MEDC 9 (2038 ) DTZS / SADC SARA H T 93: 2017  
 
                                                                                                                                                                                             
                                                                                     
 
 
 
©TBS 20 23  First  Edition  DRAFT TANZANIA STANDARD  
 
 
 
MEDC 9 (20 38) CD2 / SADC SARA HT: 93 : 2017 - Railway Safety Management – Human 
Factors Management.  
 
 
 
 
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
TANZANIA BUREAU OF STANDARDS  
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
i 
©TBS 202 3 – All rights reserved  This Tanzania Standard was published under the authority of the Board o f Directors of Tanzania Bureau 
of Standards  2023 -mm-dd. 
 
Tanzania Bureau of Standards (TBS) is the statutory national standards body for Tanzania, established 
under the Standards Act No. 3 of 1975, amended by Act No. 2 of 2009.  
 
The Mechanical Engineering Divisional Standards Committee (MEDC) under whose supervision this 
Tanzania Standard was prepared consists of representatives from the following organizations:  
 
University of Dar es Salaam (UDSM)  
National Development Corporation (NDC)  
Weights and Measures  Agency (WMA)  
Tanzania Industrial Research Development Organization (TIRDO)  
Aluminium Africa  
*National Institute of Transport (NIT)  
Ministry of Works, Transport and Communications.  
 
The organization marked with an asterisk (*) in the above list togethe r with the following were directly 
represented on the Technical Committee entrusted with the preparation of this Tanzania Standard:  
 
Traffic Police HQ  
Land Transport Regulatory Authority (LATRA)  
University of Dodoma (UDOM)  
Superdoll Ltd  
 
 
 
 
 
 
 
 
 
Tanzania B ureau of Standards  
P O Box 9524  
Dar es Salaam  
Tel:  022 2450206/2450298/2450949  
Fax: 022 2450959  
E-mail: info@tbs.go.tz  
 
 
 
 
 
 
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
  
 
NATIONAL FOREWORD  
This Tanzania Standard has been prepared under Automotive Components Technical Committee 
(MEDC 09), unde r supervision of Mechanical Engineering Standards Divisional Committee.  
It is identical to SADC SARA HT: 93 : 2017, Railway Safety Management – Human Factors 
Management , published by SADC Cooperation in Standardization (SADCSTAN) . 
 
 
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
  
  SADC SARA HT: 93: 2017   
  
 
 
 
 
 
 
 
 
 
 
SADC HARMONISED TEXT   
 
Railway Safety Management – Human Factors 
Management  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
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 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
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 Foreword  
 
The SADC Protocol on Trade was established under the SADC Treaty in 1996, to provide 
for the  elimination of tariffs and  non-tariff barriers to trade.  One of the objectives of the 
Protocol on Trade under the Technical Barriers to Trade (TBT) Annex (No. 8) is to 
establish a common technical regulation framework, which is supported by seven (7) 
regional TBT Cooperation Struct ures. The TBT Annex places  an obligation on Member 
states to pursue harmonization of standards and this is done through the SADC 
Cooperation in Standardisation (SADCSTAN) which is one of the 7 regional TBT 
Cooperation Structures.  
 
Co-operation in standardi sation is expected to result into having uniformly harmonised 
standards. Harmonisation of standards within the region is expected to reduce TBTs that 
are normally encountered when goods and services are exchanged among SADC Member 
States due to differences  in technical requirements. Harmonized SADC Standards are also 
expected to result into benefits such as greater industrial productivity and competitiveness, 
increased agricultural production and food security, a more rational exploitation of natural 
resour ces among others.  
 
Harmonized SADC Standards are developed by the SADC experts on standards through 
SADCSTAN Technical Committees  representing the National Standards Bodies and other 
stakeholders. Further, SADCSTAN in certain instances collaborates with SA DC Sector 
Associations in the harmonization of standards to address sector specific needs. In this 
regard, SADCSTAN collaborated with Southern African Railway Association (SARA) in the 
harmonization of this standard.   
 
This SADC  Harmonized Standards was p repared by the SADCSTAN Technical Committee 
on Automobile and Transportation (SADCSTAN TC 2) in collaboration with SARA.  
 
SADC Harmonized Standards are drafted in accordance with the SADCSTAN 
Harmonization Procedures which are in line with international pr ocedures and practices.  
 
