychiatric conditions
- 7.1 Relevance to the driving task
- 7.2 General assessment and management guidelines
- 7.3 Medical standards for licensing
8. Sleep disorders
- 8.1 Relevance to the driving task
  - 8.1.1 Evidence of crash risk
  - 8.1.2 Impact of treatment on crash risk
- 8.2 General assessment and management guidelines
- 8.3 Medical standards for licensing
9. Substance misuse (including alcohol, illicit drugs and prescription drug 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
  - 10.1.1 Effects of vision and eye disorders on driving
  - 10.1.2 Evidence of crash risk
- 10.2 General assessment and management guidelines
- 10.3 Medical standards for licensing
Part C: Appendices
Appendix 1: Regulatory requirements for driver testing (as at February 2016)
Appendix 2: Forms
- Appendix 2.1: Medical report form
- Appendix 2.2: Medical condition notification
Appendix 3: Legislation relating to reporting
- Appendix 3.1: Legislation relating to reporting by drivers (as at December 2015)
- Appendix 3.2: Legislation relating to reporting by health professionals (as at December 2015)
Appendix 4: Drivers’ legal BAC limits
Appendix 5: Alcohol interlock programs
Appendix 6: Disabled car parking and taxi services (as at January 2016)
Appendix 7: Seatbelt use
Appendix 8: Helmet use
Appendix 9: Driver licensing authority contacts (as at January 2016)
Appendix 10: Specialist driver assessors
Tables
- Table 1: Examples of management of temporary conditions
- Table 2: Key roles and responsibilities with respect to fitness to drive
- Table 3: Choice of standard according to vehicle/licence type
- Table 4: Examples of licence conditions that may be required by the driver licensing authority*
- Table 5: Suggested non-driving periods post cardiovascular events or procedures
- Table 6: Examples of vehicle modifications and personal restrictions relevant to musculoskeletal disorders*
Figures
- Figure 1: The driving task
- Figure 2: Relationships/interaction between patients/drivers, health professionals and the driver licensing authority (DLA)
- Figure 3: Medical decision-making process for assessing fitness to drive
- Figure 4: Conducting an examination at the request of a driver licensing authority
- Figure 5: Assessing and reporting on fitness to drive in the course of patient treatment
- Figure 6: Management of blackouts and driving
- Figure 7: Bruce protocol nomogram for men
- Figure 8: Bruce protocol nomogram for women
- Figure 9: Clarke hypoglycaemia awareness survey
- Figure 10: Management of diabetes and driving
- Figure 11: Management of hearing loss in commercial vehicle drivers
- Figure 12: General functional requirements for driving motor vehicles (excluding motorcycles)
- Figure 13: Overview of management of a driver with seizures
- Figure 14: Epilepsy treated for the first time
- Figure 15: Visual acuity requirements for private and commercial vehicle drivers

Assessing Fitness to Drive

2.3 Assessing and supporting functional driver capacity

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