REC121-3705

The ITSRR should develop standards for periodic medical examinations which include the following:
(a) all medical examinations of safety critical employees must contain a predictive element, including use of a cardiac risk factor predictions chart to assess risk of sudden incapacitation, and follow-up procedures, where indicated;
(b) medical examinations must be conducted by medical practitioners with an understanding of the duties and responsibilities of the safety critical employees being examined;
(c) a medical practitioner conducting such a medical examination should, with the employee’s consent, have access to his or her medical history. If such consent is not given, the employee must be required to undertake a more exhaustive medical examination with specialist diagnostic procedures;
(d) all such medical examinations must be reviewed on behalf of the employer by an occupational physician;
(e) appropriate follow up examinations, such as a stress ECG or examination by a cardiologist, must be arranged for any safety critical employee whom the occupational physician believes may be at risk of sudden incapacitation;
(f) medical histories of employees should be monitored by an occupational physician to enable identification of any trends that may indicate a deteriorating state of health;
(g) routine basic psychological screening, by means of a questionnaire such as the K10 questionnaire, should form part of periodical medical examinations;
(h) medical standards should be reviewed at least every five years to ensure that recent advances in medical knowledge and technology are utilised; and
(i) periodic examination standards prescribed by ITSRR should take into consideration medical standards for safety critical rail staff prescribed elsewhere in Australia to ensure, so far as possible, uniformity of such standards.