Attention is drawn to the possibility that some of the elements of this document may be the 
subject of patent rights. SADCSTAN shall not be held responsible for identifying any or all 
such patent rights.  
 
 
 
 
 
 
 
 
 
 
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
 
 
 
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Contents  
 
Acknowledg ement  ………………………………………………………………………………...i  
Foreword  .......................................................................................................................…...ii  
Contents ……………………………………………………………………………………………iii  
1 Scope  ................................ ................................ ................................ ............................  1 
2 Normative references  ................................ ................................ ................................ .... 2 
3 Terms, definitions and abbrev iations ................................ ................................ ..............  2 
4 Human factors in design (human -system interface)  ................................ .......................  7 
4.1 General  ................................ ................................ ................................ .................  7 
4.2 Requirements for the management of human factors in design  .............................  8 
4.3 Roles and responsibilities ................................ ................................ ......................  8 
4.4 Education and  training  ................................ ................................ ..........................  9 
4.5 Risk assessments  ................................ ................................ ................................ . 9 
4.6 Controls  ................................ ................................ ................................ ..............  10 
4.7 Monitori ng, evaluation and review  ................................ ................................ ....... 10 
5 Physical environmental factors  ................................ ................................ ....................  11 
5.1 Noise ................................ ................................ ................................ ...................  11 
5.1.1  General  ................................ ................................ ................................ .............  11 
5.1.2  Requirements for the management of noise  ................................ ......................  11 
5.1.3  Roles and responsibilities  ................................ ................................ ..................  11 
5.1.4  Education and training  ................................ ................................ .......................  12 
5.1.5  Risk assessments  ................................ ................................ .............................  12 
5.1.6  Controls  ................................ ................................ ................................ .............  13 
5.1.7  Monitoring, evaluation and review  ................................ ................................ ..... 13 
5.2 Vibration  ................................ ................................ ................................ ..............  14 
5.2.1 General  ................................ ................................ ................................ .............  14 
5.2.2  Requirements f or the management of vibration  ................................ .................  14 
5.2.3  Roles and responsibilities  ................................ ................................ ..................  15 
5.2.4  Education and training  ................................ ................................ .......................  15 
5.2.5  Risk assessments  ................................ ................................ .............................  15 
5.2.6  Controls  ................................ ................................ ................................ .............  16 
5.2.7  Monitoring, evaluation and review  ................................ ................................ ..... 16 
5.3 Lighting  ................................ ................................ ................................ ...............  16 
5.3.1  General  ................................ ................................ ................................ .............  16 
5.3.2  Requirements for the management of lighting  ................................ ...................  17 
5.3.3  Roles and responsibilities  ................................ ................................ ..................  17 MED C 9 (2038) DTZS / SADC SARA HT 93 : 2017  
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 5.3.4  Education and training  ................................ ................................ .......................  17 
5.3.5  Risk assessments  ................................ ................................ .............................  17 
5.3.6  Controls  ................................ ................................ ................................ .............  18 
5.3.7  Monitoring, evaluation and review  ................................ ................................ ..... 19 
5.4 Thermal environment  ................................ ................................ ..........................  19 
5.4.1  General  ................................ ................................ ................................ .............  19 
5.4.2  Requirements for the management of the thermal environment  ........................  20 
5.4.3  Roles and responsibilities  ................................ ................................ ..................  20 
5.4.4  Education and training  ................................ ................................ .......................  20 
5.4.5  Risk assessments  ................................ ................................ .............................  21 
5.4.6  Controls  ................................ ................................ ................................ .............  21 
5.4.7  Monitoring, evaluation and review  ................................ ................................ ..... 22 
5.5 Hazardous substances and agents  ................................ ................................ ..... 22 
5.5.1  General  ................................ ................................ ................................ .............  22 
5.5.2  Requirements for the management of hazardous substances and agents  .........  22 
5.5.3  Roles and responsibilities  ................................ ................................ ..................  23 
5.5.4  Education and training  ................................ ................................ .......................  23 
5.5.5  Risk assessments  ................................ ................................ .............................  24 
5.5.6 Controls  ................................ ................................ ................................ .............  24 
5.5.7  Monitoring, evaluation and review  ................................ ................................ ..... 24 
6 Organizational and psychological factors  ................................ ................................ ..... 25 
6.1 Recruitment and selection  ................................ ................................ ...................  25 
6.1.1  General  ................................ ................................ ................................ .............  25 
6.1.2  Requirements for the management of recruitment and selection  .......................  25 
6.1.3  Recruitment and selection principles  ................................ ................................ . 25 
6.1.4  Development of recruitment and selection cri teria ................................ .............  26 
6.1.5  Sourcing strategy  ................................ ................................ ..............................  28 
6.1.6  Selection methods  ................................ ................................ .............................  28 
6.1.7 Assessment procedures  ................................ ................................ ....................  29 
6.1.8  Appointment and placement  ................................ ................................ ..............  31 
6.1.9  Monitoring, evaluation and review  ................................ ................................ ..... 31 
6.2 Training and development  ................................ ................................ ...................  31 
6.2.1  General  ................................ ................................ ................................ .............  31 
6.2.2  Requirements for the manageme nt of training and development  .......................  32 
6.2.3  Roles and responsibilities  ................................ ................................ ..................  33 
6.2.4  Training and development elements  ................................ ................................ .. 34 
6.2.5  Assessment and moderation  ................................ ................................ .............  35 
6.2.6  Certification and licensing  ................................ ................................ ..................  36 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
 
