2010 BC Guide in Determining Fitness to Drive

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Percent Holding LicensesMillionsMillionsPopulation ChangeAges 15 - 64Ages 65+24109238227621542031921181996 2000 2006 2016 2026 2036 205101996 2000 2006 2016 2026 2036 2051YearYearSource: Statistics Canada, 2002These increases are reflected in the driving population, with thepercentage of drivers who are older increasing over time. Increases in thepercentage of older women who have a driver’s licence will also have animpact. Currently, 50% of females over the age of 65 are licensed todrive; in 2031 it is projected to be 85%.100806040MalesFemales2001950 1984 1997Source: Rosenbloom, 1998Aging and multiple medical conditionsBecause of the association between age and many chronic medicalconditions, aging drivers are more likely to have one or more of theseconditions. A 2003 survey found that 33% of Canadians age 65 and olderhad 3 or more chronic medical conditions, compared with 12% of younger382
Percentadults. The survey also found that the average number of chronicconditions increases with age.706050Number of chronic diseases (0 to 2 or more)reported by age403020012 or more10020-39 40-59 60-79 80+AgeSource: Rapoport, Jacobs, Bell & Klarenbach (2004)With an increased rate of multiple medical conditions, there is also agreater likelihood that aging drivers will be taking multiple medications(polypharmacy). With each additional medication taken, there is anincreased risk of side effects and adverse interactions betweenmedications, which may affect fitness to drive. While in many cases theadverse effects may be temporary or avoidable, where specificmedications or dosages are required there may be a persistent impairmentof the functions needed for driving.Aging and adverse driving outcomesAs a group, older drivers are less likely to be involved in a crash thanother age groups. However, the reason for this is that older drivers spendless time driving than others. When driving exposure is considered, olderdrivers show an increased crash risk, an increased risk for at-fault crash,and an increased risk of being injured and dying in a crash.Statistics from ICBC indicate that older drivers are involved in adisproportionate number of at-fault crashes. The chart below shows theratio of at-fault (50% liable) to not-at-fault crashes for different agegroups. Drivers between the ages of 16 and 20 have more than 1.5 timesthe average at-fault versus not-at-fault crashes. Drivers in the 30 to 65 agegroup have a lower-than-average at-fault crash ratio. At about age 70, the383
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Ministry of Public Safety and Solic
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AcknowledgmentsResearcherBonnie M.
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Table of Contents (click on any ite
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11.7 Private and commercial drivers
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BACKGROUND ........................
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PART 1:BACKGROUND1
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Appendix 2: Excerpts from the MVA t
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Chapter 2: The Driver Fitness Progr
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for the exercise of discretion by O
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1. SCREENINGA driver disclosesa med
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2.3 Roles and responsibilitiesOSMV
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Medical practitionersMedical practi
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Chapter 3:Driver Fitness Program Pr
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Because of these limitations, OSMV
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Example: the temporary storage of i
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Motor functions (including sensorim
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an individual with poor contrast se
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3.5 Best informationDriver fitness
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Chapter 4: Introduction to the Poli
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3. DETERMINATIONFrom2. AssessmentAn
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Once identified, a DMER is mailed t
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5.3 Screening aging driversDefiniti
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5.5 Transient impairmentsDefinition
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Chapter 6: Assessment Policies and
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6.2 Assessments will only be reques
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6.4 Requesting specialist assessmen
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Policy6.5.1 If a case manager or ad
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Persistent and episodic impairments
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further assessment. Drivers who sco
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6.9.4 A case manager or adjudicator
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ASSESSMENT PROCEDURESCase manager o
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A driver fitness determination is a
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Policy rationaleBecause individuals
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7.5.3 Generally, an individual whos
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7.6.2 In particular, the case manag
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7.8.3 Whether an individual can com
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in order to be fit to drive, the ca
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has the judgment and willingness to
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Policy7.11.1 If a case manager or a
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(e) the medical condition results i
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7.12 Communicating a decisionPolicy
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7.13 Determination proceduresThe fo
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During the reconsideration, the adj
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8.3 Reconsideration proceduresThe f
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Chapter 9:Introduction to the Medic
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9.4 Medical condition chapter templ
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Private and commercial drivers who
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Chapter 11: Diabetes - Hypoglycemia
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PercentFigure 1 - Prevalence of Dia
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neuropathy, nephropathy, cardiovasc
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11.8 Private drivers with diabetes
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11.9 Commercial drivers with diabet
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RestrictionsRe-assessmentguidelines
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Policy rationaleSevere hypoglycemia
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11.12 Private drivers who have pers
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11.13 Commercial drivers who have a
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11.14 Commercial drivers who have a
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11.15 Commercial drivers who have p
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PART B - HYPOGLYCEMIA11a. Has the p
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Produce my glycemic log for my doct
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Deep-vein thrombosisDeep-vein throm
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Aneurysms less than 5 cm in diamete
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GUIDELINES12.6 Private and commerci
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12.7 Private drivers who have an an
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12.9 Commercial drivers who have an
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Chapter 13: Musculoskeletal Conditi
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ConditionType of drivingimpairment
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ConditionsRestrictionsRe-assessment
