Driving and Your Health

A Guide for Road Transport Operators

Development of this guide has been supported by:

March 2005 National Transport Commission 15/628 Bourke Street Melbourne VIC 3000 P: 61 3 9236 5000 F: 61 3 9642 8922 www.ntc.gov.au

Driving and Your Health A Guide for Road Transport Operators

Foreword
I am happy to introduce the Driving and Your Health campaign, a National Transport Commission (NTC) and Austroads initiative to support education and awareness in relation to the health of commercial vehicle drivers. This guide is a key element of the campaign, which will also feature education materials for drivers as well as print and radio media. Many factors contribute to safety on the road. Driver health is an important consideration and one that is identified in the National Heavy Vehicle Safety Strategy 2003-2010. The strategy was developed by the NTC in conjunction with industry and community stakeholders. It identifies and focuses on factors that are critical in reducing the number of fatal and serious injury crashes involving heavy vehicles, including driver impairment related to fatigue, drug or alcohol taking and medical conditions. In October 2003 the NTC and Austroads released the revised driver medical standards for commercial vehicle drivers. Assessing Fitness to Drive 2003 (AFTD) replaced the document Medical Examinations for Commercial Vehicle Drivers 1997 and now forms the basis of all health assessments and medical certification for commercial vehicle drivers throughout Australia. Support for transport operators is necessary, including the provision of information about the health requirements for safe driving and resources to raise awareness of health issues amongst commercial drivers. The Driving and Your Health campaign has been developed to address these needs and to integrate them with a wide range of other evolving initiatives including the reforms addressing driver fatigue. The NTC recognises that measures to improve road safety through driver health management will continue to develop. Improved operator and driver understanding of the revised medical standards will enable operators to communicate with their employees about these issues. The NTC believes that the development of a culture that supports healthy lifestyles for commercial vehicle drivers will require ongoing effort from across the transport industry. It welcomes the opportunity to take initial steps towards achieving this objective. The strategy is well placed in terms of timing to capitalise on:

the increasing professionalism of drivers; current priorities in road safety management; the expanding road transport industry; and the aging driver workforce and driver retention concerns.

The NTC is grateful for the support of Austroads and for the involvement of transport agencies and Driver Licensing Authorities. The generosity of the sponsoring organisation, National Occupational Health and Safety Commission (NOHSC) is also acknowledged as is the contribution of various health agencies which have contributed their expertise and support to the project.

Stuart Hicks Chairman

Driving and Your Health A Guide for Road Transport Operators

Driving and Your Health A Guide for Road Transport Operators

Contents
1. Purpose and Scope of the Guide .......................................................... 7 2. Health and Commercial Vehicle Driving ............................................... 9
2.1 2.2 2.3 2.4 2.5 2.6 What health problems can affect fitness to drive?.............................................. 9 What is the general health profile of commercial vehicle drivers?.....................11 What are the benefits of actively addressing driver health? ..............................11 What are an operators responsibilities in relation to drivers health? ...............12 What are a drivers responsibilities in relation to their health? ..........................12 What are a treating doctors responsibilities in reporting the affect of a patients medical condition? ..............................................................................13

3. Medical Standards for Commercial Vehicle Drivers - Assessing Fitness to Drive ................................................................................... 14
3.1 3.2 How are the driver medical standards used? ................................................... 14 What are the changes to the driver medical standards and how will they affect drivers and employers? .......................................................................... 15

4. Strategies to Support Commercial Vehicle Driver Health................. 18 4.1 4.2 Driver awareness and education...................................................................... 18 Health assessments for commercial vehicle drivers ........................................ 23

5. Resources and Useful Contacts.......................................................... 24 Appendices................................................................................................. 25

Appendix 1 - Regulatory Requirements for Driver Testing ............................................... 25 Appendix 2 - State Laws on Reporting by Drivers and Health Professionals ................... 28 Appendix 3 - State Laws on Blood Alcohol Concentration and Driving Commercial Vehicles....................................................................................................... 29

Driving and Your Health A Guide for Road Transport Operators

Driving and Your Health A Guide for Road Transport Operators

1. Purpose and Scope of the Guide

This Driving and Your Health Guide for Road Transport Operators provides practical guidance for managing and promoting the health of commercial vehicle drivers. It is part of a wider campaign to promote commercial driver health. For more information see www.ntc.gov.au and www.austroads.com.au This guide has been produced as part of the Driving and Your Health campaign to provide practical guidance to road transport operators in managing and promoting the health of commercial vehicle drivers. In particular it explains the role of the revised driver medical standards Assessing Fitness to Drive (AFTD 2003) and outlines the major changes to the standards as they impact on drivers and operators. It also provides guidance regarding strategies to support driver health and highlights the relevant interfaces with evolving legislative and industry based initiatives in the area of heavy vehicle safety. In terms of resources, the guide aims to support operators in communicating relevant health messages to their employees and contractors. It provides guidance for use of Tool Box Talks and Fact Sheets developed for the Driving and Your Health campaign (located on the NTC and Austroads websites), as well as a range of other strategies. The guide is being supported by a wider campaign aimed at raising awareness of health and lifestyle issues amongst commercial vehicle drivers and operators. Details of these supporting initiatives are provided on the NTC and Austroads websites. NTC: www.ntc.gov.au Austroads: www.austroads.com.au The guide and wider campaign, recognise that driver health is just one of many factors that impact on road safety, as illustrated in Diagram 1 overleaf. It also recognises that such factors may be addressed through a variety of approaches, all of which interface and integrate to produce the desired road safety objectives. The main focus of this guide is therefore on awareness and education. While the strategies complement those outlined in some existing and emerging industry accreditation programs, the guide does not represent an industry standard in this regard. The resources referred to in the guide may be used in helping transport operators to meet accreditation and industry standard requirements as appropriate.