 
 
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 6.2.7  Management information system  ................................ ................................ ....... 37 
6.2.8  Monitoring, evaluation and review  ................................ ................................ ..... 37 
6.3 Medical surveillance  ................................ ................................ ............................  38 
6.3.1  General  ................................ ................................ ................................ .............  38 
6.3.2  Requirements for the management of medical surveillance  ...............................  39 
6.3.3  Code of practice  ................................ ................................ ................................  39 
6.3.4  Declaration  ................................ ................................ ................................ ........  39 
6.3.5  Education and training  ................................ ................................ .......................  40 
6.3.6  Health assessments  ................................ ................................ ..........................  40 
6.3.7  Roles and responsibilities  ................................ ................................ ..................  42 
6.3.8  Communication of health -related information  ................................ ....................  42 
6.3.9  Monitoring, evaluation and review  ................................ ................................ ..... 43 
6.4 Fitness for duty  ................................ ................................ ................................ ... 43 
6.4.1  General  ................................ ................................ ................................ .............  43 
6.4.2  Requirements for the management of fitness for duty  ................................ ........  44 
6.4.3  Roles and responsibilities  ................................ ................................ ..................  44 
6.4.4  Declaration  ................................ ................................ ................................ ........  45 
6.4.5  Education and training  ................................ ................................ .......................  46 
6.4.6  Health assessments  ................................ ................................ ..........................  46 
6.4.7  Training and development  ................................ ................................ .................  46 
6.4.8  Readiness for duty  ................................ ................................ ............................  46 
6.4.9  Fitness on duty  ................................ ................................ ................................ .. 47 
6.4.10  Return to work  ................................ ................................ ................................ ... 47 
6.4.11  Monitoring, evaluation and review  ................................ ................................ ..... 48 
6.5 Chronic medical conditions  ................................ ................................ .................  48 
6.5.1  General  ................................ ................................ ................................ .............  48 
6.5.2  Requirements for the management of chron ic medical conditions  .....................  48 
6.5.3  Code of practice  ................................ ................................ ................................  49 
6.5.4  Declaration  ................................ ................................ ................................ ........  49 
6.5.5  Education and training  ................................ ................................ .......................  50 
6.5.6  Health assessments  ................................ ................................ ..........................  50 
6.5.7  Monitoring, evaluation and review  ................................ ................................ ..... 51 
6.6 Medication  ................................ ................................ ................................ ..........  51 
6.6.1  General  ................................ ................................ ................................ .............  51 
6.6.2  Requirements for the management of emplo yees on medication  ......................  52 
6.6.3  Declaration  ................................ ................................ ................................ ........  52 MED C 9 (2038) DTZS / SADC SARA HT 93 : 2017  
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 6.6.4  Education and training  ................................ ................................ .......................  53 
6.6.5  Health assessments  ................................ ................................ ..........................  53 
6.6.6  Monitoring, evaluation and review  ................................ ................................ ..... 54 
6.7 Pregnancy  ................................ ................................ ................................ ...........  54 
6.7.1  General  ................................ ................................ ................................ .............  54 
6.7.2  Requirements for the programme to manage pregnant employees  ...................  54 
6.7.3  Recruitment and selection  ................................ ................................ .................  55 
6.7.4  Risk management  ................................ ................................ .............................  55 
6.7.5  Declaration  ................................ ................................ ................................ ........  55 
6.7.6  Education and training  ................................ ................................ .......................  55 
6.7.7  Health assessments  ................................ ................................ ..........................  56 
6.7.8  Deployment  ................................ ................................ ................................ ....... 56 
6.7.9  Workplace arrangements  ................................ ................................ ..................  57 
6.7.10  Monitoring, evaluation and review  ................................ ................................ ..... 57 
6.8 Employee wellness  ................................ ................................ .............................  57 
6.8.1  General  ................................ ................................ ................................ .............  57 
6.8.2  Requirements to manage employee wellness ................................ ....................  57 
6.8.3  Roles and responsibilities  ................................ ................................ ..................  58 
6.8.4  Education and training  ................................ ................................ .......................  58 
6.8.5  Interventions  ................................ ................................ ................................ ...... 58 
6.8.6  Monitoring, evaluation and review  ................................ ................................ ..... 59 
6.9 Substance abuse  ................................ ................................ ................................  59 
6.9.1  General  ................................ ................................ ................................ .............  59 
6.9.2  Requirements for the management of substance abuse  ................................ .... 60 
6.9.3  Roles and responsibilities  ................................ ................................ ..................  61 
6.9.4  Education and training  ................................ ................................ .......................  61 
6.9.5  Testing  ................................ ................................ ................................ ..............  62 
6.9.6  Treatment and rehabilitation interventions  ................................ .........................  63 
6.9.7  Monitoring, evaluation and review  ................................ ................................ ..... 64 
6.10 Fatigue management  ................................ ................................ ..........................  64 
6.10. 1 General  ................................ ................................ ................................ .............  64 
6.10.2  Requirements to manage fatigue  ................................ ................................ ....... 65 
6.10.3  Roles and responsibilities  ................................ ................................ ..................  65 
6.10.4  Education and training  ................................ ................................ .......................  66 
6.10.5  Risk management  ................................ ................................ .............................  66 
6.10.6  Controls  ................................ ................................ ................................ .............  67 
6.10.7  Monitoring, evaluation and review  ................................ ................................ ..... 68 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
 
