Five medical standards changes you need to know about…
RSSB’s Barbara Smith takes you through what you need to know about changes to our medical standards in a heartbeat.
RSSB’s medical standards are currently being revised under the guidance of the cross-industry Traffic Operations and Management Standards Committee (TOM SC). The new standards will be published in March 2025.
Here are five main changes you need to know.
1. Eye level. The Train Driving Licences and Certificates Regulations 2010 (TDLCR) lets doctors issue a derogation as follows: ‘maximum corrective lenses: hypermetropia + 5/myopia -8 (exemptions may be authorised in exceptional cases and after having obtained the opinion of an eye specialist; the recognised doctor then takes the decision)’.
To help doctors, we will provide guidance on a number of things, including how and when a doctor may seek an opinion from a specialist eye doctor, and how to assess train drivers to decide if an exemption is suitable.
2. Colour level. The TDLCR requires train drivers to have normal colour vision tested using a recognised test. Schedule 1 suggests the use of the Ishihara test (the one with the coloured dots). However, it is not mandated. The regulations also mention the use of ‘another recognised test if required’. This can be interpreted in various ways, but in other industries it’s common practice to do a secondary test if someone doesn’t pass the initial screening test. This approach can be adopted in the rail industry.
3. Vision on. New research is being worked on to define the minimum thresholds of colour vision for safety-critical railway staff. The exact timescales of the research aren’t confirmed, but we expect the results to be published during the summer of 2024.
4. Incapacity Research is also being scoped to look into providing an assessment of the likely effects on the performance of conditions of the sudden loss of consciousness, a reduction in attention or concentration, sudden incapacity, a loss of balance or coordination, or a significant limitation of mobility for an agreed range of safety-critical workers. This will be used to analyse the risk of these incapacitation events to the operating railway. The research will help the industry make a robust risk-informed decision about managing safety-critical workers.
5. Heartbeat. TDLCR could benefit from the research through subsequent railway-specific guidance about drivers with these implantable cardioverter defibrillators (ICDs). Whilst non-railway standards for people with ICDs currently exist for some industries, they may not be appropriate for us. At the moment, recognised doctors undertaking medical examinations of licenced train drivers with ICDs should seek specialist cardiac advice, as appropriate.