Driving and Your Health A Guide for Road Transport Operators

Diagram 1 - Factors affecting heavy vehicle road safety

Heavy Vehicle Road Safety

Safer Roads
-

Safer Drivers
including: Speed management Seat belt wearing Fatigue management Drugs and alcohol controls Health management Maintenance of competencies

Safer Vehicles

Supported and facilitated by:

Legislation Industry Codes Driver Training and Education Operator Polices and Practices

Driving and Your Health A Guide for Road Transport Operators

2. Health and Commercial Vehicle Driving

A drivers health can affect public safety, the environment and the drivers own safety. There is much to be gained from initiatives that actively support driver health. Driving any motor vehicle requires:

Constant attention; Good judgement; Appropriate responsiveness; and Reasonable physical capability.

All of these rely on a driver maintaining good physical and psychological health. Commercial vehicle driving brings with it additional demands due to:

The nature of the vehicle itself e.g. size, load etc; The distance travelled; The responsibility to passengers; The nature of goods carried, e.g. dangerous goods; and The demands of working hours and delivery schedules.

The extent to which medical conditions contribute to vehicle crashes is difficult to assess. However there is recognition of the potential for certain medical conditions and health circumstances to cause serious impairment. There is also recognition that lifestyle behaviours can impact on health and driving performance, particularly in relation to driver fatigue. A drivers health can therefore affect public safety and the environment as well as their own safety. So, much is to be gained from initiatives that actively support driver health.

2.1 What health problems can affect fitness to drive?

Common examples of health problems that might affect fitness to drive are described below. Employers can play an important role in supporting driver awareness about the health conditions that can impact on their safe driving ability. Sleep disorders Sleep disorders disrupt normal sleep patterns and can result in sleepiness when driving. Some disorders have been found to increase the rate of crashes by as much as seven fold. (Source: Assessing Fitness to Drive 2003). Vision problems Good vision, including acuity (ability to see clearly) and visual fields, is vital for safe driving. Drivers need to be able to detect other vehicles and pedestrians, as well as any hazards on the road. Heart Disease Heart and blood vessel disease is a risk because of possible loss of consciousness or collapse at the wheel.
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Diabetes The main risk for drivers with diabetes is a loss of consciousness due to lack of control of their condition. Effects on other organs such as the eyes and heart may also affect driving ability in the long term. Epilepsy If untreated, epilepsy can result in loss of awareness, loss of consciousness and loss of control of the body. These effects are not compatible with safe driving. Blackouts and fainting Blackouts and fainting will clearly affect a drivers ability to control a vehicle. Psychiatric disorders Mental illness can result in significant changes to a drivers behaviour. If untreated this can increase the risk of a crash by affecting concentration, decision-making and various other important aspects of the driving task. Age-related decline Getting older does not necessarily mean that driving will be affected, however drivers should be aware of changes such as reduced vision and hearing, reduced reaction times and limited movement. 2.1.1 What about fatigue? Fatigue is another important consideration for drivers and public safety, and it is an issue closely linked to health. Fatigue can result from long or difficult work and little or poor sleep. It can also be influenced by health and emotional factors. Operators need to interface health and fatigue management strategies. However, health management should not be seen as a replacement for operational (i.e. driving hours) management of fatigue. For more information about local initiatives relating to fatigue management speak to your Driver Licensing Authority or Workplace Health Authority. More information will be available upon the expected release of the Fatigue Code of Practice in 2005.

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2.2 What is the general health profile of commercial vehicle drivers?

The health profile of commercial vehicle drivers is significantly poorer than the average Australian, with increased incidences of:

The health profile of commercial vehicle drivers is significantly poorer than the average Australian, with risks such as smoking, obesity and sleep disorders being of particular concern to their safety and long-term fitness to drive. According to recent research1:

33% smoke compared to 24% of the general population; 74% are overweight or obese, compared to 58% of males in the general population; 18% score high to very high on the Epworth Sleepiness Scale, an indicator of excess daytime sleepiness; 24% have a high to very high risk of breathing problems associated with a sleep disorder; and 26% have mild hypertension (high blood pressure).

Smoking; Overweight and obesity; Sleeping disorders; and High blood pressure.

The road transport workforce is almost entirely male with an average age in the mid to late forties. These factors alone mean the workforce is subject to higher rates of heart disease, diabetes and other lifestyle-related diseases than the rest of the population. The general lifestyle of a commercial vehicle driver, particularly long haul drivers, also contributes to their poor health profile. These drivers spend the most part of their day on the road and experience long hours of sedentary work. The availability of healthy food choices can be limited; they can spend long periods away from the support of family; and tend to be poor users of medical serivces. Additional stresses can also impact on health, including financial and family responsibilities. On a positive note, whilst most drivers acknowledge that they dont often engage in preventative health measures, they are keen to learn more and to become more proactive1.

2.3 What are the benefits of actively addressing driver health?

Over recent years, much effort has been devoted to addressing issues such as driver fatigue and driver impairment from drugs and alcohol. Many operators have also started to address driver health more broadly through comprehensive programs involving worker support services, health assessments and health education. These comprehensive approaches to driver health management build on traditional occupational health and safety initiatives to achieve improved outcomes, both for drivers and operators.

1.

HealthBreak - Interim Report June 2004, Institute for Breathing and Sleep, Austin Health, Heidelberg VIC, Authors Dr M Howard and J Wilson.

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Benefits for operators include:

Reduced losses from road crashes; Improved worker retention; Improved industrial relations; and Improved corporate image.

Given the significant difference between the health status of commercial vehicle drivers and the average population, there are important benefits to be gained for commercial vehicle drivers through a comprehensive approach to health. Improved health and quality of life are obvious benefits, which can translate into longevity of their driving career and therefore improved financial security. Reduced health care costs also flow from improved health as do increased morale and job satisfaction. For employers, the benefits are also significant. They potentially include: reduced losses from road crashes and compensation payouts; improved worker retention and therefore reduced recruitment and training costs; improved industrial relations; and improved corporate image.

