-
The
following notes give advice to occupational health professionals
about the medical fitness of operators of rider-operated Lift
trucks. The standard should be regarded as a guide which can be
adapted to individual circumstances.
-
Reference
will be made to existing medical standards for drivers, and guidance
will be provided on how to apply these standards and adapt them to
prevailing circumstances by assessing the risks inherent in the work
to be carried out
.
Medical
Standards
-
Detailed
advice on medical standards of fitness to drive can be found in At a glance28 published by the Drivers’ Medical Unit of
the DVLA, Swansea. This is regularly updated and is available on the
Internet at
http://www.direct.gov.uk/Topics/MotoringAndTransport or from the Medical Adviser, Drivers’ Medical
Unit, DVLA, Longview Road, Morriston, Swansea SA99 1TU (tel:01792
783686). However, the DVLA does not have responsibility for
licensing Lift truck operators (provided they do not drive Lift
trucks on public roads). At a
glance28 should always be consulted where there is
any doubt about an individual’s fitness to operate a lift truck.
-
At
a glance28 lists separate medical standards for both
Group I entitlement (holders of ordinary driving licence) and Group
2 entitlement (HGV and PSV Licence hoLders).
Application
of medical standards
-
Each
person’s fitness for operating a Lift truck should always be
judged individually. The underlying approach should be to match the
requirements of the particular driving task with the fitness and
abilities of the driver. For most work a standard equivalent to that
of the Group I entitlement 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 if large,
heavy trucks are to be operated. In these instances some or all of
the medical standards equivalent to that of Group 2 entitlement may
be appropriate
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Applying the
principle of individual assessment of fitness should 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 a lift truck safely.
Competence in an emergency must, however, always be considered
Frequency
of assessment
-
All existing and potential lift
truck 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 Lift
truck operator and holds a Group 2 entitlement, these assessments
can be made at the same examination. A Lift truck operator who
continues after age 65 should have annual assessments for fitness.
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Assessment
is also recommended after an absence of more than one month or after
a shorter absence if it is Likely that the illness may have affected
fitness to operate Lift trucks. This assessment is recommended to
provide positive confirmation of fitness to operate lift trucks in
these circumstances. Fitness to return to work when signed off by a
GP may not indicate fitness to operate a Lift truck.
-
Assessment
is also appropriate if lift truck operators, or their employers,
suspect that they have developed a condition which may affect their
continuing liability to operate Lift trucks
-
Its
advisable for employers to agree requirements for medical screening
and/or examination of employees, in advance, in a contract of
employment.
Medication
-
Fitness
to operate lift trucks may be impaired temporarily by the effects of
medication, whether prescribed or purchased over the counter. Lift
truck operators should seek advice from their general practitioner
or the pharmacist about the potential effects any medication may
have on their ability to drive safely, and should notify their employer
if there is risk of adverse effects which may compromise safety. In
some cases ft may be necessary for them to stop operating lift
trucks until the nature and extent of any side effects has been
established.
Alcohol
and illicit drugs
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Lift
truck operation should not be carried out in circumstances when
either alcohol or drugs have been taken. Advice for employers on alcohol
and drugs is provided in Don’t
mix it: A guide for employers on alcohol at work29 and
Drug misuse at work: A guide for employers.30
Locomotor
•
There are no specific restrictions on Group I entitlement.
Standards will depend on the demands of the job but for lift truck
operation 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 lift truck instructor.
•
An experienced lift truck operator who loses a Limb or part of
a limb may be able to continue in employment after suitable
retraining.
Diabetes
mellitus
•
When managed by diet alone or treated by tablets this condition
is normally acceptable if well controlled, and 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 recognition
of
warning symptoms of
hypoglycemia. Required visual standards must be met
•
Continuing fitness will need to be kept under review.
Cardiovascular
conditions
Ischaemic
heart disease
•
History of a single uncomplicated myocardial infarction is not
a bar to lift truck operation, but lift truck operation should cease
for at Least one month. This should be followed by medical assessment,
lift truck operation may recommence thereafter, provided there is no
other disqualifying condition.
