Driver Health

Driver HealthDriver HealthThe SASOM Guidelines 2005The SASOM Guidelines 2005

OverviewOverview Fitness to Work & the LawFitness to Work & the Law The GuidelineThe Guideline CommentsComments

Fitness to Work & the Fitness to Work & the LawLaw

National Road Traffic Act & RegulationsNational Road Traffic Act & Regulations Occupational Health & Safety Act & Occupational Health & Safety Act &

Regs (Construction Regulations, Code of Regs (Construction Regulations, Code of Practice for Driven Machinery Regs) Practice for Driven Machinery Regs)

Others – Aviation, Diving, etc.Others – Aviation, Diving, etc.

Employment Equity ActEmployment Equity Act Labour Relations ActLabour Relations Act

LegislationLegislation National Road Traffic ActNational Road Traffic Act

(Act 93 of 1996)(Act 93 of 1996)Sets minimum standards of fitnessSets minimum standards of fitness

Chapter IV: “Fitness of Drivers”Chapter IV: “Fitness of Drivers” Section 15 (1)(f) & (g) - ExclusionsSection 15 (1)(f) & (g) - Exclusions

MS/MC ACT

LegislationLegislation National Road Traffic Act – Exclusions National Road Traffic Act – Exclusions

(Sect 15):(Sect 15): Uncontrolled Uncontrolled epilepsyepilepsy Sudden attacks of disabling Sudden attacks of disabling giddinessgiddiness or or

faintingfainting due to hypertension or any other due to hypertension or any other causecause

Any form of Any form of mental illnessmental illness to such an extent to such an extent that it is necessary that he or she be detained, that it is necessary that he or she be detained, supervised, controlled and treated as a patient supervised, controlled and treated as a patient in terms of the Mental Health Act, (18 of 1973).in terms of the Mental Health Act, (18 of 1973).

LegislationLegislation National Road Traffic Act – National Road Traffic Act –

Exclusions Exclusions (Sect 15):(Sect 15): Any condition causing Any condition causing muscular inco-muscular inco-

ordinationordination Uncontrolled Uncontrolled diabetes mellitusdiabetes mellitus Defective Defective vision,vision, ascertained in ascertained in

accordance with a prescribed standard accordance with a prescribed standard (Regulations,17 March 2000).(Regulations,17 March 2000).

LegislationLegislation National Road Traffic Act – Exclusions National Road Traffic Act – Exclusions

(Sect 15):(Sect 15): Any Any other diseaseother disease or or physical defectphysical defect which which

is likely to render him or her incapable of is likely to render him or her incapable of effectively driving and controlling a motor effectively driving and controlling a motor vehicle of the class to which such licence vehicle of the class to which such licence relates, without endangering the safety of the relates, without endangering the safety of the public: public: providing that providing that deafnessdeafness shall not of shall not of itself be deemed to be such a defect;itself be deemed to be such a defect;

LegislationLegislation National Road Traffic Act – National Road Traffic Act –

Exclusions:Exclusions:Note - separate statement in the statute:Note - separate statement in the statute:(g) if he or she is addicted to the use of (g) if he or she is addicted to the use of

any any drug having narcotic effectdrug having narcotic effect, or , or the excessive use of the excessive use of intoxicating intoxicating liquorliquor

LegislationLegislation National Road Traffic Act – National Road Traffic Act – Section Section

1616 : :Prohibition of failure to (self) disclose Prohibition of failure to (self) disclose

qualification!qualification!

The disqualified person should hand in his/her The disqualified person should hand in his/her licence to offices of the MEC of the province licence to offices of the MEC of the province concerned, who shall either concerned, who shall either cancelcancel it, or it, or endorseendorse it (if the impairment is remedial by it (if the impairment is remedial by means of lens correction or the use of a means of lens correction or the use of a physical aid).physical aid).

LegislationLegislation National Road Traffic Act – National Road Traffic Act – Section Section

3131 : :

ProhibitionProhibition to to employemploy unlicensed driver, or unlicensed driver, or permit an unlicensed driver to drive on a permit an unlicensed driver to drive on a public road.public road.

