2010 BC Guide in Determining Fitness to Drive

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C. Disturbances of cardiac rhythm and arrhythmia devicesVentricular arrhythmiasVF with a reversible causeNotes:VF: ventricular fibrillationExamples of reversible causes of VF:VF within 24 hours of myocardial infarctionVF during coronary angiographyVF with electrocutionVF secondary to drug toxicityPrivateCommercialNo driving until/unless successful treatment ofunderlying condition218
Chapter 18: Hearing LossBACKGROUND18.1 About hearing lossHearing loss is categorized as either conductive or sensorineural. Conductive hearing lossinvolves abnormalities in the external or middle ear, including the ear canal, eardrum or ossicles.A blockage or other structural problem interferes with how sound gets conducted through theear, making sound levels seem lower. In many cases, conductive hearing loss can be correctedwith medication or surgery.Sensorineural hearing loss typically results from permanent damage to the inner ear (cochlea) orthe auditory nerve. Typically, it is gradual, bilateral, and characterized by the loss of highfrequencyhearing. Sensorineural hearing loss is permanent and often is helped with hearingaids. Profound deafness can be treated with cochlear implants.Sensorineural hearing loss accounts for 90% of all hearing loss.18.2 Prevalence and incidence of hearing lossThe 2003 Canadian Community Health Survey (CCHS) indicated that 3% of Canadians 12 yearsof age and older have some type of hearing difficulty. The prevalence of hearing loss increaseswith age. In the CCHS, 5% of 65 to 69 year-olds reported hearing problems, with the percentageincreasing to 23% of those 80 and older. Hearing loss is more common in men than in womenacross every age group.18.3 Hearing loss and adverse driving outcomesThe effects of hearing loss on the ability to safely operate a motor vehicle are not wellestablished. Although the overall body of literature examining the relationship between hearingloss and driving is small, since the 1990’s there has been an increasing amount of research in thisarea. The results are equivocal. Some studies report an association between impairments inhearing and adverse driving outcomes while others have not found an association.Although variability in methodology makes it difficult to draw conclusions across studies, resultsfrom studies indicate that, for the majority (70%) of study measures, no significant relationshipwas found between hearing loss and adverse driving outcomes (e.g. crashes, violations,convictions).219
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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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Page 203 and 204: 17.29 Private drivers with permanen
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Page 207 and 208: 17.33 Private drivers where ICD the
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Page 211 and 212: 17.37 Commercial drivers with inher
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Page 215 and 216: 17.41 Private drivers with surgical
Page 217 and 218: 17.43 Private drivers with mitral v
Page 219 and 220: 17.45 Private drivers with congesti
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Page 223 and 224: 17.47 Private drivers with left ven
Page 225 and 226: 17.49 Private drivers with a heart
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Page 235 and 236: GUIDELINES18.6 Private drivers with
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Page 239 and 240: PLEASE COMPLETE THE FOLLOWING: YES
Page 241 and 242: this manual. Axis IV addresses exte
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Page 245 and 246: Schizophrenia (Axis I)Schizophrenia
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Page 249 and 250: Suicidal ideationSuicidal ideation
Page 251 and 252: GUIDELINES19.6 Private and commerci
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Page 255 and 256: Cerebrovascular accidentCVAs are th
Page 257 and 258: ConditionType of drivingimpairment
Page 259 and 260: GUIDELINES20.6 Private and commerci
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Page 267 and 268: Visual field impairment refers to a
Page 269 and 270: Right homonymous hemianopiaBinasal
Page 271 and 272: An example of the effects of diabet
Page 273 and 274: Retinitis pigmentosaRetinitis pigme
Page 275 and 276: GlaucomaApproximately 67 million pe
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Page 281 and 282: 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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