Industrial Rail: Railway Medical Rules for Positions Critical to Safety
1. Short Title
1. For ease of reference, these Guidelines may be referred to as the "Industrial Railway Medical Rules".
2.1 These Guidelines, which have been developed pursuant to Section 20 (1) (a) of the adopted provisions from the Railway Safety Act (Canada), define the Medical Fitness for Duty requirements for Safety Critical Positions within railway companies subject to the jurisdiction of the MOTI.
3.1 "Chief Medical Officer" means a physician licensed to practice medicine in Canada and who is employed or contracted by a railway company for the purpose of, among other things, directing and managing the area of Medical Fitness for Duty requirements and guidelines.
3.3 "Medical Fitness for Duty" means that a determination was made by the Chief Medical Officer, subject to any restrictions or requirements imposed under Section 6 hereof, that a person has taken the medical assessments required by these rules, and that the person meets all of the Medical Fitness for Duty requirements provided herein.
3.3.1 “MOTI” means the provincial Ministry of Transportation and Infrastructure;
3.4 "Safety Critical Position" has the same meaning as provided in the Industrial Railway Rules Governing Safety Critical Positions Guidelines.
3.5 "person" means a person in a Safety Critical Position.
4. Frequency of Medical Assessments
4.1 Subject to subsection 4.2, a person shall undergo a company organized Medical Fitness for Duty assessment:
1. prior to commencement of employment in a Safety Critical Position;
2. upon promotion or transfer to a Safety Critical Position; and
3, every five years until the age of forty, and every three years thereafter until retirement, or until that person is no longer employed in a Safety Critical Position.
4.2 Without varying the requirement of subsection 4.1(c), no assessment shall be required under subsection 4.1(b) if the person had previously occupied a Safety Critical Position which, in the opinion of the Chief Medical Officer, had similar mental and physical demands as the Safety Critical Position into which the person is entering.
4.3 The Chief Medical Officer may require additional assessments to those set out in Section 4.1 if:
b. the person has or may have a medical condition that requires assessment or more frequent monitoring; or
c. the person is returning to work in a Safety Critical Position after a leave due to illness or injury.
5. Assessment for Medical Fitness for Duty
5.1 The Medical Fitness for Duty for a person shall be assessed on an individual basis, taking into consideration medical conditions, both past and current, that could result in:
1. sudden impairment;
2. impairment of cognitive function including alertness, judgment, insight, memory and concentration;
3. impairment of senses;
4. significant impairment of musculoskeletal function; or
5. other impairment that is likely to constitute a threat to safe railway operations.
5.2 The medical conditions referred to in Section 5.1 shall include:
1. diseases of the nervous system, including seizure disorders, narcolepsy, sleep apnea and other disturbances of consciousness, vestibular disorders, disorders of coordination and muscle control, head injury, post traumatic conditions and intracranial tumors;
2. cardiovascular diseases, including high blood pressure, coronary artery disease, myocardial infarction, cerebrovascular disease, aortic aneurysm, congestive heart failure, cardiac arrhythmia, valvular heart disease and cardiomyopathy;
3. metabolic diseases, including diabetes mellitus, thyroid disease, Cushing's Disease, Addison's Disease and pheochromocytoma;
4. musculoskeletal disabilities, including amputation of a limb, arthritis, significant joint dysfunction, disease of the spine, obesity or other significant musculoskeletal conditions;
5. respiratory diseases, including obstructive or restrictive conditions resulting in functional impairment;
6. mental disorders, including the following types of mental disorders:
1. cognitive, including dementia's, delirium and amnesia;
2. psychotic, including schizophrenia;
3. mood, including depression, manic, bipolar;
4. anxiety, including panic attacks and phobias; and
5. personality, resulting in anti-social, erratic or aggressive behaviour;
7. substance abuse, including abuse or dependence on alcohol, prescription medications, or illicit drugs;
8. hearing impairment, including hearing acuity;
9. visual impairment, including distant visual acuity, field of vision, colour vision; and
10. any other organic, functional or structural disease, defect or limitation that is likely to constitute a threat to safe railway operations.
5.3 In addition to the medical conditions referred to in Section 5.2, the individual assessment of a person's Medical Fitness for Duty shall also take into consideration:
1. the occupational demands of the person's job and the person's ability to meet those demands;
2. the person's performance record; and
3. any prescription or over the counter medications that the person is using, or has used, that may cause mental or physical impairment or affect judgment.
5.4 Notwithstanding subsections 5.1 and 5.2, the Chief Medical Officer may determine that any additional assessments required under subsection 4.3 may be limited to assessments of particular medical conditions.
6. Medical Restrictions
6.1 If the Chief Medical Officer, in making an individual assessment of a person's Medical Fitness for Duty, is of the opinion that there exists a threat to safe industrial railway operations, the Chief Medical Officer may:
1. restrict a person from occupying a Safety Critical Position;
2. require the use of corrective devices or other medical aids; or
3. otherwise restrict a person's ability to work or perform certain tasks in a Safety Critical Position.
6.2 Upon completion of a Medical Fitness for Duty assessment, the Chief Medical Officer shall advise each person, and the person's supervisor of that person's Medical Fitness for Duty and of any restrictions or requirements imposed pursuant to subsection 6.1.
7. Records To Be Kept by Chief Medical Officer
7.1 The Chief Medical Officer of the railway company shall maintain records of all persons' medical assessments required hereunder and any restrictions required pursuant to subsection 6.1.
7.2 The Chief Medical Officer shall maintain copies of all medical policies and guidelines used by a railway company for the examination or assessment of persons employed in Safety Critical Positions.
7.3 The Chief Medical Officer shall make records, policies, and guidelines related to these guidelines available to the MOTI upon reasonable request.