National governments need to review their ‘fitness to drive’ regulations. This is according to a new report from the European Transport Safety Council (ETSC).

The current assessments for drivers medical fitness to hold a licence are not effective.

The report– ‘Are medical fitness to drive procedures fit for purpose?’ – examines the current state of play in European countries.  The various national assessments of medical fitness to drive are based around the current EU rules. The review looks at the directive on driver licensing.

Inherent issues

EU countries rely significantly on age-based assessment. This is despite studies concluding that specific medical conditions, substance abuse, mental disorders, epilepsy and diabetes are actually more important factors. While age is relevant when it comes to medical fitness to drive, it should not be relied upon as the principle determinator.

“Medical fitness to drive is a matter of judgement as well as science and the levels of training or guidance provided to those assessing medical fitness to drive in PIN countries vary. Eleven PIN countries help those assessing medical fitness to drive with a set of guidelines and seventeen PIN countries have a regulation which stipulates how fitness to drive should be assessed. A clear set of guidelines issued to those assessing medical fitness to drive is known to have a positive effect.

Driving while under the influence of alcohol poses a serious risk to road safety: 25% of all road deaths in the EU have been estimated to be alcohol related. Diagnostic, therapeutic and rehabilitation aspects of alcohol-use disorders have been neglected in the Directive and in many guidelines. The upcoming revision of the Driving Licence Directive represents an opportunity for review.”

Holistic aptitude

The reports conclusion is that mandatory age-based screening of older drivers shows it is ineffective in preventing severe collisions.  In fact, older drivers with poor health ho have their licences revoked, often become vulnerable road users.

The ETSC is recommending that national governments should make wider use of conditional licences. This could allow those who may be at slight risk to continue to drive under certain circumstances.

Improving information gathering

A lack of good data on the role played by medical conditions and disorders in road collisions is a significant problem. Therefore, pan-European in-depth collision investigation data could help. Currently, only a small number of countries systematically collect such data.

One important exception is Finland. Here, every fatal collision undergoes in-depth investigation. Between 2014 and 2018, Finnish investigators attributed the cause of a fatal collision to driver illness in 16% of cases.

The most common disease risk factor contributing to crashes is cardiovascular disease – 119 out of 141 fatal collision between 2014-18.

A formal proposal for the revision of the EU legislation will come in 2022.