LegislationLegislation National Road Traffic National Road Traffic RegulationsRegulations

(17 March 2000)(17 March 2000)Provision for:Provision for: New classes of motor vehicleNew classes of motor vehicle Specific fitness standards for vision Specific fitness standards for vision

(acuity and peripheral).(acuity and peripheral).


New licence codes:New licence codes: A1A1: Motorcycle <125cc: Motorcycle <125cc A:A: Motorcycle >125cc Motorcycle >125cc B:B: Tractor (old Tractor (old code 05code 05), industrial equipment (Forklift) ), industrial equipment (Forklift)

(old (old code 07code 07), & especially adapted vehicles for the ), & especially adapted vehicles for the “physically disabled” (old “physically disabled” (old code 12code 12))

EB: (Old code 08) Motor vehicle (incl. minibus, bus or EB: (Old code 08) Motor vehicle (incl. minibus, bus or goods vehicle) of size <3’500kg.goods vehicle) of size <3’500kg.

EC1: (Old code 10) Motor vehicle (incl. minibus, bus or EC1: (Old code 10) Motor vehicle (incl. minibus, bus or goods vehicle) of size 3’500 – 16’000kg.goods vehicle) of size 3’500 – 16’000kg.

EC: (Old code 11, 13 & 14) Motor vehicle (incl. EC: (Old code 11, 13 & 14) Motor vehicle (incl. minibus, bus or goods vehicle) of size > 16’000kg.minibus, bus or goods vehicle) of size > 16’000kg.

LegislationLegislation

National Road Traffic National Road Traffic Regulations – Part Regulations – Part IV.IV.Professional Driver’s Permit (PRDP):Professional Driver’s Permit (PRDP): Cat DCat D: :

Dangerous goods to the weight of >3’500kgDangerous goods to the weight of >3’500kg Vehicles which meet requirements of SABS 1398 (petrol Vehicles which meet requirements of SABS 1398 (petrol

tankers) & SABS 1518 (dangerous good vehicles)tankers) & SABS 1518 (dangerous good vehicles) Cat P:Cat P:

BusesBuses 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 driverAny motor vehicle conveying >11 people including the driver

Cat GCat G: Goods & breakdown vehicles: Goods & breakdown vehicles


Specific fitness standards for visionSpecific fitness standards for vision Codes A1 – EB (Code 08 & less):Codes A1 – EB (Code 08 & less):

AcuityAcuity: >6/12 (20/40); if one eye is under : >6/12 (20/40); if one eye is under standard (or blind), the better eye must be standard (or blind), the better eye must be >6/9 (20/30).>6/9 (20/30).

Periperal VisionPeriperal Vision: 70: 7000 temporal, or >115 temporal, or >11500 total field (one eye blind).total field (one eye blind).


Specific fitness standards for visionSpecific fitness standards for vision Codes C1 – EC (Code 10 & higher):Codes C1 – EC (Code 10 & higher):

AcuityAcuity: >6/9 (20/30) for each eye. Both eyes : >6/9 (20/30) for each eye. Both eyes required.required.

Periperal VisionPeriperal Vision: 70: 7000 temporal in each eye. temporal in each eye.

National StandardsNational Standards South African Society of South African Society of

Occupational Medicine (SASOM)Occupational Medicine (SASOM) Specific fitness standards for Specific fitness standards for

Professional Drivers and OperatorsProfessional Drivers and Operators

SASOM

The SASOM GuidelineThe SASOM Guideline IntroductionIntroduction LegislationLegislation Driver CategoriesDriver Categories Driver PolicyDriver Policy Health Evaluation IntervalsHealth Evaluation Intervals Suggested (sample) capture Suggested (sample) capture

DocumentsDocuments Minimum requirement standardsMinimum requirement standards

Source PublicationsSource Publications Driver & Vehicle Licensing Authority Driver & Vehicle Licensing Authority

(DVLA-UK)(DVLA-UK) Previous GuidelinesPrevious Guidelines Others:Others:

Australian & New ZealandAustralian & New Zealand USAUSA British ColumbiaBritish Columbia

Introduction to GuidelineIntroduction to Guideline StatisticsStatistics Poor compliance with PrDP.Poor compliance with PrDP.

