Proposal for improvement of ophthalmological diagnostic techniques for professional drivers in Brazil
Autor(a) principal: | |
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Data de Publicação: | 2013 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Saúde, Ética & Justiça (Online) |
Texto Completo: | https://www.revistas.usp.br/sej/article/view/75136 |
Resumo: | Introduction: Part of the motor vehicle accidents that occur on public roads may also be considered occupational accidents, given that the majority of those involved occur while in the service of companies. The main sense system used to drive is that of eyesight, which must be carefully evaluated in obtaining and renewing a of professional drivers license. Brazilian statistics indicate an overall increase in the number of deaths from traffic accidents, especially among professional drivers of large vehicles between 1998 and 2008. Compared to the United States, Brazil has a higher overall rate of deaths in road accidents. By the social and economic importance of this group of drivers, it is necessary to perform a more stringent ophthalmic evaluation than that performed in general population. Objective: Discuss the differences between the minimum indicators required by ophthalmological examination for obtaining and renewing professional driver’s license in Brazil and propose an improvement of ophthalmological diagnostic techniques for professional drivers in Brazil. Materials and Methods: We performed a literature review on the PubMed and SciELO databases and selected articles published in Portuguese and English between 1980 and 2011. The keywords used were: Ophthalmological diagnostic techniques, Eye diseases, Automobile driver examination and Automobile driving. As inclusion criteria, only articles were selected about professional drivers (categories C, D and E in Brazil, and groups A, B and C of commercial vehicle drivers in the United States). We excluded publications related to non-professional drivers (ACC, A and B in Brazil, and non-commercial vehicles in the United States). In both countries two indicators were assessed that had been used in ophthalmological diagnostic techniques as part of the examination for obtaining and renewing driver’s licenses of professional drivers: visual acuity (VA) and visual field (VF). The color vision test is the same in both countries, therefore not being a subject of discussion in this study. Results: In Brazil, the parameters for measurement of visual acuity, such as those of the visual field, are used more strictly. The indicators required in Brazil must be maintained, especially the visual field, considering that the higher the amplitude of the visual field, the safer it is for vehicle guidance. We suggest there be a screening evaluation of visual, cognitive and motor skills included in the medical examination, as can be done with the ADReS (Assessing Driving Related Skills) battery tests. With softwares like the Driving Health Inventory and the measurement of the Useful Field of View (UFOV) the expectation can be maintained that in a few years they will be applied with professional drivers, resulting in greater road safety not only to this class of professionals, but to the entire population. Conclusion: Indicators of visual acuity and visual field used in Brazil are stricter regarding those used in the United States of America. The requirement of color vision is the same in both countries. Despite vision acuity being controversial in the literature regarding driving ability and traffic safety, there are consistent data that provide evidence that more attention should be given to visual field. The authors propose, as a suggestion to be applied in Brazil, that the assessment of the visual field should be analyzed 20 degrees above and 20 degrees below the horizontal axis in each eye, as proposed by Berson et al4 . It is further proposed, also for these indexes, that there be standardization of the tests of threshold of night vision and reaction to glare with previous determination of parameters of ability and inability to be applied by the medical examiner. |
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Proposal for improvement of ophthalmological diagnostic techniques for professional drivers in BrazilProposta de aprimoramento das técnicas de diagnóstico oftalmológico para motoristas profissionais no BrasilTécnicas de diagnóstico oftalmológicoOftalmopatiasExame para habilitação de motoristasCondução de veículoDiagnostic techniquesophthalmologicalEye diseasesAutomobile driver examinationAutomobile driving.Introduction: Part of the motor vehicle accidents that occur on public roads may also be considered occupational accidents, given that the majority of those involved occur while in the service of companies. The main sense system used to drive is that of eyesight, which must be carefully evaluated in obtaining and renewing a of professional drivers license. Brazilian statistics indicate an overall increase in the number of deaths from traffic accidents, especially among professional drivers of large vehicles between 1998 and 2008. Compared to the United