•
For angina, Lift truck operation should cease until
satisfactory control of symptoms is achieved, It will not be a bar
unless occurring during lift truck operation or at rest, or unless
medication produces side effects which may interfere with lift truck
operation. Lift truck operation may recommence when satisfactory
symptom control is achieved.
•
A second or complicated myocardial infarction will require
careful assessment in the light of residual function, risk factors etc.
Hypertension
•
Lift truck operation may continue unless treatment causes
unacceptable side effects.
Arrhythmia
•
Lift truck operation must stop with an arrhythmia which may
distract the operator’s attention or
render him or her liable to sudden impairment of
cerebral function. Lift truck operation may resume when
satisfactory control of symptoms is achieved
provided that cardiac function is also satisfactory.
Other conditions
•
In general, lift truck 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 lift truck
operation. Specialist advice should be sought in all
cases of doubt.
Vision
•
Operators must be able to read in good Light (with the aid of
glasses or contact tenses 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 individuals vary in their ability to compensate for
their impairment and to operate a Lift truck safely. Fitness to operate a lift truck cannot be assumed and,
after medical assessment, this should be
determined following practical lift truck operating tests. This
approach should also be adopted for the
experienced operator who becomes monocular, after allowing a
period of adaptation.
•
Visual field defects. Lift truck operation should cease unless
an operator is confirmed able to meet the recommended national
guideline for visual field. A full definition is provided in At a glance.28
•
Uncontrolled diplopia will disqualify an individual from
operating a lift truck. Resumption may be
permitted when satisfactory control of
symptoms is achieved. Regular review is recommended
Nervous system
•
Vertigo, giddiness and disorders of balance. Lift truck
operation should cease on diagnosis. Resumption may be permitted when satisfactory control
of symptoms is achieved. Regular review is recommended
•
For neurosurgical disorders, including intracranial tumors and hemorrhage,
detailed advice is given in
At a glance.28
•
After acute illness, such as a stroke, lift truck operation
should cease for at Least one month. The extent of recovery should then be assessed.
Where recovery is complete then Lift truck operation may
recommence. Progressive or relapsing conditions will require careful
assessment of function and prognosis
•
Long-standing static deficits, such as weakness of a Limb
following poliomyelitis, should be assessed for functional ability. Lift truck operation may be practical,
possibly with the help of suitable adaptation to the lift truck.
Epilepsy
•
This will not normally be a bar to Lift truck operation where
an individual qualifies for an ordinary driving license (ie 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 Lift truck
operator.
•
Annex 3 of At a glance28 gives full details of the epilepsy
regulations as prescribed by the Motor Vehicles (Driving Licenses)
Regulations 1996. This should be used as guidance to assess
suitability for Lift truck 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 then this should be assessed audio metrically.
Alcohol
and drugs
•
An individual who is dependent on alcohol or drugs should not
operate a lift truck. 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 lift truck operator is considered. Medical assessment
of fitness to operate a lift truck should then be carried out.
Reference to At a glance28 is
recommended in individual cases.
Psychiatric
disorders
•
Suspicion or knowledge of psychiatric disorders should Lead to
suspension from Lift truck operation pending medical assessment.
Guidance is complex and At a
glance28 provides detailed advice under the following
headings:
(a)
Anxiety or depression;
(b)
More severe anxiety or depressive illness;
(c) Acute psychotic episodes of any type or cause;
(d) Chronic schizophrenia;
(e) Dementia or any organic brain
syndrome;
(f) Learning disability;
(g) Persistent behavior disorder.
[240kb] and in HSE's priced book 'Controlling Noise at Work'
(L108) (ISBN 0-7176-6164-4) available from
Hundreds
of thousands of workers suffer from musculoskeletal pain at one time
or another, and the musculoskeletal problems of drivers can be some
of the most serious. There is evidence that drivers of some types of
industrial vehicles suffer musculoskeletal pains earlier than other
workers and that some of them will leave their work at a
comparatively young age because of it.
Exposure to loud noise can cause permanent hearing damage