2016 Review Outcomes
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Outcomes of the Assessing Fitness to Drive 2016 Review

Improved guidance for health professionals is a key feature of the updated driver medical standards contained in the latest edition of Assessing Fitness to Drive, which will come into effect from 1 October 2016.

The new edition is the outcome of a review conducted by the National Transport Commission (NTC) during 2014 and 2015 and will replace the current 2012 edition.

The NTC has worked closely with health professionals, driver licensing authorities and consumer health groups in conducting the review, which has resulted in some changes to the licensing criteria to account for developments in medical understanding and practice.

A range of additional changes serve to improve clarity around the key considerations for assessing fitness to drive and support consistency of assessment and decision making.

The new edition comes into effect on 1 October 2016, from which date all assessments conducted for the purpose of driver licensing should be undertaken according to the updated edition.

There are a small number of significant changes that will affect drivers. These are summarised in the report Reviewing Assessing Fitness to Drive: Summary. 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.

 

Links

See Frequently Asked Questions about the 2016 Review

AP G56 16 AFTD400px Download a PDF or purchase a hardcopy of the 2016 edition of Assessing Fitness to Drive
AFTD Summary cover Read a summary of the changes to the 2016 edition | 1 MB PDF

 

 

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