States, Brazil has a higher overall rate of deaths in road accidents. By the social and economic importance of this group of drivers, it is necessary to perform a more stringent ophthalmic evaluation than that performed in general population. Objective: Discuss the differences between the minimum indicators required by ophthalmological examination for obtaining and renewing professional driver’s license in Brazil and propose an improvement of ophthalmological diagnostic techniques for professional drivers in Brazil. Materials and Methods: We performed a literature review on the PubMed and SciELO databases and selected articles published in Portuguese and English between 1980 and 2011. The keywords used were: Ophthalmological diagnostic techniques, Eye diseases, Automobile driver examination and Automobile driving. As inclusion criteria, only articles were selected about professional drivers (categories C, D and E in Brazil, and groups A, B and C of commercial vehicle drivers in the United States). We excluded publications related to non-professional drivers (ACC, A and B in Brazil, and non-commercial vehicles in the United States). In both countries two indicators were assessed that had been used in ophthalmological diagnostic techniques as part of the examination for obtaining and renewing driver’s licenses of professional drivers: visual acuity (VA) and visual field (VF). The color vision test is the same in both countries, therefore not being a subject of discussion in this study. Results: In Brazil, the parameters for measurement of visual acuity, such as those of the visual field, are used more strictly. The indicators required in Brazil must be maintained, especially the visual field, considering that the higher the amplitude of the visual field, the safer it is for vehicle guidance. We suggest there be a screening evaluation of visual, cognitive and motor skills included in the medical examination, as can be done with the ADReS (Assessing Driving Related Skills) battery tests. With softwares like the Driving Health Inventory and the measurement of the Useful Field of View (UFOV) the expectation can be maintained that in a few years they will be applied with professional drivers, resulting in greater road safety not only to this class of professionals, but to the entire population. Conclusion: Indicators of visual acuity and visual field used in Brazil are stricter regarding those used in the United States of America. The requirement of color vision is the same in both countries. Despite vision acuity being controversial in the literature regarding driving ability and traffic safety, there are consistent data that provide evidence that more attention should be given to visual field. The authors propose, as a suggestion to be applied in Brazil, that the assessment of the visual field should be analyzed 20 degrees above and 20 degrees below the horizontal axis in each eye, as proposed by Berson et al4 . It is further proposed, also for these indexes, that there be standardization of the tests of threshold of night vision and reaction to glare with previous determination of parameters of ability and inability to be applied by the medical examiner.Introdução: Entre os acidentes automobilísticos que ocorrem em vias públicas, uma parte também pode ser considerada acidentes de trabalho, haja vista que a maioria dos envolvidos se encontra a serviço das empresas. O principal sistema orgânico utilizado no ato de dirigir é o sentido da visão, devendo este ser bem avaliado na obtenção e renovação da habilitação de motoristas profissionais. As estatísticas brasileiras apontam para um aumento global do número de óbitos por acidentes de trânsito, especialmente entre motoristas profissionais de veículos de grande porte entre 1998 e 2008. Em comparação com os Estados Unidos, o Brasil apresenta um maior índice global de óbitos no trânsito. Pela importância social e econômica desse grupo de motoristas, faz-se necessária a realização de uma avaliação oftalmológica mais estrita que na população em geral. Objetivos: Discutir sobre as diferenças entre os índices mínimos exigidos no exame oftalmológico para obtenção e renovação da carteira de habilitação profissional no Brasil e propor aprimoramento das técnicas de diagnóstico oftalmológico em motoristas profissionais no Brasil. Materiais e Métodos: Foi realizada uma revisão bibliográfica nas bases de dados Pubmed e SciELO em que foram selecionados os artigos publicados em português e inglês entre 1980 e 2011. As palavras-chave utilizadas foram: Técnicas de diagnóstico oftalmológico (Ophthalmological diagnostic techniques), Oftalmopatias (Eye diseases), Exame para habilitação de motoristas (Automobile driver examination) e Condução de veículo (Automobile driving). Foram pesquisados os sites do Código Nacional de Trânsito (Brasil) e do Federal Motor Carrier Safety Administration (Estados Unidos). Como critério de inclusão, foram selecionados apenas artigos sobre motoristas profissionais (categorias C, D e E no Brasil; e grupos A, B e C de motoristas de veículos comerciais nos Estados Unidos). Foram excluídas as publicações relacionadas a motoristas