We believe we can learn lessons and derive inspiration from seeing how other transport sectors have met human factors, wellbeing and health needs in their workforce to reduce work-related risk and create a safer working environment. We've captured some of their approaches, sector-specific regulatory requirements and initiatives below. 

Aviation 

Pilots require in-depth psychological and medical screening on application, with a wide range of medical screening conducted annually. Cabin crew and air traffic controllers also require medical examinations. 

Pilot and crew duty hours and rest hours are strictly regulated. However, as well as upper limits aviation systems take into account other factors, such as how many trips a pilot has done, whether they have been away from home or shift changes which may have caused fatigue. 

Fatigue management is built into crew scheduling systems. The Civil Aviation Authority says: "It's also important to recognise the difference between working a number of hours and being fatigued. While the maximums put in place are important to give an ultimate limit, individual pilots have a constant duty to monitor themselves and declare whether or not they are fit to fly." 

Any pilot who is fatigued or unwell to the extent that it may compromise their performance must declare themselves unfit for duty. Airline staff are also expected to monitor one another for signs of fatigue. 

Rail driver health 

The Rail Safety and Standards Board has extensive resources and charters about rail driver health. It has identified key issues, most of which are included in this guide, as safety critical issues for the rail industry, including fatigue, mental health and colour blindness. 

These are a few of the RSSB's recent initiatives: 

The Occupational Road Risk Management Charter 

This Charter sets out a series of commitments to reduce road risk. This risk relates to the likelihood of being killed or injured while driving, or being driven, for work purposes. These commitments, which also extend to your supply chain, help ensure the effective management of occupational road risk. 

The Charter was created between RSSB, Parliamentary Advisory Council for Transport safety (PACTS) and the Office of Road and Rail. 

It is designed as a statement of commitment. Every participating company has a board level signatory and appoints a road risk champion. The company will then embed road risk management tools in line with the Rail Health and Safety Strategy for the management of road risk. 

The Railway Mental Health Charter is a recently updated document which provides five key action areas for companies to address employee mental health support. 

Healthy Cultures: There are a number of initiatives which have started under the 'healthy cultures' banner. We've summarised a few below. 

Irish Rail fostered various initiatives to encourage its 90% male workforce to discuss and access support for health issues. 

Colas Rail developed a 'health by design' approach to complex delivery projects to prevent the decline in motivation and concentration levels which can lead to safety incidents. 

Southeastern already had a chaplain, mental health first aiders and an EAP programme – yet some of its team members still struggled to access support. So it instituted a one-on-one advocacy programme, so that employees could be partnered with a colleague who understood the difficulties of the job and could signpost help. 

Hull Trains decided to encourage its workers to enjoy some of the beautiful countryside easily accessed from their stations to improve their mental health and activity levels with a series of videos called 'Moment for Movement'. 

Colour vision testing 

RSSB has also developed more extensive and specific testing for applicants related to colour vision. Traditionally anyone with a colour sight deficiency could not be a train driver. However, now candidates can be further assessed to find out whether their colour deficiency would increase their risk in practice. 

This is a good example of where good medical screening can be used to recruit or keep people in the workforce, rather than excluding them. 

Train driver health requirements 

To gain a train driving licence, individuals must comply with the following train driver health requirements: 

• A psychological fitness examination. This usually includes psychomotor skills, cognitive and communication skills elements. This may be repeated at any point if an employer or doctor feels it necessary. 

• An initial medical examination, including vision, hearing, an ECG, and blood or urine tests. 

• A periodic medical at least every three years until the age of 55 and annually thereafter. Other medical examinations may be required if an employer or doctor deems it necessary. 

• Train drivers must also not be suffering from any medical conditions, or be taking any medication, drugs or substances which are likely to cause: 

• a sudden loss of consciousness 

• a reduction in attention or concentration 

• a sudden incapacity 

• a loss of balance or coordination  

• a significant limitation of mobility 

Comparisons of medical testing required by law of different types of driver/pilot. 

*The Railway Safety Standards Board says that while there is no legal requirement for those tests marked *, they are nonetheless frequently included in medical screening for train drivers. 

Pilot and train drivers require far more extensive testing than HGV drivers. This might be explicable in terms of the number of passengers they are directly responsible for. However, even lone pilots in small private planes, or balloon pilots, require a high level of medical certification. 

Any company operating transport has the same duty of care under health and safety legislation to adequately risk assess and take all reasonable precautions to ensure employee and public safety. This means that while HGV, van and car drivers may not specifically require extensive testing in terms of sectoral regulation, an employer still has a duty to ensure they are fit to drive.  

378 people died in air crashes worldwide in 2023-24. 

10 people died in train-related crashes in 2023-24. 

1,624 fatalities occurred on UK roads in 2023. 

(The most recent available figures for each sector.) 

These figures suggest that the most rigorous standards of health screening should be applied by employers to road transport drivers, in line with those in other sectors.