 
 
vii 
 6.11 Stress management  ................................ ................................ ............................  69 
6.11.1  General  ................................ ................................ ................................ .............  69 
6.11.2  Requirements to manage stress  ................................ ................................ ........  70 
6.11.3  Roles and responsibilities  ................................ ................................ ..................  71 
6.11.4  Education and training  ................................ ................................ .......................  71 
6.11.5  Risk management  ................................ ................................ .............................  71 
6.11.6  Controls  ................................ ................................ ................................ .............  72 
6.11.7  Monitoring, evaluation and review  ................................ ................................ ..... 72 
Annex A  (informative)   General human -factors -in-design checklists  ..............................  72 
Annex B  (informative)   Thermal environmental conditions for enclosed spaces  .............  77 
Annex C  (normative)   Essential guidelines for the development of a code of practice for 
medica l surveillance  ................................ ................................ ................................ ........  77 
Annex D  (normative)   Medical action and exclusion criteria for employees who undertake 
safety -related -work  ................................ ................................ ................................ ..........  78 
Annex E  (informative)   Potential side effects of certain medication  ..............................  105 
Annex F  (informative)   Guidelines for the development of an employee wellness 
programme  ................................ ................................ ................................ ....................  108 
Annex G  (informative)   Signs and symptoms of stress  ................................ .................  110 
Bibliography  ................................ ................................ ................................ ...................  114 
 
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
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_____________________________________ ____________  
Railway Safety Management – Human Factors Management 
_______________________________________________ __ 
 
1 Scope  
 
1.1 This standard  provides minimum requirements to RA‟s  for the man agement of HF  for 
employees who undertake safety -related work. It is to read and implemented in 
conjunction with the relevant national legislation and applicable standards  applicable 
in the country in which the RA operates as well as other SARA safety standards . 
 