StatisticsStatistics



Driver CategoriesDriver Categories SASOM Category ISASOM Category I

PrDP cat “D” (hazardous dangerous PrDP cat “D” (hazardous dangerous goods)goods)

PrDP cat “P” (passengers, ie. taxis, PrDP cat “P” (passengers, ie. taxis, buses, company employee transport)buses, company employee transport)

SASOM Category IISASOM Category II PrDP cat “G” (conveying goods)PrDP cat “G” (conveying goods)

Driver CategoriesDriver Categories SASOM Category IIISASOM Category III

Special vehicle drivers (eg. Forklifts, Special vehicle drivers (eg. Forklifts, cranes, mobile plants, etc.)cranes, mobile plants, etc.)

The vehicles considered by The vehicles considered by Construction RegsConstruction Regs

Remember also the Driven Machinery Remember also the Driven Machinery Code of PracticeCode of Practice

“… “… where skill, method of operation and where skill, method of operation and place of operation require attention.”place of operation require attention.”

Driver CategoriesDriver Categories SASOM Category IVSASOM Category IV

PrDP cat “B” (“standard” operating PrDP cat “B” (“standard” operating conditions)conditions)

““StandardStandard vehicle drivers operating vehicle drivers operating light vehicles in standard transport, light vehicles in standard transport, circumstances where no special circumstances where no special requirements exist over and above the requirements exist over and above the required licence and personal skills to required licence and personal skills to operate the vehicle. This includes the operate the vehicle. This includes the driving of a driving of a breakdown vehiclebreakdown vehicle.”.”

Health IntervalsHealth IntervalsType of Health EvaluationType of Health Evaluation Driver CategoryDriver Category

II(D/P)(D/P)

IIII(G)(G)

IIIIII(Special)(Special)

IVIV(B)(B)

Pre-employmentPre-employment YesYes YesYes YesYes YesYes

PRDPPRDP (time interval in (time interval in months)months)

24 (D/P)24 (D/P) 24(G)24(G) 24(B)24(B)

PeriodicPeriodic (time interval in (time interval in months) as per company months) as per company policypolicy

1212 1212 1212 On requestOn request

Return to work after Return to work after significant ill health significant ill health absence (>10 days)absence (>10 days)

YesYes YesYes YesYes On On RequestRequest

Post incident (evaluation Post incident (evaluation immediately or soon after immediately or soon after incidentincident

YesYes YesYes YesYes YesYes

KeyKey

(legislative requirement)(legislative requirement)

Yes = indicatedYes = indicated (Doctor’s discretion/company requirement)(Doctor’s discretion/company requirement)

O = optionalO = optional Pre-Pre-EmploymentEmployment

Periodic/Periodic/PRDPPRDP

ReturnReturnToTo

WorkWorkPostPost

IncidentIncident

Medical History:Medical History: Past historyPast history YesYes

Current historyCurrent history YesYes YesYes YesYes YesYes

Occupational History:Occupational History: Past historyPast history YesYes

Current historyCurrent history YesYes YesYes YesYes YesYes

Physical Examination:Physical Examination: YesYes YesYes YesYes YesYes

Sensory:Sensory: Vision (& fields)Vision (& fields) YesYes YesYes OO OO

HearingHearing YesYes YesYes OO OO

Special investigationsSpecial investigations YesYes OO OO OO

““Thorny” IssuesThorny” Issues EpilepsyEpilepsy Diabetes MellitusDiabetes Mellitus Psychiatric DiseasePsychiatric Disease Substance abuseSubstance abuse ConfidentialityConfidentiality

SASOM DVLA

EpilepsyEpilepsy Epilepsy (Epilepsy (RelapsingRelapsing Seizures) Seizures)(>seizure, over >24hrs)(>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 meds1-year seizure free on meds Must make every attempt to comply with Must make every attempt to comply with

medsmeds

EpilepsyEpilepsy Epilepsy (Epilepsy (SingleSingle Seizure, Seizure,

unprovokedunprovoked)) (One event, or >1event in <24hrs)(One event, or >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.