não profissionais (ACC, A e B no Brasil; e veículos não comerciais nos Estados Unidos). Nos países selecionados, foram avaliados dois indicadores utilizados nas técnicas de diagnóstico oftalmológico que fazem parte do exame para obtenção e renovação de habilitação de motoristas profissionais: acuidade visual (AV) e campo visual (CV). O teste de visão cromática é o mesmo nos dois países, não sendo, portanto, objeto de discussão neste estudo. Resultados: No Brasil, os parâmetros utilizados para a mensuração da acuidade visual são utilizados de forma mais rigorosa, assim como o campo visual. Os indicadores exigidos no Brasil devem ser mantidos, especialmente o campo visual, considerando-se que quanto maior a amplitude do campo visual, mais segura é a direção veicular. Sugere-se uma avaliação de triagem das habilidades visuais, cognitivas e motoras na ocasião do exame médico, como pode ser feito com a bateria de testes ADReS (Assessing Driving Related Skills). Softwares como o Driving Health Inventory e a medida do campo visual útil (Useful Field of View - UFOV) mantêm a expectativa de que em alguns anos eles possam ser aplicados nos motoristas profissionais, resultando em maior segurança no trânsito não apenas a esta classe de profissionais, mas a toda população. Conclusão: Os indicadores acuidade visual (AV) e campo visual (CV) utilizados no Brasil são mais estritos em relação aos do país norte-americano. Já a exigência quanto à visão cromática é a mesma nos dois países. Apesar da AV ser um indicador controverso na literatura quanto à capacidade de condução do motorista e de segurança no trânsito, já existem dados consistentes para que seja dada mais atenção ao exame de campo visual. Como proposto por Berson et al3, sugere-se, no Brasil, que na avaliação do campo visual sejam analisados 20o acima e 20o abaixo do eixo horizontal em cada olho. Propõe-se, ainda, também para esses índices, a padronização dos testes de limiar de visão noturna e de reação ao ofuscamento com determinação prévia de parâmetros de aptidão e inaptidão a serem aplicados pelo médico examinador.Universidade de São Paulo. Faculdade de Medicina. Departamento de Medicina Legal, Ética Médica e Medicina do Trabalho.2013-06-25info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionART.application/pdfhttps://www.revistas.usp.br/sej/article/view/7513610.11606/issn.2317-2770.v18i1p103-109Saúde Ética & Justiça ; v. 18 n. 1 (2013); 103-1092317-2770reponame:Saúde, Ética & Justiça (Online)instname:Universidade de São Paulo (USP)instacron:USPporhttps://www.revistas.usp.br/sej/article/view/75136/78694Sá, Eduardo CostaLessa, Gustavo FerreiraRachkorsky, Luiz Lippiinfo:eu-repo/semantics/openAccess2016-02-03T15:49:26Zoai:revistas.usp.br:article/75136Revistahttps://www.revistas.usp.br/sej/indexPUBhttps://www.revistas.usp.br/sej/oairevistasej@fm.usp.br||2317-27701414-218Xopendoar:2016-02-03T15:49:26Saúde, Ética & Justiça (Online) - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Proposal for improvement of ophthalmological diagnostic techniques for professional drivers in Brazil Proposta de aprimoramento das técnicas de diagnóstico oftalmológico para motoristas profissionais no Brasil |
title |
Proposal for improvement of ophthalmological diagnostic techniques for professional drivers in Brazil |
spellingShingle |
Proposal for improvement of ophthalmological diagnostic techniques for professional drivers in Brazil Sá, Eduardo Costa Técnicas de diagnóstico oftalmológico Oftalmopatias Exame para habilitação de motoristas Condução de veículo Diagnostic techniques ophthalmological Eye diseases Automobile driver examination Automobile driving. |
title_short |
Proposal for improvement of ophthalmological diagnostic techniques for professional drivers in Brazil |
title_full |
Proposal for improvement of ophthalmological diagnostic techniques for professional drivers in Brazil |
title_fullStr |
Proposal for improvement of ophthalmological diagnostic techniques for professional drivers in Brazil |
title_full_unstemmed |
Proposal for improvement of ophthalmological diagnostic techniques for professional drivers in Brazil |
title_sort |
Proposal for improvement of ophthalmological diagnostic techniques for professional drivers in Brazil |
author |
Sá, Eduardo Costa |
author_facet |
Sá, Eduardo Costa Lessa, Gustavo Ferreira Rachkorsky, Luiz Lippi |
author_role |
author |
author2 |
Lessa, Gustavo Ferreira Rachkorsky, Luiz Lippi |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Sá, Eduardo Costa Lessa, Gustavo Ferreira Rachkorsky, Luiz Lippi |
dc.subject.por.fl_str_mv |
Técnicas de diagnóstico oftalmológico Oftalmopatias Exame para habilitação de motoristas Condução de veículo Diagnostic techniques ophthalmological Eye diseases Automobile driver examination Automobile driving. |
topic |
Técnicas de diagnóstico oftalmológico Oftalmopatias Exame para habilitação de motoristas Condução de veículo Diagnostic techniques ophthalmological Eye diseases Automobile driver examination Automobile driving. |
description |
