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Driver Health The SASOM Guidelines 2005. Overview Fitness to Work & the Law Fitness to Work & the Law The Guideline The Guideline Comments Comments.

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Presentation on theme: "Driver Health The SASOM Guidelines 2005. Overview Fitness to Work & the Law Fitness to Work & the Law The Guideline The Guideline Comments Comments."— Presentation transcript:

1 Driver Health The SASOM Guidelines 2005

2 Overview Fitness to Work & the Law Fitness to Work & the Law The Guideline The Guideline Comments Comments

3 Fitness to Work & the Law National Road Traffic Act & Regulations National Road Traffic Act & Regulations Occupational Health & Safety Act & Regs (Construction Regulations, Code of Practice for Driven Machinery Regs) Occupational Health & Safety Act & Regs (Construction Regulations, Code of Practice for Driven Machinery Regs) Others – Aviation, Diving, etc. Others – Aviation, Diving, etc. Employment Equity Act Employment Equity Act Labour Relations Act Labour Relations Act

4 Legislation National Road Traffic Act National Road Traffic Act (Act 93 of 1996) Sets minimum standards of fitness Chapter IV: “Fitness of Drivers” Chapter IV: “Fitness of Drivers” Section 15 (1)(f) & (g) - Exclusions Section 15 (1)(f) & (g) - Exclusions MS/MCACT

5 Legislation National Road Traffic Act – Exclusions National Road Traffic Act – Exclusions (Sect 15): Uncontrolled epilepsy Uncontrolled epilepsy Sudden attacks of disabling giddiness or fainting due to hypertension or any other cause Sudden attacks of disabling giddiness or fainting due to hypertension or any other cause Any form of mental illness to such an extent that it is necessary that he or she be detained, supervised, controlled and treated as a patient in terms of the Mental Health Act, (18 of 1973). Any form of mental illness to such an extent that it is necessary that he or she be detained, supervised, controlled and treated as a patient in terms of the Mental Health Act, (18 of 1973).

6 Legislation National Road Traffic Act – Exclusions National Road Traffic Act – Exclusions (Sect 15): Any condition causing muscular inco-ordination Any condition causing muscular inco-ordination Uncontrolled diabetes mellitus Uncontrolled diabetes mellitus Defective vision, ascertained in accordance with a prescribed standard (Regulations,17 March 2000). Defective vision, ascertained in accordance with a prescribed standard (Regulations,17 March 2000).

7 Legislation National Road Traffic Act – Exclusions National Road Traffic Act – Exclusions (Sect 15): Any other disease or physical defect which is likely to render him or her incapable of effectively driving and controlling a motor vehicle of the class to which such licence relates, without endangering the safety of the public: providing that deafness shall not of itself be deemed to be such a defect; Any other disease or physical defect which is likely to render him or her incapable of effectively driving and controlling a motor vehicle of the class to which such licence relates, without endangering the safety of the public: providing that deafness shall not of itself be deemed to be such a defect;

8 Legislation National Road Traffic Act – Exclusions: National Road Traffic Act – Exclusions: Note - separate statement in the statute: (g) if he or she is addicted to the use of any drug having narcotic effect, or the excessive use of intoxicating liquor

9 Legislation National Road Traffic Act – Section 16 : National Road Traffic Act – Section 16 : Prohibition of failure to (self) disclose qualification! The disqualified person should hand in his/her licence to offices of the MEC of the province concerned, who shall either cancel it, or endorse it (if the impairment is remedial by means of lens correction or the use of a physical aid).

10 Legislation National Road Traffic Act – Section 31 : National Road Traffic Act – Section 31 : Prohibition to employ unlicensed driver, or permit an unlicensed driver to drive on a public road.

11 Legislation National Road Traffic Regulations National Road Traffic Regulations (17 March 2000) Provision for: New classes of motor vehicle New classes of motor vehicle Specific fitness standards for vision (acuity and peripheral). Specific fitness standards for vision (acuity and peripheral).

12 Legislation National Road Traffic Regulations National Road Traffic Regulations New licence codes: A1: Motorcycle <125cc A1: Motorcycle <125cc A: Motorcycle >125cc A: Motorcycle >125cc B: Tractor (old code 05), industrial equipment (Forklift) (old code 07), & especially adapted vehicles for the “physically disabled” (old code 12) B: Tractor (old code 05), industrial equipment (Forklift) (old code 07), & especially adapted vehicles for the “physically disabled” (old code 12) EB: (Old code 08) Motor vehicle (incl. minibus, bus or goods vehicle) of size <3’500kg. EB: (Old code 08) Motor vehicle (incl. minibus, bus or goods vehicle) of size <3’500kg. EC1: (Old code 10) Motor vehicle (incl. minibus, bus or goods vehicle) of size 3’500 – 16’000kg. EC1: (Old code 10) Motor vehicle (incl. minibus, bus or goods vehicle) of size 3’500 – 16’000kg. EC: (Old code 11, 13 & 14) Motor vehicle (incl. minibus, bus or goods vehicle) of size > 16’000kg. EC: (Old code 11, 13 & 14) Motor vehicle (incl. minibus, bus or goods vehicle) of size > 16’000kg.

