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Safety: How health issues can affect drivers' accident rates

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Driving is the most dangerous work activity that most people undertake.

Department for Transport research indicates that about 440 people are killed and almost 6,000 seriously injured every year in crashes involving someone driving for work.

A person’s fitness to drive can be affected by a medical condition, by temporary illness and by the environment in which they work, drive and live.

Health impairments such as sleep disturbance can lead to unsafe road behaviour, and if not properly managed may lead to a deterioration in health or aggravate a pre-existing condition such as back pain.


What is it and what are the dangers?
The human body loses and needs to replace two to three litres of water a day. However, as every individual’s body responds differently and weather conditions and activity levels also influence dehydration rates, experts say there is no set amount of water that drivers should consume on a daily basis to remain hydrated.

A Loughborough University study shows that even mild dehydration is equivalent to being over the drink-driving limit in terms of driver errors.

“The results suggested mild hypohydration produced a significant increase in minor driving errors during a prolonged, monotonous drive, compared to that observed while performing the same task in a hydrated condition,” says Ron Maughan, emeritus professor of sport and exercise nutrition. “The levels of driver errors we found are similar to those found in people with a blood alcohol content at the UK legal driving limit. In other words, drivers who are not properly hydrated could make the same number of errors as people over the drink-drive limit.

What can a fleet operator do? 
“Driver education programmes should encourage appropriate hydration practices,” says Maughan. “Drinking should be sufficient to meet needs and deliberate restriction because of access to toilets should be avoided.”


What are the dangers?
Drivers with impaired vision are much more likely to be involved in a road crash than those with good eyesight and are estimated to cause 2,900 casualties a year, research by RSA Insurance Group has found.

The minimum legal requirement is for a driver to be able to read (with glasses or contact lenses if necessary) a car registration plate made after September 1, 2001, from 20 metres.

But after that, drivers do not have to take another eye test for the rest of their lives.

However, road safety charity Brake says eyesight can deteriorate quickly, with the driver often unaware this is happening.

What can a fleet operator do?
Many fleets have made eyesight tests part of their driver policy, and some carry out spot checks to see if a driver can read the number plate of a parked car from the legal distance. 

Road safety charity Brake is calling for the Government to introduce compulsory tests for drivers, but until this happens it recommends that drivers undergo regular (at least two-yearly), eyesight tests. Companies may choose to have a corporate eyecare arrangement through an optician or require drivers to provide proof of an independent eye test.


What are the dangers?
Driving requires many simultaneous skills, mainly hand-eye co-ordination with accurate speed and direction calculations. This requires full concentration, while evidence suggests that sleepiness and fatigue is responsible for around 20% of road accidents.

Many of these sleep-related accidents are due to lifestyle issues, such as driving without adequate sleep, early-morning starts or  late-night socialising, and often happen at times when levels of concentration are naturally low, such as in the afternoon and at night. 

However, some are due to medical conditions, such as sleep apnoea (see panel, below), Parkinson’s disease or multiple sclerosis.

What can a fleet operator do?
Make drivers aware of the risks and advise them to stop driving if they feel tired. Recommend they have a nap until feeling sufficiently refreshed to be safe again. If the sleepiness is not explicable by lifestyle issues, the driver should be advised to seek medical advice.

The Highway Code recommends drivers take a 15-minute break at least every two hours.

Sleep apnoea 

What is it?
Obstructive sleep apnoea syndrome (OSAS) is a medical condition which causes repeated episodes of complete or partial blockage of the upper airway during sleep, causing excessive tiredness. 

Those who suffer from it are likely to have poor hazard awareness and reduced reaction times. It is the most common sleep-related medical disorder and occurs most commonly, but not exclusively, in overweight individuals. 

OSAS sufferers rarely wake from sleep feeling fully refreshed and tend to fall asleep easily when relaxing.

What can a fleet operator do?
If a driver has been diagnosed with OSAS they must make the company aware and follow medical advice.


What are the dangers?
Drink and drug-driving is one of the biggest killers on the roads. Alcohol, even in very small quantities, significantly increases the risk of accidents while illegal drugs and some medicines also impair driving, for example by slowing reaction times, affecting co-ordination or encouraging risky behaviour. 

In March this year, it became illegal to drive if you are either unfit to do so because you’re on legal or illegal drugs, or you have certain levels of illegal drugs in your blood even if they haven’t affected your driving.

The drug-driving laws saw the Government impose restrictions on 16 drugs, eight of which are available on prescription (clona-zepam, diazepam, flunitrazepam, lorazepam, methadone, morphine or similar derivative drugs, oxazepam and temazepam).

What can a fleet operator do?
Many organisations already screen for alcohol and drug use among employees, and road safety charity Brake says it is crucial drivers are educated on the risks of alcohol and drug use.

It also suggests fleets should introduce a drug and alcohol policy which states: “The use of any motor vehicle on company business while under the influence of alcohol or drugs is strictly prohibited. It is the responsibility of the driver to ensure they do not drive with any alcohol in their body, and that any medicine taken, including prescription drugs, will not impair his/her ability to operate the vehicle safely. If there is a question concerning any prescription drug and the operation of a vehicle while taking that drug, contact for guidance.”

Back pain 

What are the dangers?
Drivers who fail to adjust their vehicle seat and steering wheel to suit their individual needs are putting their health at risk, warn physiotherapists.

The Chartered Society of Physiotherapy (CPS) says poor driving posture can lead to musculoskeletal problems such as back and neck pain.

Left untreated, minor discomfort can lead to a more serious problem that causes an absence from work.

“Both people and cars come in different shapes and sizes, and no one size fits all,” says chartered physiotherapist Joshua Catlett, of the Association of Chartered Physiotherapists in Occupational Health and Ergonomics.

“Most people understand the importance of ensuring that their office workstation is individually suited to them but the car is often overlooked.

“It is so important to be aware of your posture when driving. Persistent poor sitting posture can contribute to
musculoskeletal pain and discomfort.”

What can a fleet operator do?
Staff should be given advice or training on how to ensure their driving position is correct and head restraints properly used.

CPS has produced a Drive Free of Pain guide which includes advice for drivers on ensuring they have the correct car set-up and ways to improve posture, plus some simple stretches for when drivers take a break from the wheel.

Recommendations include the driver raising their seat as high as possible for a maximum view of the road, moving the seat forward so the pedal can be depressed fully and being close enough to the steering wheel so that their elbows are bent at a 30 to 40-degree angle.

■ The report can be downloaded from csp.org.uk/publicationsdrive-clear-pain

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