2.4 What are an operators responsibilities in relation to drivers health?

Occupational health and safety legislation imposes a duty of care on Australian employers to protect the health and safety of others in the workplace. This general duty includes: provision of a safe working environment; provision of information and instructions on workplace hazards; provision of adequate welfare facilities; and monitoring the effects of work on the health of the worker. Individual State and Territory legislation further details these duties as does Dangerous Goods legislation. Additionally, various industry and jurisdiction accreditation programs (such as TruckSafe) require more specific and extensive responsibilities from participating operators and their workers in order to meet the standards of these programs. Antidiscrimination legislation also plays a role, requiring that where possible the employer accommodates the limitations on the workers capabilities due to health issues through strategies such as job modifications, alternate duties or supervision as appropriate. Employers also have a responsibility to ensure privacy principles are maintained with respect to workers personal and health information. (For more information about privacy requirements see www.privacy.gov.au or the Privacy Commissioner in your State or Territory).

2.5 What are a drivers responsibilities in relation to their health?

Drivers have responsibilities under both road safety laws and occupational health and safety laws. Road safety law in all States and Territories (except Western Australia) requires drivers, including drivers of private and

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In all States and Territories (except Western Australia) drivers have a responsibility under road safety law to report to the Driver Licensing Authority any permanent or long term illness that is likely to affect their ability to drive safely.

commercial vehicles, to report to the Driver Licensing Authority any permanent or long-term illness that is likely to affect their ability to drive safely. Doctors are able to advise drivers about whether they should be reporting a health condition to the Driver Licensing Authority. Commercial drivers should tell their doctor about the nature of their work so that he or she can assess the impact of the drivers health on their ability to drive safely. In addition to these responsibilities under road safety law, drivers also have a duty of care to themselves, the public and fellow workers. Under health and safety laws they must not knowingly place themselves or others in a situation where health and safety is at risk. This means that if a worker develops an illness which could affect their ability to drive safely, either in the short or long term, they should tell their employer so that they may arrange alternative duties if possible, and facilitate their return to work as appropriate. Under privacy legislation, workers are not required to tell the employer the nature of their medical condition but the employer is able to request that the worker attend a health assessment to determine their fitness for duty.

2.6 What are a treating doctors responsibilities in reporting the effect of a patients medical condition?
The relationship between a driver and their treating doctor (e.g. their general practitioner) is confidential. Therefore a doctor will not normally communicate directly with the Driver Licensing Authority or with an employer regarding their patients fitness to drive. The doctor will provide the driver with advice about their ability to drive as well as with a letter or report to take to the Driver Licensing Authority and/or employer. In circumstances where a doctor has reason to believe that the patient is continuing to drive and has not alerted the Driver Licensing Authority or the employer, he or she may make a report directly to the authority. Laws in most States and Territories (except Western Australia) indemnify the doctor for making such reports in the interests of public safety. Laws in South Australia and the Northern Territory require a doctor in this situation to report the driver to the Driver Licensing Authority. (Refer Assessing Fitness to Drive 2003, Appendix 3).

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3. Medical Standards for Commercial Vehicle Drivers - Assessing Fitness to Drive

Medical standards for drivers exist in order to facilitate management of drivers health and thus support road safety. The revised national driver medical standards, Assessing Fitness to Drive 2003 (AFTD), were introduced throughout Australia in October 2003. AFTD 2003 replaces the document Medical Examinations for Commercial Vehicle Drivers 1997, and forms the basis of medical certification for commercial vehicle drivers throughout Australia. The standards also provide medical criteria for private vehicle drivers. The standards focus mainly on long-term medical conditions which might impact on safe driving ability, but also provide general guidance for management of drivers with short-term conditions. The standards have been endorsed widely by road transport and medical authorities, and are taken up into road safety or occupational health and safety legislation in all States and Territories.

3.1 How are the driver medical standards used?

The driver medical standards Assessing Fitness to Drive 2003 may be downloaded from the NTC or Austroads websites www.ntc.gov.au www.austroads.com.au The driver medical standards define the health requirements for safe driving. They are used by doctors when assessing fitness to drive. Doctors refer to the standards when undertaking an assessment for a Driver Licensing Authority, for example a regular assessment required for public passenger vehicle licensing. Doctors also refer to the standards when undertaking health assessments at the request of an operator, in order to determine fitness for duty. A drivers own doctor will also refer to the standards in their dayto-day treatment, so that they can advise the driver about how their health might affect their driving ability and their work.

3.1.1 Health assessments conducted for Driver Licensing Authorities and other certifying bodies Driver Licensing Authorities require drivers to meet the health standards in order to hold a licence. Depending on the type of vehicle being driven, the authority may require drivers to undergo a health assessment or they might simply require the driver to make a declaration that they have no medical conditions that would affect their driving ability. Drivers of public passenger vehicles for example are required to have a health assessment and to meet the medical standards, each time they renew their certification (refer Appendix 1).
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3.1.2 Health assessments conducted for fitness for duty The medical standards may also be used as a basis for health assessments conducted on behalf of employers. These include programs of periodic health assessments which support ongoing fitness for duty by actively monitoring worker health throughout their employment. Such assessments are conducted over and above those required for driver licensing and may or may not be part of an industry accreditation program. 3.1.3 Regular medical consultations Doctors (such as a drivers general practitioner) will also refer to the standards in the day-to-day treatment of their patients. In this way they are able to advise about how a drivers health might affect their driving ability and thus their work and their drivers licence. Diagram 2 (overleaf) illustrates the responsibilities and lines of communication with respect to the types of health assessments described above.

3.2 What are the changes to the driver medical standards and how will they affect drivers and employers?
The revised standards reflect advances in medical diagnosis and treatment. They also reflect transport industry developments, including road engineering changes that improve safety. What this means for drivers is that some conditions that previously may have prevented them from working are no longer considered a safety risk. 3.2.1 Colour Vision Colour vision is a particular example. Colour vision deficiency no longer prevents a person from holding a commercial vehicle licence as the engineering improvements and the positioning of the coloured lights have been shown to be adequate for safety. However, colour vision assessment may be required if the licence holder commits repeated offences for running red lights or being involved in frequent rear-end crashes. 3.2.2 Conditional licences / Conditional Fitness for Duty Treatment advances mean that many medical conditions can be well managed and drivers can remain on the road, perhaps on a conditional licence. Conditional licences are not a new feature of the licensing system, however the revised standards place greater emphasis on the use of conditional licences as a means of balancing safety requirements with the needs of drivers.

