*28-JAN-2012*
*
*
*Umesh Isalkar*

*PUNE *: The horror of Maharashtra State Road Transport Corporation's bus
driver Santosh Mane's act on Wednesday which snuffed out eight lives on the
city's roads is beginning to sink in.

For one, it has highlighted the lack of attention to medical fitness of bus
drivers. Doctors have suggested a yearly or two-yearly health check-up
including neurological and psychiatric assessment as mandatory for
professional drivers.

Experts have also suggested that the state government should make it a norm
for all doctors and hospitals to update information of a person who may
pose a risk to public life because of his medical conditions.

"There are some medical and especially neurological conditions incompatible
with driving, or in which a person should not drive for his own safety and
that of others. These conditions include epilepsy, stroke, recurrent
syncope, psychiatric illness, sleep apnea syndrome (daytime sleepiness),
alcoholism and usage of certain medicines," said neurologist Rajas
Deshpande of Sancheti Hospital.

Deshpande said, "In our country, there is no effective health or
neurological screening before issuing a driving licence. It is scary to
imagine that there maybe many drivers on the road who can lose control
without them realizing it or being able to stop it."

He specialises in treatment of neurological conditions including epilepsy
and sees about 150 to 250 fresh cases of epilepsy every year.

"Only after repeated questioning, do some patients disclose that they are
drivers. Of the 150 patients of epilepsy I diagnose every year, three to
four turn are drivers. Almost all others (except minors) drive some or
other vehicle regularly. After explaining the risks, some comply, but most
don't, and continue to ride or drive," Deshpande said.

One can understand that a family may be dependent on driver, but it was not
acceptable to risk many lives including that of the driver, who has the
highest risk, he added. Besides, alcoholism is very common among drivers,
and it can cause rum fits due to both excess and withdrawal.

"That's the reason why neurological and psychiatric assessment must be made
mandatory for all professional drivers. This should include EEG and MRI
scan of brain. Such a comprehensive health check of professional drivers
can be conducted yearly or in two years," Deshpande said.

Neurologist Anand Alurkar said, "Patients with epilepsy or other
neurological conditions working as a driver in private sector do get
absorbed in other departments when they produce a medical certificate from
a neurologist. I have seen such patients and given them certificates. This
should also be a norm in government sector."

"Stressful situations include lack of sleep, fever, low blood sugar levels,
drug or alcohol consumption etc. Almost all medicines used for treatment in
this condition cause drowsiness and sedation of different extent. Those
with a family history of epilepsy are more likely to suffer from this
illness," Alurkar said.

Hence a person applying for driving licence must be screened for this
disorder, as is compulsory for all pilots, say experts in the field.

Experts have also hinted at making it mandatory for doctors and hospitals
to inform of a patient who may pose a risk to public life because of his
medical conditions.

"The Regional Transport Office (RTO) must make it mandatory for hospitals,
physicians and psychiatrists to update the name and details of medical
condition of any patient who may be a risk to public life, and to ensure
that adequate check-ups are done to treat and rehabilitate the patient,"
Deshpande said.

However, senior psychiatrist Alka Pawar, head of Maharashtra Institute of
Mental Health (MIMH), a state government unit that trains workforce in
mental health thinks that a doctor can always inform the patients' office
on his own if he is going be a threat to public life due to his or her
medical conditions. "The doctor can always inform the authorities in the
best interest of society," Pawar said.

However, some doctors said that informing the authorities without taking
the patient into confidence may pose a threat to their security and lead to
unnecessary legal procedures.

*Panel to review drivers' health*

The Maharashtra State Road Transport Committee (MSRTC) has decided to form
a technical committee to review the mental and physical health of its
37,000-odd drivers. At present, the MSRTC does not have a system of knowing
the health status of drivers, except for the mandatory health check done
when drivers join service and when they turn 40.

MSRTC managing director Deepak Kapoor could not be contacted despite
repeated attempts.

However, senior depot manager Vijaykumar Divte confirmed that a committee
would soon be formed to look into the health of drivers and conductors. "If
some systemic change is brought in, it will be true homage to those we lost
on Wednesday," said neuro-psychiatrist Sanjay Phadke.

http://articles.timesofindia.indiatimes.com/2012-01-28/pune/30673402_1_drivers-epilepsy-eeg

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