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Tue 20 Jan 2009 04:00 AM

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Sick on the job

Dr. Mark Newson-Smith examines the fitness needed to drive and operate machinery safely.

Dr. Mark Newson-Smith examines the fitness needed to drive and operate machinery safely.

The value to business of sound safety practice is well recognised, particularly in businesses where risks to man, machine and product are significant and seen on a daily basis.

The Build Safe UAE initiative is a good example of this. Less well recognised is the impact of workers health on business, particularly in terms of overall performance, productivity, attendance and safety.

The employee is frequently the least well looked after piece of "equipment" within a business, yet is an essential asset and within many skilled areas one that is becoming harder to find. Compared with other causes ill health ranks relatively low on the list of causal factors for accidents involving vehicles and machinery yet its contribution to accidents is probably substantially underestimated and certainly ill health adversely impacts on performance.

For example, slower reactions, reduced decision making capacity and inattention can all be brought on by poor health - and also on other things as productivity within the workplace.

Whilst there are few, if any, detailed fitness to drive standards within the Gulf Region there are well documented international standards that are applicable everywhere.

These look at fitness in relation to the type of vehicle being driven but tend to be limited to cars, vans, lorries and buses. It is, however, many occupational physicians (doctors trained in looking at fitness to work) assessing fitness to work on other types of vehicles will adapt these standards (based on the nature of the vehicle and the work carried out by it) to suit the task.

It's also important to remember that driving the vehicle may be only one of the tasks carried out by that employee and although he may he fit to drive, he might not be able to lift the 20kg hose coupling for unloading his tanker.

The recommended frequency for examinations vary between countries. In the US Commercial Motor Vehicle Licenses require a medical examination at least every 2 years whereas in the UK the medicals for large lorry and bus drivers are generally a minimum of every 5 years from age 45 to 65 and then annually (the original medical usually lasts to the age of 45).What the guidelines are looking to determine are the presence of functional impairments that can effect the individual's ability to drive safely (for example vision, cognition and physical movement) and conditions that can cause sudden collapse such as epilepsy, a heart attack or low blood sugar levels. Some things may seem a little strange at first glance.

Why does a driver of a 50 foot truck need good hearing as the there is a very large mass of metal between him and the 4WD behind blowing his horn? The reason is in fact so that the driver is aware of any changes in engine, machinery or road noise that may indicate that a problem is developing.

It's important that the assessing physician understands what the employees job actually involves. Following the Waterfall rail crash in Australia where the train driver (who suffered a heart attack while driving) and 6 passengers were killed, the inquiry concluded that "medical examinations must be conducted by medical practitioners with an understanding of the duties and responsibilities of the safety critical employees being examined".

Shiftwork is another significant factor in fitness to work and the risk of accidents particularly in relation to fatigue. An important factor to remember is that it is not just the hours at work that are important but also the amount of sleep an individual is getting. It might sound obvious but four hours a day driving to and from work can have a big impact.

Risk based health surveillance and shift management of drivers and machine operators can be effective tools in increasing work efficiency and reducing accidents and incidents within the workplace. Think about it.

Operating vehicles and machinery in general require a higher level of physical and mental fitness than many workers to operate safely, in particular due to the consequences of error.

Information on the impact of ill health on vehicle accidents within the region is poor however globally there are many examples of the tragic and serious consequences of ill health causing accidents. Examples from the US include:

1. A Missouri truck driver's employer paid $18 million in a tort settlement after its diabetic driver crashed his tractor-trailer into traffic on an interstate, killing four women. The driver had a diabetic episode that put him into an altered state of consciousness.

2. A gasoline tanker driver had a heart attack while driving, causing the tanker to plunge over an overpass in Maryland, killing four people.

3. A 55-passenger bus crashed, killing 22 people when the driver suffered a heart attack.

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