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14.3 Chronic renal disease and adve
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14.8 Private drivers with end-stage
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14.10 Private and commercial driver
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Level ofImpairmentMildlyImpairedMod
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15.8 Commercial drivers with modera
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15.10 Commercial drivers with sever
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Policy rationaleDrivers who require
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Chapter 16: Vestibular DisordersBAC
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One study identified that 32.5% of
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ConditionType ofdrivingimpairmentan
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Re-assessmentguidelinesPolicy ratio
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Individuals who have undergone valv
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Episodic impairmentThe potential ep
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GUIDELINES17.6 Policy rationaleThes
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17.9 Commercial drivers with corona
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17.11 Private drivers who have had
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17.15 Private drivers who have vent
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17.19 Private drivers who have sust
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17.21 Commercial drivers who have s
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17.27 Private drivers with atrioven
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17.28 Commercial drivers with atrio
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17.29 Private drivers with permanen
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17.31 Private drivers who have decl
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17.33 Private drivers where ICD the
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17.35 Commercial drivers who have d
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17.37 Commercial drivers with inher
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17.39 Commercial drivers with medic
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17.41 Private drivers with surgical
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17.43 Private drivers with mitral v
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17.45 Private drivers with congesti
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17.46 Commercial drivers with conge
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17.47 Private drivers with left ven
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17.49 Private drivers with a heart
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17.51 Private drivers with hypertro
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17.53 SyncopeSee the guidelines in
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Stable coronary syndromes - waiting
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Chapter 18: Hearing LossBACKGROUND1
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GUIDELINES18.6 Private drivers with
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equirement for commercial drivers i
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PLEASE COMPLETE THE FOLLOWING: YES
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this manual. Axis IV addresses exte
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Negative symptoms are characterized
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Schizophrenia (Axis I)Schizophrenia
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19.4 Effect of psychiatric disorder
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Suicidal ideationSuicidal ideation
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Chapter 20: Cerebrovascular Disease
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Cerebrovascular accidentCVAs are th
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Re-assessmentguidelinesPolicy ratio
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20.9 Private drivers who have had s
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20.10 Commercial drivers who have h
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Visual field impairment refers to a
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Right homonymous hemianopiaBinasal
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An example of the effects of diabet
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Retinitis pigmentosaRetinitis pigme
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GlaucomaApproximately 67 million pe
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indicates that wait times of 6 mont
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Although telescopic spectacles, hem
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Policy rationaleretinopathy dependi
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Policy rationaleIndividuals with be
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Re-assessmentguidelines cont’dPol
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Re-assessmentguidelines cont’dPol
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21.13 Commercial drivers with a los
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21.17 Visual field impairmentsTypes
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21.18 Examination of visual functio
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VISUAL FIELD TEST (VFT)For drivers
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To the Driver:Under section 29 of t
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Please note:Goldman, Esterman and H
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Cardiac syncopeCardiac syncope refe
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22.7 Private drivers who have had a
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22.9 Private drivers with recurrent
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22.11 Commercial drivers who have h
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22.13 Commercial drivers with recur
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Chapter 23: Seizures and EpilepsyBA
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abnormal numbnesstingling and a cra
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23.10 Private drivers with single u
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23.12 Private drivers with epilepsy
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23.18 Commercial drivers with epile
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Level of disabilityor worsening of
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Parkinson’s diseaseThere is a sma
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ConditionsRestrictionsRe-assessment
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25.2 Prevalence and incidence of tr
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Chapter 26: Intracranial TumoursBAC
Page 345 and 346: Some examples of compensatory mecha
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Page 357 and 358: An immediate reduction in daytime s
Page 359 and 360: 28.5 CompensationIndividuals with s
Page 361 and 362: OSMV determinationguidelines cont
Page 363 and 364: ConditionsRestrictionsRe-assessment
Page 365 and 366: Policy rationaleThe general approac
Page 367 and 368: Chapter 29: Prescription and Over-T
Page 369 and 370: Examples of newer antihistamines in
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Page 373 and 374: AntiepilepticsIn general, individua
Page 375 and 376: Sedating EffectLowModerateHighTCAsd
Page 377 and 378: dizziness, andblurred or double vis
Page 379 and 380: Re-assessmentguidelinesPolicy ratio
Page 381 and 382: 30.2 Effect of general debility and
Page 383 and 384: 30.5 Private and commercial drivers
Page 385 and 386: Appendix 1: Glossary of TermsCommer
Page 387 and 388: Medical assessmentis any kind of as
Page 389 and 390: Transient impairmentmeans a tempora
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Page 395: Appendix 3: Aging DriversAbout agin
Page 399 and 400: Appendix 4: Licence ClassesThe tabl
Page 401 and 402: Appendix 5: Drafting and Approval P
Page 403: drivers, this means that BC commerc
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2010 BC Guide in Determining Fitness to Drive

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