Medical standards for drivers

This guidance is for occupational health professionals who are consulted about the medical fitness of workplace transport drivers. You can adapt the guidance to individual circumstances.

Medical standards

There is detailed advice on medical standards of fitness to drive in At a Glance published by the Drivers Medical Unit of the Driver and Vehicle Licensing Authority (DVLA) However, the DVLA does not have responsibility for licensing workplace transport drivers if they do not drive on public roads. Always consult At a Glance if you have any doubt about an individual's fitness to operate workplace transport.

At a Glance lists separate medical standards for

Group 1 (holders of ordinary driving licence); and
Group 2 (heavy goods vehicle (HSV) and public service vehicle (PSV) licence holders).

Application of medical standards

You should always judge a person's fitness for operating a vehicle individually. Your aim is to match the requirements of the driving task with the fitness and abilities of the driver.

For most work, a standard equivalent to Group 1 will be appropriate. In some cases, however, a more stringent standard may be required, for example when:

moving highly toxic or explosive materials;
working in a particularly demanding environment;
working at night; or
operating large, heavy vehicles.

In these instances some or all of the medical standards equivalent to Group 2 may be appropriate.

Assessing fitness individually should help ensure that people with disabilities are not disadvantaged. Some people with disabilities have developed compensatory skills. Reasonable adjustment to work equipment, as can be required by the Disability Discrimination Act 1995, may enable a disabled person to operate workplace transport safely. However, you must always think about their competence in an emergency

Frequency of assessment

All existing and potential workplace transport operators should be screened for fitness before employment and at five-yearly intervals from age 40. Group 2 licences are renewable five-yearly from age 45 and, where an individual is both a workplace transport operator and holds a Group 2 licence these assessments can be made at the same examination. A workplace transport operator who continues after age 65 should have annual assessments for fitness.

We recommend assessment after an absence of more than one month or after a shorter absence if it is likely that the illness has affected the worker’s fitness to operate workplace transport. This provides positive confirmation of fitness to operate workplace transport in these circumstances.

If a GP signs a worker off as fit to return to work, may not be the same as fitness to operate workplace transport.

We also recommend assessment if workplace transport operators, or their employers, suspect that they have developed a condition which may affect their continuing ability to operate workplace transport.

Employers and employees should agree requirements for medical screening and/or examination of employees in a written contract of employment.

Medication

Medication – whether prescribed or bought over-the-counter – may temporarily affect a worker's fitness to operate workplace transport. Workplace transport operators should

ask their general practitioner or pharmacist about the effects any medication may have on their ability to drive safely
tell their employer if there is a risk of adverse effects which may compromise safety

They may need to stop operating workplace transport until the nature and extent of any side effects have been established.

Alcohol and illicit drugs

No worker should drive or operate vehicles or machinery at work if they have taken alcohol or illicit drugs. There is advice for employers on alcohol and drugs in

Summary of standards

The following is a summary of standards applicable to Group 1 drivers published by DVLA Standards may change, and we recommend that you refer to At a Glance.

When setting standards for a particular work situation you should take account of both assessment of both health and safety implications and the physical and mental demands of the job. You may need to obtain specific advice on standards from a suitably competent occupational physician who is familiar with the work environment in question. The Employment Medical Advisory Service (EMAS) located at HSE offices may be able to assist in locating such doctors.

Locomotor

There are no specific restrictions on Group 1 entitlement. Standards will depend on the demands of the job but for workplace transport there should normally be full movement of the trunk, neck and upper and lower limbs. Stable deformities such as an arthrodesed joint should be assessed according to the effect on functional ability – and this may require the advice of a workplace transport instructor.

Loss of a limb

An experienced workplace transport operator who loses a limb or part of a limb may be able to continue in employment after suitable retraining.

Diabetes mellitus

For workers who control their diabetes by diet alone, or by taking tablets, this condition is normally acceptable if there are no complications, for example diabetic eye problems affecting vision.

The use of insulin is normally acceptable as long as there is satisfactory control and the worker recognises the warning symptoms of hypoglycaemia. The worker must meet visual standards

Review the worker’s fitness regularly.

