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Assessing Fitness to Drive 2016: Frequently Asked Questions


Q. Why have the driver medical standards been revised?

The driver medical standards contained in Assessing Fitness to Drive have been revised to reflect current medical knowledge and the current transport environment.

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Q. Who has been involved in reviewing the standards?

The standards have been produced through an extensive consultation process overseen by the National Transport Commission and Austroads, and involving a Maintenance Advisory Group representing driver licensing authorities, health professionals and drivers.

A number of health professional organisations made significant contributions to the technical aspects of the review, including the:

  • Australian and New Zealand Association of Neurologists Australian Diabetes Educators Association
  • Australian Diabetes Society
  • Australasian Sleep Association
  • Cardiac Society of Australia and New Zealand
  • Epilepsy Society of Australia
  • Occupational Therapy Australia
  • Optometry Australia
  • Royal Australian and New Zealand College of Ophthalmologists
  • Royal Australasian College of Physicians - Australasian Faculty of Occupational and Environmental Medicine
  • Royal Australasian College of Physicians – Chapter of Addiction Medicine
  • Contributing consumer organisations included:
  • Alzheimer’s Australia
  • Deaf Australia
  • Deaf Victoria
  • Diabetes Australia

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Q. When do the standards come into effect?

The standards are effective from the 1 October 2016, replacing the 2012 edition. From that date, all drivers should be assessed using the new standards.

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Q. What are the key changes to the standards resulting from this review?

Assessing Fitness to Drive was extensively revised in 2012, focusing on conditions likely to affect fitness to drive and resulting in a simplified structure of 10 chapters.  These changes have been well received and the current review has not resulted in major changes to the structure or to medical criteria.

Ongoing improvement has been achieved through changes that provide clarity around the key considerations for assessing fitness to drive and support consistency of assessment and decision making.

The new edition also features:

  • improved general guidance on driver assessment and management
  • a focus on functionality rather than diagnosis which supports fairness in application
  • flow charts to facilitate clinical decision making
  • improved guidance regarding assessment
  • links to supporting consumer information.

The key changes to specific chapters are described separately in the report Reviewing Assessing Fitness to Drive: Summary (1MB PDF).

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Q. Will health professionals receive hard copies of the publication?

The standards can be downloaded for free from the Austroads publications website. They will not be distributed in hard copy to health professionals as previously, but hard copies may be ordered for $25 including postage and handling.  

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Q. How will Assessing Fitness to Drive 2016 affect health professionals’ practice?

The clarity of the new standards and improved guidance will facilitate assessment of fitness to drive by health professionals and ensures greater consistency in such assessments. It is not anticipated that the standards will impact on health professionals’ workload in undertaking assessments.

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Q. How will Assessing Fitness to Drive 2016 affect Driver Licensing Authorities?

The clarity of the new standards will facilitate licensing management by Driver Licensing Authorities and support greater consistency in licensing decisions. Driver Licensing Authorities will need to manage the changes to the standards in terms of the impact on drivers with existing medical conditions, including those on existing conditional licences.

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Q. How will the new standards affect drivers?

The new standards do not mean a change in responsibility for drivers. They must continue to ensure that they do not drive if they have a condition that is likely to affect their ability to drive safely, and they must report such conditions to the Driver Licensing Authority.

The standards reflect developments in medical science and improvements in diagnosis and treatment of various health conditions. They therefore provide scope for drivers with well-managed health conditions to continue to drive safely.

There are a small number of significant changes that will affect drivers. These are summarised in the report Reviewing Assessing Fitness to Drive: Summary (1MB PDF). The changes are summarised in the table below.

Summary of changes to medical criteria in Assessing Fitness to Drive 2016

Chapter Change to criteria Detail of change to criteria
Blackout No change  
Cardiovascular Yes

Aneurysms

The aneurysm diameter at which a conditional licence may be considered has been amended based on risk stratification for different aneurysm types and current management guidelines.

Implantable cardioverter defibrillator

For commercial vehicle drivers, clarity is provided that licensing is not permitted for ICDs inserted for primary prevention.

Ventricular assist devices (VADs)

New criteria have been developed to cover VADs. A conditional licence may be considered for a private driver requiring a LVAD subject to meeting several criteria. They may not drive if they require a combined LVAD/RVAD or an artificial heart. A VAD of any type is not acceptable for commercial vehicle driving.