1.3 This standard  applies to employees who undertak e safety-related work  as determined 
by the RA. The  RA may expand the scope of HF management to include employees  
who do not undertake safety -related work . 
 
1.4 HF management comprises the following : 
 
a) human  factors  in design (human -system  interface);  
 
b) physical environmental factors:  
 
1) noise ; 
 
2) vibration ; 
 
3) lighting ; 
 
4) thermal environment ; and 
 
5) hazardous substances and agents; and  
 
c) organizational and psychological factors:  
 
1) recruitment and selection ; 
 
2) training and development ; 
 
3) medica l surveillance;  
 
4) medication;  
 
5) chronic diseases ; 
 
6) fitness  for duty; 
 
7) fatigue (shift work , night work  and call-outs); 
 
8) substance abuse;  
 
9) pregnancy;  
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
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 10) stress ; and  
 
11) employee wellness.  
 
 
2 Normative references  
 
The following referenced documents are indispensable for the application of this 
document. For dated references, the latest edition of the referenced document (including 
any amendments) applies. Information on currently valid national and international 
standards can be obtained fr om the relevant National Standards Body (NSB) or SARA.  
 
The following standards or any other relevant national or international standard  shall be 
referenced as required by each RA:  
 
SADC SARA HT 89 : Railway Safety Management  – General  
 
SADC SARA HT 90 : Ra ilway Safety Management – Technical requirements for 
engineering and operational standards  - General  
 
Relevant national legislation  applicable to each RA  has to be referenced as mentioned in 
the foreword  
 
3 Terms, definitions and abbreviations  
 
For the pur poses of this document, the terms, definitions and abbreviations given in SA RA 
001 and the following apply . 
 
3.1 Terms and definitions  
 
3.1.1  
action criteria  
measures used to determine the action to be taken when specific criteria related to fitness  
for duty are not met  
 
3.1.2  
acute  
having a rapid onset and following a short but severe course  
 
3.1.3  
anthropometric  
relating to  human dimensional data that guide the mos t efficient design of equipment, 
tools, furniture, and clothing to ensure safety and comfort  
 
3.1.4  
biological monitoring  
a planned, ongoing programme of periodic collection and analysis of body fluid, tissues, 
excreta or exhaled air in order to detect and quantify the exposure to or absorption of any 
substance or organisms by employees  
 
3.1.5  
biomechanics  
application of mechanical principles to living organisms  
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
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 3.1.6 
chronic disease  
disease th at is long -lasting or recurrent  
 
NOTE  The term "chronic disease" is u sually applied to a condition that lasts longer  than 
six months  
 
3.1.7 
circadian rhyth m 
cycle of biological activity that is based on a 24 -hour period and influenced by regular 
variations in the environment, such as the alternation of night and day  
 
NOTE  Circadian rhythms are generated by an internal clock that is synchronized to light -
dark cycles and other cues in an organism's environment and include sleeping and waking 
up. 
 
3.1.8 
competency profile  
list of competencies, qualifications, knowledge, skills, attitudes and capabilities required to 
perform a specific job successfully  
 
3.1.9  
competent  
having the qualifications, knowledge, skills, attitudes and capabilities required to function 
successfully in a given job  
 
3.1.10  
engineer  
person who uses scientific knowledge to solve practical problems and who is skilled in the 
principles and prac tice of any branch of engineering  
 
3.1.11  
ergonomics  
scientific discipline concerned with the understanding of interactions among humans and 
other elements of a system, and the profession that applies theory, principles, data and 
other methods to design in  order to optimize human well -being and overall system 
performance  
 
 
 
 
3.1.12 
exclusion criteria  
criteria used to determine whether an employee is excluded from performing a specific job 
or task  
 
3.1.13  
exposure time  
duration per day that a worker is expos ed to an environmental stressor  
 
3.1.14 
fatigue risk periods  MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
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 periods during day or night, influenced largely by circadian rhythms and hours awake when 
a person is likely to either fall asleep or show signs of fatigue , which might lead to unsafe 
actions  
 
3.1.15 
health assessment  
evaluation of the health status of an employee and that includes the health history,  a 
physical examination and special tests  
 
NOTE  Special tests may include v arious laboratory and functional tests to confirm a 
clinical impression or  to screen for possible disease to determine fitness for duty . 
 
