Changes from adopted text to adopted text

Removed(4) Member States may restrict the issue or renewal of driving licences for applicants or drivers with other cardiovascular diseases.

RemovedDIABETES MELLITUS

Removed10. For the purpose of the following points, the following definitions apply:

Removed‘severe hypoglycaemia’ means where the assistance of another person is needed;

Removed‘recurrent hypoglycaemia’ means a second severe hypoglycaemia during a period of 12 months.

RemovedGroup 1:

Removed(1) Driving licences may be issued to, or renewed for, applicants or drivers who have diabetes mellitus. When treated with medication, they shall be subject to authorised medical opinion and regular medical review, appropriate to each case, but the interval shall not exceed ten years.

Removed(2) An applicant or driver with diabetes treated with medication which carries a risk of inducing hypoglycaemia shall demonstrate an understanding of the risk of hypoglycaemia and adequate control of the condition, including through a continuous monitoring system where deemed necessary by a competent medical authority. [Am. 217]

RemovedDriving licences shall not be issued to, or renewed for, applicants or drivers who have inadequate awareness of hypoglycaemia.

RemovedDriving licences shall not be issued to, or renewed for, applicants or drivers who have recurrent severe hypoglycaemia, unless supported by competent medical opinion and regular medical assessment. For recurrent severe hypoglycaemias during waking hours a licence shall not be issued or renewed until 3 months after the most recent episode.

RemovedDriving licences may be issued or renewed in exceptional cases, provided that it is duly justified by competent medical opinion and subject to regular medical assessment, ensuring that the person is still capable of driving the vehicle safely taking into account the effects of the medical condition.

RemovedGroup 2:

Removed(3) Consideration may be given to the issuing/renewal of group 2 licences to drivers with diabetes mellitus. When treated with medication which carries a risk of inducing hypoglycaemia (that is, with insulin, and some tablets), the following criteria shall apply:

Removed(a) no severe hypoglycaemic events have occurred in the previous 12 months;

Removed(b) the driver has full hypoglycaemic awareness;

Removed(c) the driver must show adequate control of the condition by blood glucose sensors, insulin pump, insulin pen and/or hybrid close loop, at least twice daily and at times relevant to driving;

Removed(d) the driver must demonstrate an understanding of the risks of hypoglycaemia;

Removed(e) there are no other debarring complications of diabetes.

RemovedMoreover, in those cases, such licences shall be issued or renewed subject to the positive opinion of a competent medical authority and to regular medical review undertaken by a medical specialist, undertaken at intervals of not more than three years. [Am. 218]

Removed(4) A severe hypoglycaemic event during waking hours, even unrelated to driving, shall be reported and shall give rise to a reassessment of the licensing status.

RemovedNEUROLOGICAL DISEASES AND OBSTRUCTIVE SLEEP APNOEA SYNDROME

Removed11. The following rules apply to applicants with neurological diseases and obstructive sleep apnoea syndrome.

RemovedNEUROLOGICAL DISEASES

Removed(1) Driving licences shall not be issued to, or renewed for, applicants or drivers with a serious neurological disease, unless the application is supported by a positive authorised medical opinion undertaken by a medical specialist or competent medical authority. [Am. 219]

RemovedNeurological disturbances associated with developmental conditions, diseases, medical or surgical intervention affecting the central or peripheral nervous system, which lead to cognitive, behavioural, sensory or motor impairments and affect performance/function, balance and coordination, shall accordingly be taken into account in relation to their functional effects and. The risks of progression of impairment and compliance with treatment needs to be taken into account. In such cases, the issue or renewal of the licence may be subject to periodic assessment in the event of risk of deterioration. [Am. 220]

RemovedOBSTRUCTIVE SLEEP APNOEA SYNDROME

Removed(2) For the purpose of the following points:

Removed‘moderate obstructive sleep apnoea syndrome’ means a number of apnoeas and hypopnoeas per hour (Apnoea-Hypopnoea Index) between 15 and 29;

Removed‘severe obstructive sleep apnoea syndrome’ means an Apnoea-Hypopnoea Index of 30 or more, both associated with excessive daytime sleepiness.

Removed(3) Applicants or drivers in whom a moderate or severe obstructive sleep apnoea syndrome is suspected shall be referred for further authorised medical advice before a driving licence is issued or renewed. They may be advised not to drive until confirmation of the diagnosis.

Removed(4) Driving licences may be issued to applicants or drivers with moderate or severe obstructive sleep apnoea syndrome who show adequate control of their condition and compliance with appropriate treatment and improvement of sleepiness, if any, confirmed by authorised medical opinion.

Removed(5) Applicants or drivers with moderate or severe obstructive sleep apnoea syndrome under treatment shall be subject to a periodic medical review, at intervals not exceeding three years for drivers of group 1 and one year for drivers of group 2, with a view to establish the level of compliance with the treatment, the need for continuing the treatment and continued good vigilance.

RemovedEPILEPSY

Removed12. Epileptic seizures or other sudden disturbances of the state of consciousness constitute a serious danger to road safety if they occur in a person driving a power-driven vehicle.

