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Deciding when Medical Conditions and Types of Medication may become Safety Risks

Keeping everyone on the railways safe is at the heart of what we do. Deciding whether rail workers that have medical conditions, or are on medication, that can cause sudden incapacity are safe to carry out critical tasks is not simple. Occupational health specialists make subjective assessments, which are often based on a worst-case scenario. This can lead to inconsistent decision-making and an unnecessary reduction in the availability of staff.

​The risks associated with unavoidable impairment in the rail industry are low, compared with the aviation and road transport sectors.  Our guidance for occupational health specialists and duty holders contains information about the medical assessment process, follow-up health risk assessment processes and reporting.  Benchmark figures are available to support the assessment of an individual’s fitness for specific tasks and to determine whether the risk is within acceptable limits.


Topics covered:

  • Medical conditions and medication
  • Sudden incapacity
  • Medical assessments and subjectivity
  • Risks compared with other industries
  • Decision-making guidance and benchmarks


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