13 Legislation National Road Traffic Regulations – Part IV. National Road Traffic Regulations – Part IV. Professional Driver’s Permit (PRDP): Cat D: Cat D: Dangerous goods to the weight of >3’500kg Dangerous goods to the weight of >3’500kg Vehicles which meet requirements of SABS 1398 (petrol tankers) & SABS 1518 (dangerous good vehicles) Vehicles which meet requirements of SABS 1398 (petrol tankers) & SABS 1518 (dangerous good vehicles) Cat P: Cat P: Buses Buses Minibuses (>3’500kg, >11 people) Minibuses (>3’500kg, >11 people) Motor vehicles used for the conveyance of persons for reward, Motor vehicles used for the conveyance of persons for reward, Any motor vehicle conveying >11 people including the driver Any motor vehicle conveying >11 people including the driver Cat G: Goods & breakdown vehicles Cat G: Goods & breakdown vehicles

14 Legislation National Road Traffic Regulations National Road Traffic Regulations Specific fitness standards for vision Specific fitness standards for vision Codes A1 – EB (Code 08 & less): Codes A1 – EB (Code 08 & less): Acuity: >6/12 (20/40); if one eye is under standard (or blind), the better eye must be >6/9 (20/30). Acuity: >6/12 (20/40); if one eye is under standard (or blind), the better eye must be >6/9 (20/30). Periperal Vision: 70 0 temporal, or >115 0 total field (one eye blind). Periperal Vision: 70 0 temporal, or >115 0 total field (one eye blind).

15 Legislation National Road Traffic Regulations National Road Traffic Regulations Specific fitness standards for vision Specific fitness standards for vision Codes C1 – EC (Code 10 & higher): Codes C1 – EC (Code 10 & higher): Acuity: >6/9 (20/30) for each eye. Both eyes required. Acuity: >6/9 (20/30) for each eye. Both eyes required. Periperal Vision: 70 0 temporal in each eye. Periperal Vision: 70 0 temporal in each eye.

16 National Standards South African Society of Occupational Medicine (SASOM) South African Society of Occupational Medicine (SASOM) Specific fitness standards for Professional Drivers and Operators Specific fitness standards for Professional Drivers and Operators SASOM

17 The SASOM Guideline Introduction Introduction Legislation Legislation Driver Categories Driver Categories Driver Policy Driver Policy Health Evaluation Intervals Health Evaluation Intervals Suggested (sample) capture Documents Suggested (sample) capture Documents Minimum requirement standards Minimum requirement standards

18 Source Publications Driver & Vehicle Licensing Authority (DVLA- UK) Driver & Vehicle Licensing Authority (DVLA- UK) Previous Guidelines Previous Guidelines Others: Others: Australian & New Zealand Australian & New Zealand USA USA British Columbia British Columbia

19 Introduction to Guideline Statistics Statistics Poor compliance with PrDP. Poor compliance with PrDP.

20 Statistics

21 Statistics

22 Statistics

23 Driver Categories SASOM Category I SASOM Category I PrDP cat “D” (hazardous dangerous goods) PrDP cat “D” (hazardous dangerous goods) PrDP cat “P” (passengers, ie. taxis, buses, company employee transport) PrDP cat “P” (passengers, ie. taxis, buses, company employee transport) SASOM Category II SASOM Category II PrDP cat “G” (conveying goods) PrDP cat “G” (conveying goods)

24 Driver Categories SASOM Category III SASOM Category III Special vehicle drivers (eg. Forklifts, cranes, mobile plants, etc.) Special vehicle drivers (eg. Forklifts, cranes, mobile plants, etc.) The vehicles considered by Construction Regs The vehicles considered by Construction Regs Remember also the Driven Machinery Code of Practice Remember also the Driven Machinery Code of Practice “… where skill, method of operation and place of operation require attention.” “… where skill, method of operation and place of operation require attention.”

25 Driver Categories SASOM Category IV SASOM Category IV PrDP cat “B” (“standard” operating conditions) PrDP cat “B” (“standard” operating conditions) “Standard vehicle drivers operating light vehicles in standard transport, circumstances where no special requirements exist over and above the required licence and personal skills to operate the vehicle. This includes the driving of a breakdown vehicle.” “Standard vehicle drivers operating light vehicles in standard transport, circumstances where no special requirements exist over and above the required licence and personal skills to operate the vehicle. This includes the driving of a breakdown vehicle.”