““Epilepsy Guide”Epilepsy Guide”

SASOM Cat 1,2,3

SASOM Cat 4

““Epilepsy Regulations - Epilepsy Regulations - DVLA”DVLA”


SASOM Cat 4


SASOM Cat 1,2,3

EpilepsyEpilepsy Epilepsy (Epilepsy (SingleSingle Seizure, on meds Seizure, on meds

withdrawal)withdrawal)(As per “Epilepsy Guide’)(As per “Epilepsy Guide’)

Codes D,P G & “special”Codes D,P G & “special” 10-year seizure-free, 10-year seizure-free, on NO medson NO meds, so , so not not

applicableapplicable 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.

EpilepsyEpilepsy Epilepsy (Epilepsy (ProvokedProvoked Seizure) Seizure)(As per “Epilepsy Guide’)(As per “Epilepsy Guide’)

Licence issued/revoked, depending on:Licence issued/revoked, depending on: Is there a “liability to epileptic seizures” Is there a “liability to epileptic seizures”

(increased vulnerability to having a seizure)(increased vulnerability to having a seizure) Has the cause been successfully treated?Has the cause been successfully treated?

This includes seizures at This includes seizures at the time ofthe time of a a head injury, at onset of a stroke, at head injury, at onset of a stroke, at surgery, etc.surgery, etc.

For D&P drivers, seizures within 24hrs For D&P drivers, seizures within 24hrs require 6months off driving.require 6months off driving.

EpilepsyEpilepsy Loss of Consciousness (Loss of Consciousness (UnknownUnknown

Cause)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.

Diabetes MellitusDiabetes Mellitus Important features:Important features:

Metabolic complications and other end-Metabolic complications and other end-organ failuresorgan failures

The complications are often unnoticed The complications are often unnoticed (autonomic neuropathy, loss of vision, (autonomic neuropathy, loss of vision, hypertension, etc.)hypertension, etc.)

Diabetes MellitusDiabetes Mellitus On InsulinOn Insulin

Codes D, P G & “special”Codes D, P G & “special” New applicants – disqualified.New applicants – disqualified. Existing drivers – must demonstrate Existing drivers – must demonstrate

satisfactory control.satisfactory control. Codes A1-EB (code 08 or less)Codes A1-EB (code 08 or less)

Must demonstrate satisfactory control.Must demonstrate satisfactory control.

Diabetes – “Qualifying Diabetes – “Qualifying Conditions”Conditions”

Diabetes MellitusDiabetes Mellitus On Meds or Diet aloneOn Meds or Diet alone

Codes D,P G & “special”Codes D,P G & “special” All drivers – must demonstrate satisfactory All drivers – must demonstrate satisfactory

control.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.

Psychiatric DiseasePsychiatric Disease

National Road Traffic Act

Psychiatric DiseasePsychiatric DiseaseSASOM Guide

Psychiatric DiseasePsychiatric DiseaseDVLA Guide

Psychiatric DiseasePsychiatric Disease

National Road Traffic Act

Substance AbuseSubstance Abuse

Substance AbuseSubstance Abuse

UK Guide – 1 year no driving

SASOM Group 4

SASOM Groups 1,2,3

Substance AbuseSubstance AbuseSASOM Guide

Substance AbuseSubstance AbuseUK Guide

ConfidentialityConfidentiality

ConfidentialityConfidentiality

ChallengesChallenges Validity of standards as predictors of Validity of standards as predictors of

RiskRisk Consistency of application of Consistency of application of

standardsstandards Current employee vs new applicantCurrent employee vs new applicant