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Directive 2006/126/EC of the European Parliament and of the Council of 20 December 2006 on driving licences (Recast) (Text with EEA relevance)
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Group 1:
drivers of vehicles of categories A, A1, A2, AM, B, B1 and BE.
Group 2:
drivers of vehicles of categories C, CE, C1, C1E, D, DE, D1 and D1E.
National legislation may provide for the provisions set out in this Annex for Group 2 drivers to apply to drivers of Category B vehicles using their driving licence for professional purposes (taxis, ambulances, etc.).
Applicants shall be required to undergo a medical examination if it becomes apparent, when the necessary formalities are being completed or during the tests which they have to undergo prior to obtaining a driving licence, that they have one or more of the medical disabilities mentioned in this Annex.
Applicants shall undergo medical examinations before a driving licence is first issued to them and thereafter drivers shall be checked in accordance with the national system in place in the Member State of normal residence whenever their driving licence is renewed
For group 1 drivers, licensing may be considered in ‘ exceptional cases ’ where the visual field standard or visual acuity standard cannot be met; in such cases the driver should undergo examination by a competent medical authority to demonstrate that there is no other impairment of visual function, including glare, contrast sensitivity and twilight vision. The driver or applicant should also be subject to a positive practical test conducted by a competent authority.
Moreover, the horizontal visual field should be at least 120 degrees, the extension should be at least 50 degrees left and right and 20 degrees up and down. No defects should be present within a radius of the central 20 degrees.
When a progressive eye disease is detected or declared, driving licences may be issued or renewed subject to the applicant undergoing regular examination by a competent medical authority.
Moreover, the horizontal visual field with both eyes should be at least 160 degrees, the extension should be at least 70 degrees left and right and 30 degrees up and down. No defects should be present within a radius of the central 30 degrees.
Driving licences shall not be issued to or renewed for applicants or drivers suffering from impaired contrast sensitivity or from diplopia.
After a substantial loss of vision in one eye, there should be an appropriate adaptation period (for example six months) during which the subject is not allowed to drive. After this period, driving is only allowed after a favourable opinion from vision and driving experts.]
Textual Amendments
Where the disability is static, driving licences may be issued or renewed without the applicant being subject to regular medical examination.
brady-arrhythmias (sinus node disease and conduction disturbances) and tachy-arrhythmias (supraventricular and ventricular arrhythmias) with history of syncope or syncopal episodes due to arrhythmic conditions (applies to group 1 and 2);
brady-arrhythmias: sinus node disease and conduction disturbances with second degree atrioventricular (AV) block Mobitz II, third degree AV block or alternating bundle branch block (applies to group 2 only);
tachy-arrhythmias (supraventricular and ventricular arrhythmias) with
structural heart disease and sustained ventricular tachycardia (VT) (applies to group 1 and 2), or
polymorphic nonsustained VT, sustained ventricular tachycardia or with an indication for a defibrillator (applies to group 2 only);
symptomatic of angina (applies to group 1 and 2);
permanent pacemaker implantation or replacement (applies to group 2 only);
defibrillator implantation or replacement or appropriate or inappropriate defibrillator shock (applies to group 1 only);
syncope (a transient loss of consciousness and postural tone, characterised by rapid onset, short duration, and spontaneous recovery, due to global cerebral hypoperfusion, of presumed reflex origin, of unknown cause, with no evidence of underlying heart disease)(applies to group 1 and 2);
acute coronary syndrome (applies to group 1 and 2);
stable angina if symptoms do not occur with mild exercise (applies to group 1 and 2);
percutaneous coronary intervention (PCI) (applies to group 1 and 2);
coronary artery bypass graft surgery (CABG) (applies to group 1 and 2);
stroke/transient ischemic attack (TIA) (applies to group 1 and 2);
significant carotid artery stenosis (applies to group 2 only);
maximum aortic diameter exceeding 5,5 cm (applies to group 2 only);
heart failure:
New York Heart Association (NYHA) I, II, III (applies to group 1 only),
NYHA I and II provided that the left ventricular ejection fraction is at least 35 % (applies to group 2 only);
heart transplantation (applies to group 1 and 2);
cardiac assist device (applies to group 1 only);
valvular heart surgery (applies to group 1 and 2);
malignant hypertension (elevation in systolic blood pressure ≥ 180 mmHg or diastolic blood pressure ≥ 110 mmHg associated with impending or progressive organ damage) (applies to group 1 and 2);
grade III blood pressure (diastolic blood pressure ≥ 110 mmHg and/or systolic blood pressure ≥ 180 mmHg) (applies to group 2 only);
congenital heart disease (applies to group 1 and 2);
hypertrophic cardiomyopathy if without syncope (applies to group 1 only);
long QT syndrome with syncope, Torsade des Pointes or QTc > 500 ms (applies to group 1 only).