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Diagram 2 - Responsibilities and lines of communication

Driver Licensing Authority / Certifying Body

DRIVER LICENSING

Doctors and DLA do not normally communicate directly with each other, which protects patient confidentiality. Doctors may communicate directly with the DLA in extraordinary situations where patients who are known to be an imminent risk to road safety continue to drive contrary to repeated advice.

Road Safety Legislation requires drivers with serious illnesses affecting driving ability to inform the DLA. DLA may request drivers to have a health assessment for licensing purposes, including for a conditional licence.

Employers do not generally communicate directly with the DLA. Employers may enquire about licensing status with drivers consent.

Commercial Vehicle Driver

Doctor advises driver about impact of health on fitness for duty.

GP and specialists

FITNESS FOR DUTY

Employer will not know drivers medical details only fitness for duty. Employer will manage worker based on report from examining doctor.

Doctor advises driver about impact of health on fitness for duty. Also advises treating doctor who remains responsible for ongoing health management.

Employer

Employer may appoint doctors to perform health assessments for fitness for duty. Doctor will communicate the workers functional capacity to perform job safely - not specific health information.

Examining Medical Practitioner

(appointed by employer)

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A conditional licence means that the person may continue to drive as long as certain conditions or restrictions are met and as long as their health does not pose an increased safety risk. Conditions may include seeing their doctor more regularly for a check-up to make sure their illness is well managed and that they are still safe to drive. The simplest and most frequent condition of licence is a requirement to wear corrective eye glasses or contact lenses when driving. In most cases conditional licences for commercial vehicle drivers will require approval from a specialist medical practitioner (as opposed to a general practitioner). This is a new requirement of the standard and reflects the increased risk of commercial driving and the importance of ensuring drivers health is well managed. Provided there are no restrictions that affect the drivers other job tasks, a conditional licence should not affect the employment status of a driver. The specialist makes recommendations to the Driver Licensing Authority (via the driver/patient) about a conditional licence but the authority will make the final decision as to whether the conditional licence is issued. If a driver is issued with a conditional licence, it is their responsibility to comply with any driving restrictions or other conditions and to be reviewed by their doctor/specialist as required. Provided that there are no restrictions that affect the drivers other job tasks, a conditional licence should not affect the employment status of a driver, as the basis of the conditional licence is that there is no increased safety risk. The increased focus on conditional licences, and by extension, conditional fitness for duty, accommodates requirements in terms of antidiscrimination. The clearer and more consistent use of conditional licences means that drivers can benefit from developments in treatment while sharing responsibility for their ongoing fitness to drive.

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4. Strategies to Support Commercial Vehicle Driver Health

A transport operator can support the health of commercial vehicle drivers in a variety of ways as illustrated in Diagram 3 overleaf. Commonly such approaches include:

Establishment of policies that reflect an underlying commitment to health and that provide a foundation for program and service development. Establishment of a workplace environment that supports health (e.g. access to healthy food choices). Provision of information to support awareness of health issues (e.g. brochures, web site information, newsletter articles, health library; health expos). Provision of education to support skills development and behaviour change (e.g. induction training, health seminars etc). Access to services to support and manage health (e.g. employee assistance programs, critical incident management programs, quit smoking courses).

Successful approaches to worker health are also characterised by:

a commitment to long term action; integration with related programs and initiatives to ensure synergy (e.g. fatigue management programs); and consultation with workers in the development phase to ensure relevance.

The focus of Driving and Your Health is on health AWARENESS and EDUCATION. It therefore interfaces with other initiatives to support driver health, including fatigue management and occupational health and safety.

4.1 Driver awareness and education

The focus of the Driving and Your Health campaign is awareness and education. Promoting driver awareness and providing appropriate education regarding health issues are valuable ongoing strategies for achieving improvements in health behaviours and for developing a culture of health in relation to safety. 4.1.1 Content for awareness and education Awareness and education may address the following areas:

What the medical standards for drivers are and how are they applied? What are the responsibilities of drivers, operators and health professionals with respect to health and the reporting of health conditions that may impact on safety?

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What are the consequences for parties not fulfilling their responsibilities? What are the health conditions that impact on driver safety and why? What are the lifestyle factors that impact on short-term safety and on long-term ability to drive? What are the lifestyle factors that impact on fatigue? What are practical ways of improving lifestyle behaviours? How does the employer assist the driver in improving and maintaining their health? How does the employer support the driver in case of illness?

This guide and the campaign resources such Tool Box Talks and Fact Sheets, provide content to address these issues with your workers. The Resources and Useful Contents section on the campaign website (www.ntc.gov.au) provides further guidance in this regard.