Introduction: Part of the motor vehicle accidents that occur on public roads may also be considered occupational accidents, given that the majority of those involved occur while in the service of companies. The main sense system used to drive is that of eyesight, which must be carefully evaluated in obtaining and renewing a of professional drivers license. Brazilian statistics indicate an overall increase in the number of deaths from traffic accidents, especially among professional drivers of large vehicles between 1998 and 2008. Compared to the United States, Brazil has a higher overall rate of deaths in road accidents. By the social and economic importance of this group of drivers, it is necessary to perform a more stringent ophthalmic evaluation than that performed in general population. Objective: Discuss the differences between the minimum indicators required by ophthalmological examination for obtaining and renewing professional driver’s license in Brazil and propose an improvement of ophthalmological diagnostic techniques for professional drivers in Brazil. Materials and Methods: We performed a literature review on the PubMed and SciELO databases and selected articles published in Portuguese and English between 1980 and 2011. The keywords used were: Ophthalmological diagnostic techniques, Eye diseases, Automobile driver examination and Automobile driving. As inclusion criteria, only articles were selected about professional drivers (categories C, D and E in Brazil, and groups A, B and C of commercial vehicle drivers in the United States). We excluded publications related to non-professional drivers (ACC, A and B in Brazil, and non-commercial vehicles in the United States). In both countries two indicators were assessed that had been used in ophthalmological diagnostic techniques as part of the examination for obtaining and renewing driver’s licenses of professional drivers: visual acuity (VA) and visual field (VF). The color vision test is the same in both countries, therefore not being a subject of discussion in this study. Results: In Brazil, the parameters for measurement of visual acuity, such as those of the visual field, are used more strictly. The indicators required in Brazil must be maintained, especially the visual field, considering that the higher the amplitude of the visual field, the safer it is for vehicle guidance. We suggest there be a screening evaluation of visual, cognitive and motor skills included in the medical examination, as can be done with the ADReS (Assessing Driving Related Skills) battery tests. With softwares like the Driving Health Inventory and the measurement of the Useful Field of View (UFOV) the expectation can be maintained that in a few years they will be applied with professional drivers, resulting in greater road safety not only to this class of professionals, but to the entire population. Conclusion: Indicators of visual acuity and visual field used in Brazil are stricter regarding those used in the United States of America. The requirement of color vision is the same in both countries. Despite vision acuity being controversial in the literature regarding driving ability and traffic safety, there are consistent data that provide evidence that more attention should be given to visual field. The authors propose, as a suggestion to be applied in Brazil, that the assessment of the visual field should be analyzed 20 degrees above and 20 degrees below the horizontal axis in each eye, as proposed by Berson et al4 . It is further proposed, also for these indexes, that there be standardization of the tests of threshold of night vision and reaction to glare with previous determination of parameters of ability and inability to be applied by the medical examiner. |
publishDate |
2013 |
dc.date.none.fl_str_mv |
2013-06-25 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion ART. |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/sej/article/view/75136 10.11606/issn.2317-2770.v18i1p103-109 |
url |
https://www.revistas.usp.br/sej/article/view/75136 |
identifier_str_mv |
10.11606/issn.2317-2770.v18i1p103-109 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/sej/article/view/75136/78694 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Medicina. Departamento de Medicina Legal, Ética Médica e Medicina do Trabalho. |
publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Medicina. Departamento de Medicina Legal, Ética Médica e Medicina do Trabalho. |
dc.source.none.fl_str_mv |
Saúde Ética & Justiça ; v. 18 n. 1 (2013); 103-109 2317-2770 reponame:Saúde, Ética & Justiça (Online) instname:Universidade de São Paulo (USP) instacron:USP |
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Universidade de São Paulo (USP) |
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USP |
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USP |
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Saúde, Ética & Justiça (Online) |
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Saúde, Ética & Justiça (Online) |
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Saúde, Ética & Justiça (Online) - Universidade de São Paulo (USP) |
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revistasej@fm.usp.br|| |
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