26 Health Intervals Type of Health Evaluation Driver Category I(D/P)II(G)III(Special)IV(B) Pre-employmentYesYesYesYes PRDP (time interval in months) 24 (D/P) 24(G)24(B) Periodic (time interval in months) as per company policy On request Return to work after significant ill health absence (>10 days) YesYesYes On Request Post incident (evaluation immediately or soon after incident YesYesYesYes

27 Key (legislative requirement) Yes = indicated (Doctor’s discretion/company requirement) O = optional O = optionalPre-EmploymentPeriodic/PRDPReturnToWorkPostIncident Medical History: Past history Yes Current history YesYesYesYes Occupational History: Past history Yes Current history YesYesYesYes Physical Examination: YesYesYesYes Sensory: Vision (& fields) YesYesOO HearingYesYesOO Special investigations YesOOO

28 “Thorny” Issues Epilepsy Epilepsy Diabetes Mellitus Diabetes Mellitus Psychiatric Disease Psychiatric Disease Substance abuse Substance abuse Confidentiality Confidentiality SASOM DVLA

29 Epilepsy Epilepsy (Relapsing Seizures) Epilepsy (Relapsing Seizures) (>seizure, over >24hrs) Codes D,P G & “special” Codes D,P G & “special” 10-year seizure-free, on NO meds. 10-year seizure-free, on NO meds. Codes A1-EB (code 08 or less) Codes A1-EB (code 08 or less) See “epilepsy guide” See “epilepsy guide” 1-year seizure free on meds 1-year seizure free on meds Must make every attempt to comply with meds Must make every attempt to comply with meds

30 Epilepsy Epilepsy (Single Seizure, unprovoked) Epilepsy (Single Seizure, unprovoked) (One event, or >1event in 1event in <24hrs) Codes D,P G & “special” Codes D,P G & “special” 10-year seizure-free, on NO meds. 10-year seizure-free, on NO meds. Codes A1-EB (code 08 or less) Codes A1-EB (code 08 or less) 1-year seizure free on meds. 1-year seizure free on meds.

31 “Epilepsy Guide” SASOM Cat 1,2,3 SASOM Cat 4

32 “Epilepsy Regulations - DVLA”

33 SASOM Cat 4

34 “Epilepsy Regulations - DVLA” SASOM Cat 1,2,3

35 Epilepsy Epilepsy (Single Seizure, on meds withdrawal) Epilepsy (Single Seizure, on meds withdrawal) (As per “Epilepsy Guide’) Codes D,P G & “special” Codes D,P G & “special” 10-year seizure-free, on NO meds, so not applicable 10-year seizure-free, on NO meds, so not applicable Codes A1-EB (code 08 or less) Codes A1-EB (code 08 or less) 1-year seizure free on meds. 1-year seizure free on meds.

36 Epilepsy Epilepsy (Provoked Seizure) Epilepsy (Provoked Seizure) (As per “Epilepsy Guide’) Licence issued/revoked, depending on: Licence issued/revoked, depending on: Is there a “liability to epileptic seizures” (increased vulnerability to having a seizure) Is there a “liability to epileptic seizures” (increased vulnerability to having a seizure) Has the cause been successfully treated? Has the cause been successfully treated? This includes seizures at the time of a head injury, at onset of a stroke, at surgery, etc. This includes seizures at the time of a head injury, at onset of a stroke, at surgery, etc. For D&P drivers, seizures within 24hrs require 6months off driving. For D&P drivers, seizures within 24hrs require 6months off driving.

37 Epilepsy Loss of Consciousness (Unknown Cause) Loss of Consciousness (Unknown Cause) Codes D,P G & “special” Codes D,P G & “special” 5-years with no recurrence. 5-years with no recurrence. Codes A1-EB (code 08 or less) Codes A1-EB (code 08 or less) 1-year with no recurrence. 1-year with no recurrence.

38 Diabetes Mellitus Important features: Important features: Metabolic complications and other end-organ failures Metabolic complications and other end-organ failures The complications are often unnoticed (autonomic neuropathy, loss of vision, hypertension, etc.) The complications are often unnoticed (autonomic neuropathy, loss of vision, hypertension, etc.)

39 Diabetes Mellitus On Insulin On Insulin Codes D, P G & “special” Codes D, P G & “special” New applicants – disqualified. New applicants – disqualified. Existing drivers – must demonstrate satisfactory control. Existing drivers – must demonstrate satisfactory control. Codes A1-EB (code 08 or less) Codes A1-EB (code 08 or less) Must demonstrate satisfactory control. Must demonstrate satisfactory control.

40 Diabetes – “Qualifying Conditions”

41 Diabetes Mellitus On Meds or Diet alone On Meds or Diet alone Codes D,P G & “special” Codes D,P G & “special” All drivers – must demonstrate satisfactory control. All drivers – must demonstrate satisfactory control. If become insulin dependent, disqualify. If become insulin dependent, disqualify. Codes A1-EB (code 08 or less) Codes A1-EB (code 08 or less) Must demonstrate satisfactory control. Must demonstrate satisfactory control.

42 Psychiatric Disease National Road Traffic Act

43 Psychiatric Disease SASOM Guide

44 Psychiatric Disease DVLA Guide

45 Psychiatric Disease National Road Traffic Act

46 Substance Abuse

47 UK Guide – 1 year no driving SASOM Group 4 SASOM Groups 1,2,3

48 Substance Abuse SASOM Guide

49 Substance Abuse UK Guide

50 Confidentiality

51 Confidentiality

52 Challenges Validity of standards as predictors of Risk Validity of standards as predictors of Risk Consistency of application of standards Consistency of application of standards Current employee vs new applicant Current employee vs new applicant


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