RemovedFor the purpose of the following points:

Removed‘epilepsy’ means a medical condition where the person concerned has had two or more epileptic seizures, less than five years apart;

Removed‘provoked epileptic seizure’ means a seizure which has a recognisable causative factor that is avoidable.

RemovedA person who has an initial or isolated seizure or loss of consciousness shall be advised not to drive. A specialist report is required, stating the period of driving prohibition and the requested follow-up.

RemovedIt is extremely important that the person’s specific epilepsy syndrome and seizure type are identified so that a proper evaluation of the person’s driving safety can be undertaken (including the risk of further seizures) and the appropriate therapy instituted. This shall be done by a neurologist.

RemovedGroup 1:

Removed(1) Drivers assessed under group 1 with epilepsy shall be under licence review until they have been seizure-free for at least five years.

RemovedIf the person has epilepsy, the criteria for an unconditional licence shall not be deemed to be met. Notification shall be given to the licensing authority.

Removed(2) Provoked epileptic seizure: the applicant having had such a condition because of a recognisable provoking factor that is unlikely to recur at the wheel may be declared able to drive on an individual basis, subject to neurological opinion (the assessment shall be, if appropriate, in accordance with other relevant sections of Annex III (for instance in the case of alcohol or other co-morbidity)).

Removed(3) First or single unprovoked seizure: the applicant who has had a first unprovoked epileptic seizure may be declared able to drive after a period of six months without seizures, if there has been an appropriate medical assessment. National authorities may allow drivers with recognised good prognostic indicators to drive sooner.

Removed(4) Other loss of consciousness: the loss of consciousness shall be assessed according to the risk of recurrence while driving.

Removed(5) Epilepsy: drivers or applicants may be declared fit to drive after a one-year period free of further seizures.

Removed(6) Seizures exclusively in sleep: the applicant or driver who has never had any seizures other than seizures during sleep may be declared fit to drive so long as this pattern has been established for a period which must not be less than the seizure-free period required for epilepsy. If there is an occurrence of attacks/seizure arising while awake, a one-year period free of further event before licensing is required (see ‘Epilepsy’, in point 12.(5)).

Removed(7) Seizures without influence on consciousness or the ability to act: the applicant or driver who has never had any seizures other than seizures which have been demonstrated exclusively to affect neither consciousness nor cause any functional impairment may be declared fit to drive so long as this pattern has been established for a period which shall not be less than the seizure-free period required for epilepsy. If there is an occurrence of any other kind of attacks/seizures a one-year period free of further event before licensing is required (see ‘Epilepsy’ in point 12(5)).

Removed(8) Seizures because of a physician-directed change or reduction of anti-epileptic therapy: the patient may be advised not to drive from the commencement of the period of withdrawal and thereafter for a period of six months after cessation of treatment. Seizures occurring during physician-advised change or withdrawal of medication require three months off driving if the previously effective treatment is reinstated.

Removed(9) After curative epilepsy surgery: see ‘Epilepsy’ in point 12.(5).

RemovedGroup 2:

Removed(10) The applicant shall be without anti-epileptic medication for the required period of seizure freedom. An appropriate medical follow-up shall have been carried out. Extensive neurological investigation shall have shown that there is neither a relevant cerebral pathology nor any epileptiform activity on the electroencephalogram (EEG). An EEG and an appropriate neurological assessment shall be performed after the acute episode.

Removed(11) Provoked epileptic seizure: the applicant who has had a provoked epileptic seizure because of a recognisable provoking factor that is unlikely to recur at the wheel may be declared able to drive on an individual basis alone and for vehicles for private use but not for the transport of others, subject to neurological opinion. An EEG and an appropriate neurological assessment shall be performed after the acute episode. [Am. 222]

RemovedA person with a structural intra-cerebral lesion who has increased risk of seizures shall not be able to drive vehicles of group 2 until the epilepsy risk has fallen to at least 2 % per annum. The assessment shall be, if appropriate, in accordance with other relevant sections of Annex III (for instance in the case of alcohol).

Removed(12) First or single unprovoked seizure: the applicant who has had a first unprovoked epileptic seizure may be declared able to drive once five years’ freedom from further seizures has been achieved without the aid of anti-epileptic drugs, if there has been an appropriate neurological assessment. National authorities may allow drivers with recognised good prognostic indicators to drive sooner. [Am. 223]

Removed(13) Other loss of consciousness: the loss of consciousness shall be assessed according to the risk of recurrence while driving. The risk of recurrence shall be 2 % per annum or less.

Removed(14) Epilepsy: 10 years freedom from further seizures shall have been achieved without the aid of anti-epileptic drugs. National authorities may allow drivers with recognised good prognostic indicators to drive sooner. This shall also apply in case of ‘juvenile epilepsy’.

RemovedCertain disorders (for instance arteriovenous malformation or intra-cerebral haemorrhage) entail an increased risk of seizures, even if seizures have not yet occurred. In such a situation an assessment shall be carried out by a competent medical authority; the risk of having a seizure shall be 2 % per annum or less to allow licensing.

RemovedMENTAL IMPAIRMENTS

Removed13. The following rules apply to applicants or drivers with mental or intellectual impairment.