View the feedback we have received on the Improving health screening for heavy vehicle drivers paper.

• File
  • 250509 Submission .pdf
• q1

  The commercial vehicle industry is essential to Australia’s supply chain, particularly given the nation’s vast geography and freight reliance on road transport. Heavy vehicles move over 77% of non-bulk freight across the country, often across long distances and regional routes. This operational context places unique physical and mental health pressures on commercial drivers, exacerbating fatigue and chronic health risks. The health and fitness of commercial drivers is intrinsically linked to road safety outcomes. Fatigue and undiagnosed health conditions remain leading contributors to heavy vehicle crashes. Therefore, consistent and proactive health screening must be viewed not only as a workforce health measure but also a critical road safety intervention. In 2024, Queensland experienced its deadliest year on the roads, with over 300 fatalities, many involving heavy vehicles. Factors such as fatigue, impaired driving, and distractions were major contributors to these incidents.

• q10

  Accreditation for GPs: Establish a voluntary national accreditation program for medical professionals conducting AFTD assessments, with a focus on transport-sector awareness. Centralised Digital Reporting: Develop a secure digital platform for storing and transferring commercial driver medical fitness certificates. Access must be consent-based and governed under strict data privacy protocols. Integration with CoR and NHVR Audits: Embed health screening compliance within existing CoR audit frameworks in a non-punitive, educational format. This reinforces health as a shared responsibility across the supply chain. Medicare and Government Support: Introduce Medicare-funded occupational health screening and/or subsidies for small-to-medium operators to ensure equitable access to screening services.

• q11

  ALC supports a nationally consistent, risk-based approach to driver health screening that prioritises safety outcomes without increasing compliance costs for operators. Enhanced licence-based screening (1C) may assist with periodic oversight, but is insufficient on its own and risks creating administrative burden without targeting high-risk drivers. Risk-based screening (2C) offers a more efficient and evidence-driven pathway, but requires strong privacy safeguards and must not result in new unfunded obligations for industry. Employer-led screening (3C) can complement regulatory mechanisms, but must remain voluntary and supported through government co-investment, particularly for smaller operators. To ensure equitable and scalable implementation, ALC recommends leveraging existing CoR frameworks rather than creating parallel systems; providing government-funded access to screening services for SMEs; ensuring any data-sharing mechanisms are secure, consent-based, and nationally consistent.

• q12

  National Driver Health Partnership: A coordinated program between governments, industry, insurers, and health providers. Digital health passports: Secure, consent-based driver health profiles to track screening compliance and outcomes.

• q2

  Commercial drivers are an ageing workforce with limited access to regular medical services, particularly those working in regional or long-haul roles. Key health risks include cardiovascular disease due to sedentary work, poor diet, and irregular hours; type 2 diabetes, often linked with lifestyle factors and compounded by limited access to healthy food and exercise; sleep disorders, including obstructive sleep apnoea (OSA), which is particularly underdiagnosed and contributes to fatigue-related incidents; mental health concerns, often exacerbated by isolation, long hours, and pressure to meet delivery schedules. These issues are further intensified by the casualisation of the workforce, inconsistent employment conditions, and limited employer engagement with preventive health initiatives.

• q3

  The Assessing Fitness to Drive guidelines, developed by Austroads and the NHMRC, provide a nationally consistent framework. They rely heavily on self-disclosure and periodic medical assessments by general practitioners, often without specialist occupational health oversight. While the framework sets out clear criteria for medical conditions including CVD, diabetes and sleep disorders, implementation is inconsistent and lacks robust enforcement. Drivers may under-report symptoms due to fear of job loss. A more structured and sector-specific system, potentially involving accredited occupational health providers and integrated electronic reporting, could improve compliance and effectiveness.

• q4

  CVD, diabetes and OSA are prevalent among commercial drivers and directly impact driver alertness and decision-making. Screening approaches should include cardiovascular risk assessments using standard tools such as the absolute CVD risk calculator; HbA1c tests and fasting glucose screening for early detection of Type 2 diabetes; validated questionnaires (e.g. STOP-BANG) and overnight sleep studies for OSA, especially in high-risk individuals (BMI>30, history of fatigue, or hypertension). Introducing screening intervals based on risk profile (e.g. age, BMI, medical history) would improve early detection and intervention.

• q5

  Advanced driver assistance systems (ADAS) and fatigue detection technologies are increasingly used across fleets. These include cameras and AI-based systems to detect eye closure, yawning, or head movement; wearables that monitor heart rate variability and sleep patterns; vehicle telematics to assess driving behaviour (e.g. harsh braking, lane drifting)- especially in newer electric heavy vehicles. These technologies support real-time intervention and provide valuable health insights. However, their uptake depends on cost and employer engagement- which also depends on whether or not these type vehicles are allowed to operate through bridges and tunnels in various states (different government policy frameworks and asset ownership often impose restrictions for heavy ZEVs). Any health screening reform should consider integration with such technologies to provide continuous, rather than periodic, monitoring.

• q6

  Health4Transport (NSW) – on-site health checks for drivers. NTI’s Better Health Program – health and wellbeing support across its insured fleet operators. Wayfinder and ALC initiatives – promoting training, education and diversity, which support broader workforce wellbeing. Healthy Heads in Trucks and Sheds (as discussed in our submission). National consistency and long-term funding are required for scale.

• q7

  ALC supports expansion of nationally consistent and evidence-based driver health initiatives. These should be co-designed with industry to ensure practical implementation. They should also include employer incentives for participation (e.g. insurance discounts, Chain of Responsibility alignment) and promote proactive health support, not just compliance-based screening.

• q8

  Health screening should not operate in isolation. It must integrate with fatigue management frameworks under the Heavy Vehicle National Law, with Workplace health and safety obligations, aligned with Safe Work Australia guidance; with Chain of Responsibility duties, encouraging employers to embed health support in business practices. Linking screening results to digital health records (with driver consent) could also streamline follow-up care and regulatory compliance.

• q9

  Option A: Maintain Current Approach Benefits: Minimal short-term disruption to existing administrative and compliance frameworks. Costs/Barriers: Fails to address underdiagnosis of chronic conditions; relies heavily on self-reporting and generalist GPs without transport-specific training. Limitations: Lacks consistency and does not reflect the evolving health risk profile of an ageing commercial driving workforce. Option B: Strengthen Compliance with AFTD Costs: May require modest investment in GP training, systems integration, and development of supporting digital infrastructure. Barriers: Variable medical practitioner capability; risk of duplicating existing employer-led health programs. Limitations: Static assessments may not capture real-time risk. Emerging technologies and behavioural indicators could offer more dynamic, safety-aligned approaches.