When drivers with type 2 diabetes go for their annual checkup, samples are taken. If the doctor has to take more samples than required, Swedish Transport Agency regulations state that the person must be informed first. The same applies before a doctor reports someone to the Swedish Transport Agency. This has been confirmed by the Swedish Transport Agency as well as by the Welfare and Welfare Inspectorate (IVO). The Swedish Transport Agency is now reviewing the medical regulations regarding requirements for the use of substances that affect driving ability.
We followed Callie, a driver with type 2 diabetes, after he underwent a PEth test during his annual check-up at the health center without being informed, a test not included in the check-up he was there for. Among other things, PEth can manifest as excessive alcohol intake over a longer period of time. Cali lost his driver's license and his livelihood after the doctor reported the test results.
The editors have also He was contacted in Skåne by Kurt, who also has Type 2 diabetes. He went for his annual check-up and thought everything was as usual – until a letter arrived from the Swedish Transport Agency with the message that his driving license had been canceled due to also having a high PEth value. We note this in the Swedish Transport Agency's regulations at TSFS 2010:125 and the Driving License Act Chapter 10. § 5, which states that “Before making a report, the driver’s license holder must be notified“.
Ask the Swedish Transport Agency How do they deal with a notification from a doctor about a high PEth value in a truck driver with type 2 diabetes.
– If we receive information about a high PEth value, we will likely need to know more about the person's alcohol habits. This is done by requiring the person to come with an alcohol medical certificate, says the Swedish Transport Agency.
Is it possible to join? Can a primary care physician's PEth samples alone diagnose addiction?
– If a person provides two or more elevated PEth samples (more than 0.30 µmol/L) more than five weeks apart during the past year, the Swedish Transport Agency consultant physician can state that an addiction diagnosis can be made based on the Swedish Transport Agency examination . Special Addiction Criteria This standard applies when it comes to non-temporary use that is medically harmful and appears in the Swedish Transport Agency's regulations (TSFS 2010:125) and general advice on medical requirements for possession of, among other things, driving licences, says the Swedish Transport Agency .
There's one going on Regulatory work The Swedish Transport Agency is reviewing medical regulations regarding requirements for the use of substances that affect driving ability. Before work began, a review of the rules was also carried out.
We will call The Welfare and Welfare Inspectorate (IVO) asks whether a doctor is permitted to take PEth samples that are not required for current control?
– The doctor may take samples and request various tests that he deems necessary to be able to issue a driver’s license certificate at a higher level of authority. For example, previous addictions or other illnesses may require different types of tests. Thus it can be PEth in some cases
Necessary to assess suitability, but then the patient must be informed, and IVO is given.
Does this mean that? May the doctor take additional samples without informing the person concerned – contrary to Swedish Transport Agency regulations?
– PEth may in some cases be necessary to assess suitability, but then the patient should be informed, says IVO.
there Complexity with alcohol and we read Discussion article In Lakartedningen, written by Sven Wallen, Specialist in General Medicine, Chief Physician, Sven Andreasson, Chief Physician, Professor of Social Medicine, Karolinska Institutet, Stockholm Addiction Center, Agent Røs, District Physician, Uppsala District and former Consultant Physician at the Transport Agency. Title reads “Alcoholism in itself is not a reason for revocation of a driving licence“.
In the article he raises They consider the Driving License Act (1998:488) and the Swedish Transport Agency's regulation on medical requirements for obtaining a driving license (TSFS 2013:2) to be two important pieces of the traffic safety puzzle as medical conditions can lead to traffic risks.
The article continues. In the case of dependence or abuse, unlike most other diagnoses, a medical assessment of the severity of the condition or road safety risks is not required. Therefore, the diagnosis itself constitutes an obstacle to obtaining a driving licence.
but, “Regulatory framework However, it relies on a lack of knowledge about diagnosis and, for example, does not take into account knowledge about the epidemiology of alcoholism. Ironically, the rules have the opposite effect, with less attention paid to people with alcohol addiction and a lack of help for them“.
Authors He criticizes the Swedish Transport Agency's regulations TSFS 2013:2 and believes that “The regulations are based on the misconception that alcoholism is usually a condition that poses a road safety risk“.
on condition About 600,000 Swedes suffer from alcohol addiction or harmful abuse/use, and the Swedish Transport Agency would not reasonably be able to handle the checks if the medical profession starts following the regulations. “In addition, health care will be burdened by 600,000 new patients who will have to be evaluated, screened with tests and eventually issued certificates. The consequences will be a prolonged suspension of driving licenses with unreasonable living and social consequences as well as displacement effects for patients“.
Authors write The Swedish Transport Agency's view of people with alcohol addiction who need a “sober lifestyle” is not unique but “A lack of knowledge and an oppressive attitude represent a very common bias, often with black and white thinking such as “either you have a problem then you shouldn't drink, or you don't have a problem then you're a deviant if you don't drink”. The reality is considerably more nuanced with significant variation in the problem“.
additional last condition In Läkartidningen covers how to evaluate PEth tests. The authors Anders Helander, Hospital Chemist, Clinical Chemistry and Clinical Pharmacology at Karolinska University Laboratory and Therese Hansson, Hospital Chemist, Clinical Service and Laboratory Medicine at Scania University Hospital in Lund, wrote, “Value can indicate consumption levels, but does not determine them“.
The text continues With measurable PEth confirms alcohol intake, but unable to determine exact amount or timing due to individual variation in test response and half-life. “A PEth value greater than 0.30 µmol/L is a strong indicator of excessive alcohol consumption. A negative PEth result rules out regular heavy alcohol intake, but does not confirm complete sobriety“.
The Swedish Transport Agency A review of the regulations now indicates that the reality is not so simple and that it is rarely just black or white. As Callie and Kourt say:Surely no one should care what I do in my free time as long as I don't drive drunk?“
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