2010 BC Guide in Determining Fitness to Drive

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PART 3:MEDICAL CONDITIONCHAPTERS78
Chapter 9:Introduction to the Medical Condition Chapters9.1 Purpose of the medical condition chaptersThe medical condition chapters in this part of the Manual: identify what conditions may have an impact on an individual’s fitnessto drive highlight the risk of impairment and crash associated with certainmedical conditions identify appropriate screening and assessment tools to evaluate fitnessto drive of an individual with a medical condition identify compensation strategies, devices and/or training that may beimplemented to compensate for the effects of a medical condition ondriving, and include guidelines to assist OSMV staff in determining whether anindividual with a medical condition is fit to drive and appropriate reassessmentintervals.9.2 Source of the medical condition chaptersThe medical condition chapters in this Manual are based primarily on theintegrative review of Dr. Bonnie Dobbs and her report Medical Conditionsand Driving: Current Knowledge 2010 (pending). In preparing thatdocument, Dr. Dobbs used a multi-step process to critically evaluate andcompile evidence from a number of sources, including research studies,consensus conference guidelines and expert opinion.The best available evidence for a medical condition depends on how muchresearch has been conducted on that condition and driving and the qualityof the research. Unfortunately, the impact of some medical conditions onthe functions necessary for driving has not been studied or has not beenstudied in depth. A lack of evidence does not mean that the condition hasno impact. Rather, it simply means that the relevant research has not beenconducted. In each medical condition chapter, the evidence associatingthe medical condition with an increased crash risk or an impairment of thefunctions necessary for driving is clearly stated.In general, due to the variability in methodology and variability inoutcome measures and statistical analyses, the evidence supporting arelationship between a medical condition and driving performance is based79
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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
Page 41 and 42: Chapter 4: Introduction to the Poli
Page 43 and 44: 3. DETERMINATIONFrom2. AssessmentAn
Page 45 and 46: Once identified, a DMER is mailed t
Page 47 and 48: 5.3 Screening aging driversDefiniti
Page 49 and 50: 5.5 Transient impairmentsDefinition
Page 51 and 52: Chapter 6: Assessment Policies and
Page 53 and 54: 6.2 Assessments will only be reques
Page 55 and 56: 6.4 Requesting specialist assessmen
Page 57 and 58: Policy6.5.1 If a case manager or ad
Page 59 and 60: Persistent and episodic impairments
Page 61 and 62: further assessment. Drivers who sco
Page 63 and 64: 6.9.4 A case manager or adjudicator
Page 65 and 66: ASSESSMENT PROCEDURESCase manager o
Page 67 and 68: A driver fitness determination is a
Page 69 and 70: Policy rationaleBecause individuals
Page 71 and 72: 7.5.3 Generally, an individual whos
Page 73 and 74: 7.6.2 In particular, the case manag
Page 75 and 76: 7.8.3 Whether an individual can com
Page 77 and 78: in order to be fit to drive, the ca
Page 79 and 80: has the judgment and willingness to
Page 81 and 82: Policy7.11.1 If a case manager or a
Page 83 and 84: (e) the medical condition results i
Page 85 and 86: 7.12 Communicating a decisionPolicy
Page 87 and 88: 7.13 Determination proceduresThe fo
Page 89 and 90: During the reconsideration, the adj
Page 91: 8.3 Reconsideration proceduresThe f
Page 95 and 96: 9.4 Medical condition chapter templ
Page 97 and 98: Private and commercial drivers who
Page 99 and 100: Chapter 11: Diabetes - Hypoglycemia
Page 101 and 102: PercentFigure 1 - Prevalence of Dia
Page 103 and 104: neuropathy, nephropathy, cardiovasc
Page 105 and 106: 11.7 Private and commercial drivers
Page 107 and 108: 11.8 Private drivers with diabetes
Page 109 and 110: 11.9 Commercial drivers with diabet
Page 111 and 112: RestrictionsRe-assessmentguidelines
Page 113 and 114: Policy rationaleSevere hypoglycemia
Page 115 and 116: 11.12 Private drivers who have pers
Page 117 and 118: 11.13 Commercial drivers who have a
Page 119 and 120: 11.14 Commercial drivers who have a
Page 121 and 122: 11.15 Commercial drivers who have p
Page 123 and 124: PART B - HYPOGLYCEMIA11a. Has the p
Page 125 and 126: Produce my glycemic log for my doct
Page 127 and 128: Deep-vein thrombosisDeep-vein throm
Page 129 and 130: Aneurysms less than 5 cm in diamete
Page 131 and 132: GUIDELINES12.6 Private and commerci
Page 133 and 134: 12.7 Private drivers who have an an
Page 135 and 136: 12.9 Commercial drivers who have an
Page 137 and 138: Chapter 13: Musculoskeletal Conditi
Page 139 and 140: ConditionType of drivingimpairment
Page 141 and 142: GUIDELINES13.6 Private and commerci
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ConditionsRestrictionsRe-assessment
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14.3 Chronic renal disease and adve
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GUIDELINES14.6 Private and commerci
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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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ConditionType of drivingimpairment
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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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25.2 Prevalence and incidence of tr
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Chapter 26: Intracranial TumoursBAC
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Some examples of compensatory mecha
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i. aphasia (language disturbance)ii
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27.2 Prevalence and incidence of co
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27.4 Effect of cognitive impairment
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Chapter 28: Sleep DisordersBACKGROU
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An immediate reduction in daytime s
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28.5 CompensationIndividuals with s
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OSMV determinationguidelines cont
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Policy rationaleThe general approac
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Chapter 29: Prescription and Over-T
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Examples of newer antihistamines in
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Stimulants (for ADHD)Examples of st
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AntiepilepticsIn general, individua
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Sedating EffectLowModerateHighTCAsd
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dizziness, andblurred or double vis
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30.2 Effect of general debility and
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Appendix 1: Glossary of TermsCommer
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Medical assessmentis any kind of as
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Transient impairmentmeans a tempora
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must cause to be issued to the appl
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(ii) cancel the person's driver's l
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Appendix 3: Aging DriversAbout agin
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Percentadults. The survey also foun
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Appendix 4: Licence ClassesThe tabl
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Appendix 5: Drafting and Approval P
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drivers, this means that BC commerc
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2010 BC Guide in Determining Fitness to Drive

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