Diabetes, Cataracts, Obstructed Sleep Apnoea and Fatigue.

Medical conditions have been reviewed in the last year in the light of an entitlement to drive privately and vocationally. Each condition brings with it the necessity to understand how each one impacts upon the reactiveness of a driver.

Diabetes UK (via the DVLA), have for some time (since 2011) been trying to change a European Union directive that when introduced, caused many drivers to lose their driving licence. The Association of Optometrists (AOP) have been advising the DVLA in consideration for new guidelines concerning drivers with only mild bilateral cataracts. The OSA (Obstructed Sleep Apnoea) Partnership Group, working with healthcare professionals and with the DVLA, have been instrumental in the introduction of new guidelines for drivers suffering from OSA. Regarding self-inflicted fatigue, the Freight Transport Association, have welcomed new DVSA powers that now enable the enforcement authorities to take serious action upon vocational drivers that repeatedly ignore the drivers’ hours rules within the Working Time Directive.

Driving with Diabetes

Diabetes can result in an episode of hypoglycaemia (hypo), where an abnormally low level of sugar, or glucose, in the blood is experienced. Symptoms that will affect drivers include; lack of concentration, blurred vision and fatigue. The European Directive prior to the 1st of January 2018 meant that diabetics experiencing a night-time episode of severe hypoglycaemia became medically unfit to drive a vehicle, resulting in the loss of a driving licence.

The DVLA pursued a change in the legislation so that only an episode of severe hypoglycaemia during “Waking Hours” should be considered for invalidating a driving licence, not when the diabetic is asleep; when they are not able to manage their diabetes. Diabetes UK stated people with diabetes have the right to drive if they are able to prove medical fitness.

Driving with Cataracts

A cataract is a clouding of the lens in an eye or both eyes. Symptoms that directly relate to drivers include; blurred vision, night blindness, double vision and bright light issues. The DVLA, prior to the new guidelines, advised that Group One drivers (car and motorcycle), to inform them if the driver had cataracts in both eyes.

Now licence holders, only need to tell the DVLA if they are unable to conform to the relevant visual standards required for driving. The AOP advised the DVLA that notification from a licence holder was not necessary where the cataracts were mild, bilateral and met the visual standards.

For Group Two (PCV and LGV) drivers with cataracts, the same guideline applies unless the licence holder has developed a greater sensitivity to brightness. The D4 Medical examination report for Group 2 licence holders includes a visual assessment that is required to be filled in by a doctor or optician/optometrist.

Driving with Obstructed Sleep Apnoea

Obstructed Sleep Apnoea is a condition where the walls of the throat (muscles) relax, narrowing or blocking the airway for 10 seconds or more. This can cause regularly interrupted sleep and other medical issues. People with severe OSA can be woken up hundreds of times during the night without being aware of the occurrence. Licence holders with OSA, risk driving when tired and fatigued. Previously the DVLA would expect that the condition is reported with the potential loss of a driving licence and employment if driving is vocational.

OSA can now be treated very effectively without the loss of a driving licence. The DVLA have been approached by the OSA Partnership and health professionals in order to simplify the process of reporting the condition. Such that now only after diagnosis, if the excessive sleepiness is not experienced or there is no adverse symptom that would impact on driving, the DVLA does not need to be informed.

If a driver does experience sleepiness that could be detrimental to driving, but has yet to be diagnosed with OCA, then the guidance is that the licence holder should stop driving but does not have to notify the DVLA until the diagnosis of OCA causing the excessive sleepiness is confirmed. If subsequent treatment is successful in diminishing the extreme sleepiness, the DVLA will not revoke the driving licence.

Driving with Self-Inflicted Fatigue

The Licence Link news article called “Driver Distraction, Inattention or Fatigue.” discussed the following:

Fatigue does not just happen, warning signs are often given but even so drivers continue with the journey instead of taking the necessary break periods required. The Working Time Directive is in place to ensure that professional driving duties conform to the regulated period allowed for those activities.

Self-Inflicted Fatigue has been identified as a significant cause of accidents involving tired LGV drivers. It has been stated that 40% of sleep-related accidents involve commercial vehicles, at a cost of £16.3 billion to the UK economy.

This year the Driver and Vehicle Standards Agency can now fine lorry, bus or coach drivers on the spot for every time they have driven tired in the previous 28 day period. These new powers intend to reduce the amount of abuse of the Working Directive rules and subsequently decreasing the number of tired drivers on the road.


With Diabetes, Cataracts and Obstructed Sleep Apnoea, the DVLA have taken a pragmatic approach to these medical conditions. Under consultation and guidance the DVLA have acted with compassion, changing rules that consider the diagnosis as far as outright fitness to drive is concerned. The DVSA, on the other hand, have been forced into further punitive actions to reduce vocational drivers flaunting the driving hours rules.

It is always worthwhile taking a look at legislative changes that can have an impact upon risk assessments of a company car or vocational driver. Understanding the medical conditions that can affect employed drivers can help HR and Fleet Managers manage the processes for determining entitlement to drive on their behalf. Identifying drivers that self-inflict tiredness is in the self-interest of businesses and organisations in order to reduce corporate risk but also help reduce serious accidents that commercial vehicles can cause.

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