• Donna Noonan, Margaret Ryan, Declan Whelan, and Desmond O'Neill.
• National Office for Traffic Medicine, Royal College of Physicians of Ireland, Dublin, Ireland.
• Ir J Med Sci. 2023 Oct 1; 192 (5): 248724932487-2493.

BackgroundEmergency service vehicle (ESV) drivers are an important part of the health, fire and police services. ESV driving is associated with increased crash risk, but little guidance exists in the literature on relevant medical conditions among drivers and their potential for adding to higher crash risks.AimsWe undertook a narrative review to examine the role of medical and other conditions in crash risk of ESV drivers.MethodA literature search was conducted using the ScienceDirect and Transport Research International Documentation (TRID) databases. There was no time frame for the search, and results were restricted to review and research articles.ResultsOf 570 papers identified, 13 remained after screening and full-text review. A range of factors have been shown to have an impact on increased crash risk, including the nature of the task, physical features of the equipment, training, experience, environmental conditions and secondary tasks. There was scant information on medical conditions other than alcohol use disorders.ConclusionsGiven issues of speed, vehicle and environment, it would seem prudent to mandate levels of medical fitness to drive similar to and sometimes exceeding (i.e. colour blindness for traffic signals and alerts, hearing impairment as first responders) those for group 2 drivers with extra stipulations relating to specific service needs such as enhanced visual (such as colour blindness and contrast sensitivity) and auditory function. Further research is needed on the prevalence and emergence of relevant medical conditions among ESV drivers, with due consideration of their application to the driving tasks in each service.© 2023. The Author(s).

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