Cardiovascular conditions

Ischaemic heart disease

Ischaemic heart disease
History of a single uncomplicated myocardial infarction is not a bar to workplace transport operation, but the worker should take at least a month off after the attack. They can usually return to work after a full medical assessment, if there is no other disqualifying condition.

Workers with angina should not operate (including driving) workplace transport until their symptoms are under control. It will not be a bar unless it occurs during operation or at rest, or unless medication produces side effects that may interfere with the driving or operation.

A second or complicated myocardial infarction will require careful assessment.

Hypertension

Workers with hypertension may continue to operate (including driving) workplace transport machinery unless treatment causes unacceptable side effects.

Arrhythmia

Workers with an arrhythmia which may distract their attention or suddenly impair their cerebal function must not operate (including driving) workplace transport. Operating may resume when satisfactory control of symptoms is achieved provided that cardiac function is also satisfactory.

Other conditions

In general, workplace transport operation should cease for a month after any cardiac event, following which fitness should be reassessed.

Other serious cardiac conditions, for example valvular disease with complications such as a history of cerebral ischaemia, are likely to be a bar to workplace transport operation. You should seek specialist advice in all cases of doubt.

Vision

Reading

Operators must be able to read in good light (with the aid of glasses or contact lenses if required) a vehicle registration mark at a distance of 20.5 metres, with both eyes together. This corresponds to visual acuity of between 6/9 and 6/12 on the Snellen chart.

Monocular vision

People who only have the use of one eye vary in their ability to compensate for their impairment and to operate workplace transport safely. You cannot assume that they are fit to operate workplace transport and, after medical assessment, you should set them practical workplace transport operating tests. You should also do this if an experienced operator loses the use of an eye, after they have had time to adjust

Visual field defects

Workplace transport operation should cease unless an operator is confirmed able to meet the recommended national guideline for visual field. There is a full definition in At a Glance.

Uncontrolled diplopia will disqualify an individual from operating workplace transport. They may start again when they have achieved when satisfactory control of symptoms is achieved. Regular review is recommended.

Nervous systems

Vertigo, giddiness and disorders of balance

Workplace transport operation should cease on diagnosis. Resumption may be permitted when satisfactory control of symptoms is achieved. Regular review is recommended.

Neurosurgical disorders

For neurosurgical disorders, including intracranial tumours and haemorrhage, there is detailed advice in At a Glance.

Acute illness

After acute illness, such as a stroke, workplace transport operation should cease for at least one month. The extent of recovery should then be assessed. Where recovery is complete, workplace transport operation may recommence. Progressive or relapsing conditions will require careful assessment of function and prognosis.

Long-standing deficits

Long-standing static deficits, such as weakness of a limb following poliomyelitis, should be assessed for functional ability. Workplace transport operation may be practical, possibly with the help of suitable adaptation to the workplace transport vehicle.

Epilepsy

This will not normally be a bar to lift truck operation where an individual qualifies for an ordinary driving licence (i.e. has been free from epileptic attack for one year). Any necessary medication should be maintained, and a recurrence of seizures should result in a reassessment. If the individual no longer meets the requirements for a Group 1 entitlement he/she will not be fit for work as a workplace transport operator.

Annex 3 of At a Glance gives full details of the epilepsy regulations as prescribed by the Motor Vehicles (Driving Licences) Regulations 1996. This should be used as a guide to assess suitability for workplace transport operation.

Hearing

Hearing defects do not normally affect Group 1 entitlement. However, cases should be assessed individually, taking into account the working environment, materials being handled and other duties associated with the work. If good hearing is thought to be particularly important, this should be assessed audiometrically.

Alcohol and drugs

An individual who is dependent on alcohol or illicit drugs should not operate workplace transport. Where there is such a history there should be a clear period of freedom from dependence of at least one year before employment as a workplace transport operator is considered. Medical assessment of fitness to operate workplace transport should then be carried out. Reference to At a Glance is recommended in individual cases.

Psychiatric disorders

Suspicion or knowledge of psychiatric disorders should lead to suspension from workplace transport operation pending medical assessment. Guidance is complex and At a Glance provides detailed advice under the following headings:

anxiety or depression;
more severe anxiety or depressive illness;
acute psychotic episodes of any type or cause;
chronic schizophrenia;
dementia or any organic brain syndrome;
learning disability;
persistent behaviour disorder.

Medical standards for drivers