Diagram 3 - Approaches to supporting driver health

Driver Health & Wellbeing

Healthy Workplace Policy

Integration with related programs

Healthy Working Environment

Education to support skills development

Information to support health awareness

Access to facilities & services to support health and wellbeing

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4.1.2 Awareness and education mechanisms Opportunities for awareness raising and education with respect to health are many and varied and include existing mechanisms (e.g. driver briefings, noticeboards, etc) as well as new initiatives to specifically address health. The use of a variety of mechanisms is recommended in order to reinforce messages and ensure all workers are reached. Induction training Worker induction is an ideal opportunity to communicate your commitment to worker health and to outline the policies and initiatives that reflect this commitment. It is also an opportunity to establish responsibilities for health. Provision of Fact Sheets about various health issues might also be appropriate, though care should be taken not to overload the worker with information at this stage. Tool Box Talks and Fact Sheets Tool Box Talks is a term in common use to describe briefings given to workers about a range of issues including occupational health and safety issues. Tool Box Talks are a convenient and effective means of providing information that is relevant to driver health. It is helpful to develop a planned and structured approach to such communication opportunities, building on awareness and identifying and addressing particular issues. Tool Box Talk presentations and supporting Fact Sheets have been developed as part of the Driving and Your Health campaign (refer further description on page 22) and may be downloaded from the NTC website (www.ntc.gov.au). Articles in employee newsletters and bulletins Workplace newsletters/bulletins are also helpful communication tools for reinforcing health messages. The key to successful communication is to keep messages clear and simple and to present them in an easy to read format. The Fact Sheets developed for the Driving and Your Health campaign may form a basis for newsletter articles and are downloadable from the NTC website (www.ntc.gov.au). Information on organisation website Whilst many drivers may not have regular access to the internet (or intranet), inclusion of information on the companys website not only provides useful reinforcement, but is a highly visible demonstration of the organisations commitment to worker health. The web site is particularly suited for inclusion of policies and procedures that relate to driver health. The Fact Sheets and other resources provided as part of the Driving and Your Health campaign, may also be included on the organisations website. Posters Posters are highly visible reminders of your commitment to driver health and wellbeing. Included as part of the Driving and Your Health campaign is a poster that draws attention to the importance of driver health in relation to road safety and career

Tool Box Talk - Heart and Blood Vessel Disease

Fact Sheet - Driving and Your Health

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longevity. Further posters regarding specific health issues such as heart disease, diabetes, smoking etc may be accessed from health organisations (refer campaign website www.ntc.gov.au). Health events and seminars As awareness of health issues develops within your organisation, it might be appropriate to offer more detailed education regarding health issues. Seminars on lifestyle issues such as diet, exercise, stress management, smoking, relationships etc may be of interest. Health Expos, displaying and showcasing a variety of health information and services might also be of interest. Importantly, worker input into such initiatives is vital for their success so consultation is advised before health education initiatives step up to this level. Health organisations such as those listed on the campaign website may be able to provide services in this regard. Given the itinerant nature of the drivers work, access to such opportunities is an issue that will need to be considered. Health screening Health screening can be another popular awareness raising and educational activity. It should be clearly differentiated from health assessments conducted for licensing or fitness for duty purposes. Screening usually involves a 20-30 minutes onsite consultation in which measures such as cholesterol, blood pressure and body mass index are taken, lifestyle risks are discussed and support information and counseling is provided. Referral to the workers own general practitioner is also provided if a health risk is identified. Such screening programs are popular across a variety of industries and can be particularly valuable amongst workforces where use of other health services is poor. Confidentiality of worker results is a critical issue that should be openly addressed with workers.

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INFORMATION RESOURCES
A number of resources have been developed as part of the Driving and Your Health campaign, which may be used in awareness and education initiatives. Tool Box Talks
Tool Box Talks are included to assist operators in communicating health messages to drivers. The talks address key driver health issues including those listed below. The Tool Box Talks may be combined into regular team briefings or may be used as the basis for a stand-alone session. Facilitators Notes are provided for each as well as Power Point slides of the key messages. Topics include: 1. Driving & Your Health an overview of health and driving including driver medical standards 2. Sleep Disorders and Driving 3. Fatigue and Driving 4. Diabetes and Driving 5. Heart and Blood Vessel Disease 6. Healthy Food Choices 7. Be Active Every Day (30 mins) 8. Mental Illness and Driving 9. Mental Fitness 10. Cancer Prevention The key content elements for each Tool Box Talk include: A description of the particular issue; How the issue relates to commercial vehicle driving; Signs and symptoms, causes and consequences; Preventative steps - healthy lifestyle messages; What can be done to manage the health issue/ disease/ risk factor; Who to contact for more information.

Fact Sheets
A series of Fact Sheets have also been developed to further support communication to drivers about the revised driver medical standards and the key health areas listed above. The Fact Sheets are intended to be used as handouts at the Tool Box Talks but may also be used independently, for example: Inclusion in induction kits. As a basis for newsletters or bulletins. As downloadable files on the company intranet. A key message across all Tool Box Talks and the Fact Sheets will be that investing in a healthy lifestyle pays dividends. Therefore frequently occurring healthy lifestyle messages include: healthy food choices, regular exercise, appropriate rest and relaxation, regular check-ups and resourcing useful contacts - help is available.

Posters and Brochures

A poster and general brochure encouraging drivers to think about how health impacts on their driving and highlighting key health areas are further campaign resources.

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4.2 Health assessments for commercial vehicle drivers

Health assessments provide a means of monitoring driver health and identifying medical conditions that might impact on fitness to drive. They also provide an opportunity to highlight and address health risks and lifestyle behaviours that might impact on driver fitness in the future. 4.2.1 Health assessments and licensing The medical standards contained in Assessing Fitness to Drive are applicable nationally to all drivers of commercial vehicles. The requirements for drivers to be examined against the standards can vary between States and Territories. See Appendix 1 or contact your local Driver Licensing Authority for details. Whilst the medical standards contained in Assessing Fitness to Drive are applicable nationally and are adopted in road safety or occupational health and safety legislation in each jurisdiction (State or Territory), the requirements for drivers to be examined against the standards vary. Requirements for health assessments for licensing or driver certification vary depending on the driving task. For example: Dangerous goods drivers There is a requirement nationally for dangerous goods drivers to undergo a health assessment at each renewal of their certification (every three years). Public passenger vehicle drivers Health assessment requirements for public passenger vehicle drivers vary between the States and Territories but all require periodic assessment for authority renewal. The frequency of assessment increases with age (refer Appendix 1). Heavy vehicle drivers Requirements for other heavy vehicle drivers also vary. In most States and Territories (with the exception of New South Wales and South Australia) heavy vehicle drivers are not subject to periodic health assessment for licensing purposes. Most, however are required to self-report to the Driver Licensing Authority, health issues that are likely to impact on their ability to drive safely (except in Western Australia). Driver Licensing Authorities may also request a driver to have a health assessment based on reports from others, including the police, employers, the public etc. Operators should refer to individual jurisdiction requirements (Appendix 1). 4.2.1 Health assessments and fitness for duty A proportion of employed drivers are subject to regular health assessments as part of industry or local jurisdiction accreditation programs. Increasingly, transport operators are also initiating health assessment programs as they recognise the value of internal systems to manage and support driver health. These programs require periodic health assessments to monitor driver health. The frequency of assessment increases with increasing age. There is currently no national comprehensive guidance for operators in implementing health assessments. Accreditation

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programs such as TruckSafe do however incorporate a health management and health assessment aspect. For more information contact TruckSafe.

