title: Sleep disorders and driving licence: the current Italian legislation and medico-legal issues.
abstract: Road traffic accidents (RTA) are a serious issue in all industrialized countries and have dramatic social and healthcare-related implications. Fatigue (sleepiness) is the principal identifiable and preventable cause of road traffic accidents. Obstructive sleep apnoea syndrome (OSAS) and narcolepsy are two of the leading causes of excessive daytime sleepiness. In this article, the authors analyze the current Italian legislation regarding driving licence issuance and fitness to drive, in order to evaluate the potential implications of sleep disorders, particularly OSAS and narcolepsy. In European Legislation and in Italy, OSAS and narcolepsy are not included among the illnesses or invalidating conditions that limit the fitness to drive for driving licence issuance purposes. In fact, they are not included in the Annex III of the European Council Directive 91/439/EEC of the 29th of July 1991 on driving licences. Some Countries of the European Union (Belgium, France, Finland, Great Britain, the Netherlands, Spain and Sweden) had implemented the 91/439/EEC Directive with national restrictions on driving licence issuance policies in case of OSAS and narcolepsy. Given the well-established scientific evidence available, in Italy, the lack of legislation regulating the assessment of the psychophysical requisites for the issuance and renewal of driving licences of individuals affected by sleep disorders seems extremely worrying. Furthermore, the current lack of legal obligation in Italy for healthcare facilities to disclose such diagnoses to the organs responsible for issuing driving licences (such as the Motorizzazione Civile - the Department of motor vehicles) remains the subject of heated debate.
authors.affiliation: Department of Experimental Medicine, Second University of Naples, Naples.
authors.forename: A
authors.initials: A
authors.lastname: Masullo
authors.affiliation: Department of Experimental Medicine, Second University of Naples, Naples.
authors.forename: A
authors.initials: A
authors.lastname: Feola
authors.affiliation: Section of Legal Medicine, University of Rome 'Tor Vergata', Rome.
authors.forename: V
authors.initials: V
authors.lastname: Marino
authors.affiliation: Division of Pulmonology, Second University of Naples, Naples.
authors.forename: C
authors.initials: C
authors.lastname: Iadevaia
authors.affiliation: Department of Anesthesiological, Surgical and Emergency Sciences, Second University of Naples, Naples.
authors.forename: M
authors.initials: M
authors.lastname: Trabucco Aurilio
authors.affiliation: Legal Medicine and Social Security Services, Department of Biomedicine and Prevention, University of Rome 'Tor Vergata', Rome, Italy.
authors.forename: L T
authors.initials: LT
authors.lastname: Marsella
mesh_terms: D000063:Accidents, Traffic; D001334:Automobile Driving / Q000331:legislation & jurisprudence*; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis* / Q000517:prevention & control; D005062:European Union; D005602:France; D006291:Health Policy / Q000331:legislation & jurisprudence*; D006801:Humans; D007558:Italy; D009290:Narcolepsy / Q000175:diagnosis*; D011050:Policy Making; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000517:prevention & control; D013030:Spain; D006113:United Kingdom; D014851:Wakefulness
keywords: OSAS; driving licence; medico-legal evaluation; narcolepsy