implant of a defibrillator (applies to group 2 only);
peripheral vascular disease — thoracic and abdominal aortic aneurysm when maximum aortic diameter is such that it predisposes to a significant risk of sudden rupture and hence a sudden disabling event (applies to group 1 and 2);
heart failure:
NYHA IV (applies to group 1 only),
NYHA III and IV (applies to group 2 only);
cardiac assist devices (applies to group 2 only);
valvular heart disease with aortic regurgitation, aortic stenosis, mitral regurgitation or mitral stenosis if functional ability is estimated to be NYHA IV or if there have been syncopal episodes (applies to group 1 only);
valvular heart disease in NYHA III or IV or with ejection fraction (EF) below 35 %, mitral stenosis and severe pulmonary hypertension or with severe echocardiographic aortic stenosis or aortic stenosis causing syncope; except for completely asymptomatic severe aortic stenosis if the exercise tolerance test requirements are fulfilled (applies to group 2 only);
structural and electrical cardiomyopathies — hypertrophic cardiomyopathy with history of syncope or when two or more of the following conditions present: left ventricle (LV) wall thickness > 3 cm, non-sustained ventricular tachycardia, a family history of sudden death (in a first degree relative), no increase of blood pressure with exercise (applies to group 2 only);
long QT syndrome with syncope, Torsade des Pointes and QTc > 500 ms (applies to group 2 only);
Brugada syndrome with syncope or aborted sudden cardiac death (applies to group 1 and 2).
Driving 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.
The risk of sudden incapacitating events shall be evaluated in applicants or drivers with well described cardiomyopathies (e.g. arrhythmogenic right ventricular cardiomyopathy, non-compaction cardiomyopathy, catecholaminergic polymorphic ventricular tachycardia and short QT syndrome) or with new cardiomyopathies that may be discovered. A careful specialist evaluation is required. The prognostic features of the particular cardiomyopathy shall be considered.
Textual Amendments
Driving licences shall not be issued to, or renewed for, applicants or drivers who have inadequate awareness of hypoglycaemia.
Driving 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.
Driving 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.]
no severe hypoglycaemic events have occurred in the previous 12 months,
the driver has full hypoglycaemic awareness,
the driver must show adequate control of the condition by regular blood glucose monitoring, at least twice daily and at times relevant to driving,
the driver must demonstrate an understanding of the risks of hypoglycaemia,
there are no other debarring complications of diabetes.
Moreover, in these cases, such licences should be issued subject to the opinion of a competent medical authority and to regular medical review, undertaken at intervals of not more than three years.
Neurological disturbances associated with diseases or surgical intervention affecting the central or peripheral nervous system, which lead to sensory or motor deficiencies and affect balance and coordination, must accordingly be taken into account in relation to their functional effects and the risks of progression. In such cases, the issue or renewal of the licence may be subject to periodic assessment in the event of risk of deterioration.
Textual Amendments
Epilepsy is defined as having had two or more epileptic seizures, less than five years apart. A provoked epileptic seizure is defined as a seizure which has a recognisable causative factor that is avoidable.
A person who has an initial or isolated seizure or loss of consciousness should be advised not to drive. A specialist report is required, stating the period of driving prohibition and the requested follow-up.
It 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 should be done by a neurologist.
If the person has epilepsy, the criteria for an unconditional licence are not met. Notification should be given to the licensing authority.
A person with a structural intra-cerebral lesion who has increased risk of seizures should not be able to drive vehicles of group 2 until the epilepsy risk has fallen to at least 2 % per annum. The assessment should be, if appropriate, in accordance with other relevant sections of Annex III (e.g. in the case of alcohol).
Certain disorders (e.g. arterio-venous malformation or intra-cerebral haemorrhage) entail an increased risk of seizures, even if seizures have not yet occurred. In such a situation an assessment should be carried out by a competent medical authority; the risk of having a seizure should be 2 % per annum or less to allow licensing.]
severe mental disturbance, whether congenital or due to disease, trauma or neurosurgical operations,
severe mental retardation,
severe behavioural problems due to ageing; or personality defects leading to seriously impaired judgment, behaviour or adaptability,
unless their application is supported by authorised medical opinion and, if necessary, subject to regular medical check-ups.
After a proven period of abstinence and subject to authorised medical opinion and regular medical check-ups, driving licences may be issued to, or renewed for, applicant or drivers who have in the past been dependent on alcohol.
Driving licences shall not be issued to or renewed for applicants or drivers who are dependent on psychotropic substances or who are not dependent on such substances but regularly abuse them, whatever category of licence is requested.
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