5. Resources and Useful Contacts

The Campaign website contains an up-to-date list of Useful Contacts and resources to assist operators in implementing health initiatives for their drivers.

www.ntc.gov.au

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Appendices
Appendix 1 - Regulatory Requirements for Driver Testing
Drivers in most States and Territories (except Western Australia at the time of publication) are required to make a medical self-declaration in relation to their fitness to drive at licence application and renewal. The information obtained may result in a requirement for medical assessment or refusal of the application. In addition, each State and Territory has specific requirements for medical examinations or road testing depending on the drivers age or the type of vehicle being driven. The following table summarises these requirements at the date of publication. Note, all review requirements may be amended on medical advice or on self-declaration or at the request of the Driver Licensing Authority. The table also includes health assessment requirements for fatigue management where applicable. This information is current as of Feb 2005. Refer to your State or Territory Driver Licensing Authority for current requirements.
REGULATORY REQUIREMENTS FOR HEALTH ASSESSMENT & ROAD TESTING OF COMMERCIAL VEHICLE DRIVERS STATE/ TERRITORY ACT
Heavy vehicle drivers (class MR and above) - vision test on initial application and on each renewal; when upgrading to Medium-Rigid (class MR) or above; at ages 50, 60, 65, 70 and 75; thereafter annually. Public passenger vehicle drivers (H, M, O, T, W) - vision test on initial application and annually thereafter. Dangerous goods vehicle drivers vision test on initial application, then every three years.

VISION TEST

MEDICAL ASSESSMENT Licensing requirements

Heavy vehicle drivers (class MR and above) - medical assessment at 75 years and annually thereafter.

ROAD TEST

Heavy vehicle drivers (class MR and above) - road test on initial application; when upgrading to MR class or above. No prescribed period or age thereafter, unless declared or reported. Public passenger vehicle drivers (H, M, O, T, W) - road test on application; at 70 years of age and thereafter annually. Dangerous goods vehicle drivers no prescribed period or age, unless declared or reported.

Public passenger vehicle drivers (H, M, O, T, W) - medical assessment on initial application and annually thereafter. Dangerous goods vehicle drivers medical assessment on initial application, then every three years.

NSW
Vision test for all drivers on initial licence and on each renewal and replacement. Multiple Combination vehicle (road train) drivers (class MC) vision test with medical assessment on initial application, then at age 21 and every 10 yrs up to age 40; at age 40 then every 5 years until age 60; at age 60 then every 2 years until age 70; at age 70 then annually thereafter. Public passenger vehicle drivers (buses) On initial application then every three years until the age of 60 years; annually thereafter. Dangerous Goods vehicle drivers vision test on initial application, then every three years.

Licensing requirements
Medical assessment for all licence classes at 80 years of age and annually thereafter. Multiple Combination vehicle (road train) drivers (class MC) - medical assessment on initial application then at age 21 and every 10 yrs up to age 40; at age 40 then every 5 years until age 60; at age 60 then every 2 years until age 70; at age 70 then annually thereafter. Public passenger vehicle drivers (buses) medical assessment on initial application then every three years until the age of 60 years; annually thereafter. Dangerous Goods vehicle drivers medical assessment on initial application, then every three years. Fatigue Management requirements Participants of TFMS must ensure drivers have a medical examination unless the driver has had a medical examination within 12 months of the application to TFMS. Thereafter medical examinations must be conducted every 3 years for drivers up to the age of 49 years and annually thereafter. Annual road test required: for buses and trucks ( MR, HR and HC) from 80 years of age. Multiple Combination vehicle (road-train) drivers (class MC) road test at 70 years and annually thereafter.

Public passenger vehicle drivers (buses) - road test at 80 years.

Dangerous Goods vehicle drivers no prescribed period or age, unless declared or reported.

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REGULATORY REQUIREMENTS FOR HEALTH ASSESSMENT & ROAD TESTING OF COMMERCIAL VEHICLE DRIVERS STATE/ TERRITORY NT
Vision test on initial application, then 5 yearly.

VISION TEST

MEDICAL ASSESSMENT

ROAD TEST

Licensing requirements
Medical assessment only when a condition is reported by health professional or driver. Public Passenger vehicle drivers medical assessment on initial application, then 5 yearly, or sooner if a condition is reported. Only if recommended professional. by health

Public Passenger vehicle drivers vision test on initial application, then 5 yearly.

Public Passenger vehicle drivers road test only if recommended by health professional.

QLD
Heavy vehicles vision test required if applicant declares a vision or eye disorder and if requested by the chief executive.

Licensing requirements
Heavy vehicles - a person must obtain a current medical certificate if they have a medical or physical incapacity that may affect their driving. OR are 75 years of age or older. Currency of certificate is determined by the doctor. Public passenger vehicle drivers vision test every 5 years and with prescribed medical assessment until age 75; annually thereafter. Dangerous goods vehicle drivers vision test on initial application, then every three years. Driving instructors No vision test required. Public passenger vehicle drivers medical assessment every 5 years, or less if required by a doctor, until age 75; annually thereafter. Dangerous goods vehicle drivers medical assessment on initial application, then every three years. Driving instructors No medical examination required. Public passenger vehicle drivers no prescribed period or age, unless declared or reported. Heavy vehicles road test required only if a doctor determines a person medically fit to drive subject to passing a practical driving re-test.