Diabetes Yes

Diabetes treated by glucose-lowering agents other than insulin

  • For private vehicle drivers, the criterion ‘the person experiences early warning symptoms of hypoglycaemia’ has been qualified to also include ‘or has a documented management plan for lack of early warning symptoms’.
  • For commercial vehicle drivers, the criterion for a conditional licence ‘the condition is satisfactorily controlled’ has been removed so that the criteria focus on the main risks to safety, which are hypoglycaemia and end-organ effects.
  • For both private and commercial vehicle drivers, a suitable specialist is defined as an endocrinologist / consultant physician specialising in diabetes.

Diabetes treated by insulin

  • For both private and commercial drivers, the criterion for a conditional licence ‘the condition is satisfactorily controlled’ has been removed so that the criteria focus on the main risks to safety, which are hypoglycaemia and end-organ effects.
  • For private vehicle drivers, the criterion ‘the person experiences early warning symptoms of hypoglycaemia’ has been qualified to also include ‘or has a documented management plan for lack of early warning symptoms’.
  • For both private and commercial vehicle drivers, a suitable specialist is defined as an endocrinologist / consultant physician specialising in diabetes.

Definition of severe hypoglycaemic event

For the purposes of the standard the definition of severe hypoglycaemic event encompasses hypoglycaemic seizures.

Hearing Yes Wording changes provide clarity that:
  • audiometry should only be undertaken if clinically indicated (i.e. if hearing loss is identified on clinical assessment)
  • if the hearing threshold is not able to be reached with hearing aids, a person can be individually assessed for suitability for a conditional licence.
Musculoskeletal No change  
Neurological Conditions – Dementia No change  
Neurological Conditions – Epilepsy and seizures Yes

Where EEG is required

For commercial vehicle drivers, where EEG demonstrating no epileptiform activity is required, timeframes for the EEG are now provided. For example, in the default standard, for a conditional licence an EEG conducted in the last six months must have shown no epileptiform activity, and no other EEG conducted in the last 12 months must have shown epileptiform activity.

Reduced periodic review requirements

For drivers with epilepsy under treatment who have been seizure-free for an extended period (10 years for private drivers and 20 years for commercial), the driver licensing authority may consider a longer review period on the advice of an independent specialist. Ongoing review for commercial vehicle drivers will continue to be by a specialist in epilepsy.

Neurological Conditions – Vestibular Yes This chapter has been deleted. Ménière’s disease is referred to in the text of ‘Other neurological conditions’.
Neurological Conditions – Other Yes

Stroke

For private vehicle drivers, the requirement for a conditional licence and periodic review has been removed if the driver has recovered adequate neurological function. This reflects the non-progressive nature of stroke. The standard cross refers to management of treatable causes of stroke.

Risk of post-traumatic epilepsy

The head injury standard for commercial vehicle drivers now includes criteria relating to risk of post-traumatic epilepsy. A non-driving period of 12 months (without seizures) applies if they are determined to have a high risk of seizures following a head injury. There is not a similar standard for private vehicle drivers.

Intellectual disability

The standard for intellectual disability has been removed, including reference to IQ. This is covered in ‘Other neurological conditions’.

Psychiatric Conditions No change  
Sleep Disorders No change  
Substance Misuse No change  
Vision and eye disorders Yes

Visual fields

The standard for private vehicle drivers has been clarified by including the additional criterion to define when a driver no longer meets the requirements for an unconditional licence:

  • if there is any significant field loss (scotoma) with more than four contiguous spots within 20 degrees radius from fixation.

Monocular vision

For commercial vehicle drivers, the review period for drivers with a conditional licence has changed from one year to two years.

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Q. Who should drivers speak to about how the changes might affect them?

Drivers who have an existing medical condition and who are on a conditional licence, or have other driving restrictions, should refer to the Austroads website for an explanation of the changes. They may also speak to their local Driver Licensing Authority about how the new standards will affect them.

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Q. How will Austroads communicate any future changes or issues relevant to health professionals and drivers?

Register here to subscribe to alerts regarding updates to Assessing Fitness to Drive.



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Q. Can I access a detailed report of the review?

The report Review of Transport Medical Standards: Final Report for the Review of Assessing Fitness to Drive (1.3MB PDF) outlines the methodology and findings of the review.

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