Dangerous goods vehicle drivers no prescribed period or age, unless declared or reported. Driving instructors No road test required.

SA
Heavy vehicles drivers vision test annually from 70 years of age or with prescribed medical examinations.

Licensing requirements
Heavy vehicle drivers medical assessment annually from 70 years of age for all licence holders unless prescribed otherwise (see below). Multiple Combination vehicle drivers (class MC) operating south of Port Augusta medical assessment every 3 years up to 49 years of age, then annually. Public passenger vehicle drivers vision test with medical assessment every 5 years up to age 70 years then annually thereafter. Dangerous Goods vehicle drivers vision test on initial application, then every three years. Driving instructors vision test on licence application and renewal. Public passenger vehicle drivers medical assessment every 5 years up to age 70 years then annually thereafter. Dangerous Goods vehicle drivers medical assessment on initial application, then every three years. Driving instructors medical assessment on licence application and renewal. Public passenger vehicle drivers no prescribed period or age, unless declared or reported. Heavy vehicle drivers road test annually from age 85.

Dangerous Goods vehicle drivers no prescribed period or age, unless declared or reported. Driving instructors no prescribed period or age unless declared or reported.

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REGULATORY REQUIREMENTS FOR HEALTH ASSESSMENT & ROAD TESTING OF COMMERCIAL VEHICLE DRIVERS STATE/ TERRITORY TAS
Multiple Combination vehicle drivers (class MC) vision test on initial application (as part of medical assessment). Public passenger vehicle drivers vision test on initial application and then as part of required medical assessments (see next column).

VISION TEST

MEDICAL ASSESSMENT Licensing requirements

Multiple Combination vehicle drivers (class MC) medical assessment on initial application. Public passenger vehicle drivers (Ancillary Certificate Public Passenger Vehicles) - medical assessment on initial application then every 3 years up to age 65, then annually. (ACPPV's are further categorised taxi, coach, hire car etc.)

ROAD TEST

Heavy vehicle drivers - road test on initial application; no tests are required thereafter. Public passenger vehicle drivers (ACPPV ) - road test at age 65, 70, and then annually thereafter.

Dangerous goods vehicle drivers vision test on initial application, then every three years. Driving instructors - vision test on initial application and then as part of required medical assessments (see next column).

Dangerous goods vehicle drivers medical assessment on initial application, then every three years. Driving instructors (Ancillary Certificate in Driving Instruction) medical assessment on initial application, then every 5 years until age 40; every 2 years aged 41 to 60; then yearly from age 61.

Dangerous goods vehicle drivers no prescribed period or age, unless declared or reported. Driving instructors (ACDI) test every 3 years. - road

VIC
Heavy vehicle drivers - vision test on initial application. Otherwise no specified period, unless declared or reported. Public passenger vehicle drivers (taxis, bus) - vision test on initial application then every 3 years until age 60 years; then annually. Dangerous goods vehicle drivers vision test on initial application, then every three years. Driving instructors - vision test on initial application then every 3 years until age 60 years; then annually.

Licensing requirements
Heavy vehicle drivers - no prescribed period or age, unless declared or reported. Public passenger vehicle drivers (taxis, bus) - medical assessment on initial application then every 3 years until age 60 years; then annually. Dangerous goods vehicle drivers medical assessment on initial application, then every three years. Driving instructors - medical assessment on application then every 3 years until age 60 years, then annually. Heavy vehicle drivers - no prescribed period or age, unless declared or reported. Public passenger vehicle drivers (taxis, bus) - no prescribed period or age, unless declared or reported. Dangerous goods vehicle drivers no prescribed period or age, unless declared or reported. Driving instructors - no prescribed period or age, unless declared or reported.

WA
Heavy vehicle drivers (class MR and above) - vision test on initial application, and when applying for an additional class; then at 75, 78 and annually from 80 years of age. Public passenger vehicle drivers vision test on initial application, and when applying for an additional class; then every 5 years until age 45 years; then every 2 years until age 65; then annually from age 65. Dangerous goods vehicle drivers vision test on initial application, then every three years. Driving instructors - vision test on initial application then every 3 years.

Licensing requirements
Heavy vehicle drivers (class MR and above) - medical assessment at 75, 78 and annually from 80 years of age. Public passenger vehicle drivers medical assessment on initial application then every 5 years until age 45 years; then every 2 years until age 65; then annually from age 65. Dangerous goods vehicle drivers medical assessment on initial application, then every three years. Driving instructors - medical assessment on initial application, then every 3 years. Fatigue Management requirements Under Occupational Health and Safety Regulations introduced in July 2003, workplaces must ensure that commercial vehicle drivers are certified fit to drive the vehicle by a medical practitioner every 3 years. Heavy vehicle drivers (class MR and above) - road test at 85 years of age then annually.

Public passenger vehicle drivers road test at 85 years of age then annually.

Dangerous goods vehicle drivers no prescribed period or age, unless declared or reported. Driving instructors - road test every 3 years unless exempted.

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Appendix 2 - State Laws on Reporting by Drivers and Health Professionals

Jurisdiction ACT Legislation
Road Transport (Driver Licensing) Regulation 2000 77 (2), (3)

Discretionary reporting If a person who is the holder of a driver licence suffers any permanent or long-term illness, injury or incapacity that may impair his or her ability to drive safely, the person must tell the road transport authority as soon as practicable (but within 7 days). Maximum penalty: 20 penalty units.
It is a defence to the prosecution of a person for an offence against this section if the person establishes (a) that the person was unaware that his or her ability to drive safely had been impaired; or (b) that the person had another reasonable excuse for contravening the subsection.

NSW

Road Transport (Driver Licensing) Regulation 1999 30 (5) Motor Vehicles Act 11(3)

The holder of a driver licence must, as soon as practicable, notify the Authority of any permanent or long term injury or illness that may impair his or her ability to drive safely.

NT

If a person who is licensed to drive a motor vehicle is suffering from a physical or mental incapacity that may affect his or her ability to drive a motor vehicle with safety to the public, the person, or his or her personal representative, must notify the Registrar of the nature of the incapacity or unfitness. A person is not eligible for the grant or renewal of a Queensland driver licence if The chief executive reasonably believes the person has a mental or physical incapacity that is likely to adversely affect the person's ability to drive safely. More specifically, there is a standard for drivers of public passenger vehicles: An authorised driver must -

QLD

Transport Operations (Road Use ManagementDriver Licensing) Regulation 1999 13 (1) c

Transport Operations (Passenger Transport) Standard 2000 8(2) a,b

(a) notify the chief executive if there is a change in the drivers medical condition that makes the driver continuously unfit to safely operate a motor vehicle for more than 1 month; and (b) within every 5 years after the issue by a doctor of the last medical certificate given to the chief executive under this section, give the chief executive a fresh medical certificate.

SA

Motor Vehicles Act 1959 98AAF

The holder of a licence or learners permit who, during the term of the licence or permit, suffers any illness or injury that may impair his or her competence to drive a motor vehicle without danger to the public must, within a reasonable time after the occurrence of the illness or injury, notify the Registrar in writing of that fact. Maximum penalty: $750.

TAS

Vehicle and Traffic (Driver Licensing and Vehicle Registration) Regulations 2000 29(6), (7)

The holder of a driver licence must, as soon as practicable, notify the Registrar of (a) any permanent or long-term injury or illness that may impair his or her ability to drive safely; or (b) any deterioration of physical or mental condition (including a deterioration of eyesight) that may impair his or her ability to drive safely; or (c) any other factor related to physical or mental health that may impair his or her ability to drive safely. Penalty: Fine not exceeding 10 penalty units. ($1,000)

Unless the Registrar requires written notification, the notification need not be in writing. VIC
Road Safety (Drivers) Regulations 1999 225 (3) The holder of a driver licence or permit or any person exempted from holding a driver licence or permit under section 18(1)(a) of the Act must, as soon as practicable, notify the Corporation of any permanent or long term injury or illness that may impair his or her ability to drive safely.

WA

No duty as yet

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Appendix 3 - State Laws on Blood Alcohol Concentration and Driving Commercial Vehicles
SUMMARY OF STATE AND TERRITORY LAWS ON BLOOD ALCOHOL CONCENTRATION AND DRIVING STATE OR TERRITORY ACT DRIVERS OF CARS AND LIGHT TRUCKS, MOTORCYCLE RIDERS
The legal BAC limit applying to learner, provisional and probationary drivers and restricted licence holders is below .02 BAC. The legal limit for drivers of cars, trucks and buses (excluding public vehicles) up to 15 tonnes GVM and riders of motorcycles who hold a full licence (gold) is below .05 BAC.

DRIVERS OF TRUCKS, TAXIS, BUSES AND PRIVATE HIRE CARS

The legal BAC limit applying to drivers of heavy motor vehicles exceeding 15 tonnes GVM, dangerous goods vehicles, public vehicles (taxis, buses and private hire cars) and Commonwealth chauffer cars is below .02 BAC.

NSW

Learner licence holder, provisional licence holder, zero BAC. Supervising driver .02 BAC. Drivers not listed elsewhere .05 BAC.

Drivers of trucks over 13.9 tonnes GVM, all drivers of taxis, coaches or commercial buses and drivers of any vehicles carrying dangerous goods or radioactive substances .02 BAC. Drivers of vehicles over 15 tonnes GVM, public passenger vehicles, dangerous goods vehicles, vehicles with persons unrestrained in an open load space, vehicles carrying more than 12 persons, driving instructors while instructing, licensed drivers under age 25 licensed less than 3 years, zero BAC. Drivers not listed elsewhere .05 BAC. Drivers of trucks, buses, articulated motor vehicles, Bdouble, road trains, vehicles carrying placard load of dangerous goods, taxis or limousines, tow trucks, pilot or escort vehicles, or driver trainers, zero BAC. All other drivers, .05 BAC. Drivers of vehicles over 15 tonnes GVM, taxis, buses, licensed chauffeured vehicles, vehicles carrying dangerous goods, zero BAC. Drivers of: public vehicles including buses (more than 11 passengers) and taxis, vehicles exceeding 4.5 tonnes GVM, zero BAC.

NT

Unlicensed and learner drivers, provisional licence holders, drivers under 25 with less than 3 years experience, zero BAC. Drivers not listed elsewhere .05 BAC.

QLD

A person under 25 years of age and the holder of a learner, probationary, provisional licence, zero BAC.

SA

Learner permit holders and provisional licence holders zero BAC. Drivers not listed elsewhere .05 BAC. Unlicensed and learner drivers, provisional licence holders, persons convicted of causing death driving a motor vehicle, persons with 3 or more traffic convictions (at least 1 after 12 Dec 1991), zero BAC. Probationary drivers, drivers with Z condition on licence and motorcyclists on 260cc restriction zero BAC. Drivers not listed elsewhere .05 BAC. Learner drivers, probationary drivers, extraordinary licence holders, some drivers with drink-drive convictions .02 BAC. All other drivers .05 BAC. Drivers who have been convicted of a prescribed alcohol related offence after 1 January 1998 must not drive with a blood alcohol concentration equal to or exceeding .02 BAC for a period of three years.

TAS

VIC

Drivers of vehicles over 15 tonnes GVM, all taxi and bus drivers, and some emergency vehicle drivers zero BAC. Drivers not listed elsewhere .05 BAC. Learner drivers, probationary drivers, extraordinary licence holders, some drivers with drink-drive convictions .02 BAC. All other drivers .05 BAC. Drivers who have been convicted of a prescribed alcohol related offence after 1 January 1998 must not drive with a blood alcohol concentration equal to or exceeding .02 BAC for a period of three years.

WA

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