3.1.16 
health practitioner  
person  (excluding a student ) that practis es in a health profession that is regulated by a 
responsible council/board  
 
3.1.17 
health risk assessment  
process of identif ying health hazards and associated risks that employee s are  exposed to , 
and of determin ing the actions to be taken to mitigate, terminate or control such hazards  
 
3.1.18 
inherent job requirement  
core dut y that is carried out to fulfil the purpose of a job  
 
NOTE  Job requirements refer to what is accomplished ( i.e. results) by the job, rather than 
how or the means through which it is accomplished. Inherent job requirements are used to 
recruit and select appropriate persons  and to assess fitness  for duty.  
 
3.1.19 
job profile  
list of requirements for a specific job, including the required qualifications, skills and 
competencies, key performance indicators, and challenges and deliverables  
 
3.1.20  
medical condition  
abnormal state of the body associated with specif ic symptoms  and signs  
 
3.1.21  
medical fitness for duty  
determination made by an occupational medicine practitioner , subject to any restrictions or 
requirements, that an employee has under gone  the medical assessments required , and 
that the employee complies with  all of the medical fitness for duty requirements for a 
specific job  
 
3.1.22  
medical surveillance  
a planned p rogramme  or periodic examination (which may include clinical examinations, 
biological monitoring or medical tests), of employees by an occupational health practioner, 
or in prescribed cases by an occupational medicine practioner  
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
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 3.1.23  
medication  
substance  intended for use in a medical diagnosis , cure, treatment  or prevention  of a 
disease  
 
NOTE  Medication is also r eferred to as medicine  or medicament, treatment, pills and 
drugs.  
 
3.1.24  
moonlighting  
work at another job, often at night, in addition to one‟s regular job  
 
3.1.25  
occupational exposure limit  
OEL 
limit value for a stress factor in the workplace  as per relevant national legislation  
 
3.1.26  
occupational health  
OH 
promotion and maintenance of the highest degree of physical, mental and social well -being 
of workers in all occupations by preventing departur es from health, controlling risks and 
the adap tation of work to p eople, and people to their jobs  
 
[ILO/WHO 1950]  
 
3.1.27  
occupational health practitioner  
OHP  
An occupational medicine practioner or a person who holds a qualification in occupational 
health a s recognised by a relevant national health (medical, dental, nursing) council  
 
3.1.28  
occupational hygiene  
the anticipation, recognition, evaluation and control of conditions arising in or from the 
workplace, which may cause illness or adverse health effec ts to persons  
 
3.1.29  
occupational medicine practitioner  
OMP  
a medical practioner as defined in the relevant national  professional  health (medical and 
dental) council or who holds a qualification in occupational medicine or an equivalent 
qualification that  is recognized by national professional health (medical and dental) council  
 
 
3.1.30  
psychometric te st 
series of questions, problems or practical tasks that provide a measurement of aspects of 
somebody's personality, knowledge, ability or experience, and t hat are divided into three 
main categories , namely ability or aptitude test, achievement test, and personality test  
 
3.1.31 
rostering practices  MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
6 
 work time arrangements (work schedules or rosters)  for all employees  and shift patterns 
for shift workers  
 
3.1.3 2 
safety critical work  
functions and activities related to the authorization and control of the movement of rolling 
stock  
 
NOTE This includes the direct supervision of those functions and activities  
 
3.1.3 3 
safety related work  
functions and activities that  have an impact on safe railway operations  
 
3.1.34 
selection criteria  
qualifications, knowledge, skills, qualities, experience, abilities  and characteristics needed 
to fulfil the requirements of a job  
 
3.1.35 
shift swapping  
changes in shifts  or working on scheduled days off (or both), either requested by workers 
or by employers  
 
3.1.3 6 
side effect  
secondary and usually adverse effect of a drug or therapy  
 
3.1.37 
sleep hygiene  
behavioural and environmental factors that  might impact on the quality of sleep  
 
3.1.38 
staffing  
process whereby persons  are recruited, selected, trained, deployed and retained  for work  
 
 
 
3.1.39 
whole -body vibration  
mechanical vibration that is transmitted to the whole body, usually through a seat or the 
feet, and that  entails risks to  the health and safety of workers, in particular lower -back 
morbidity and trauma of the spine  
 
3.1.40 
workload  
number of tasks to be performed in a given time  
 
3.1.40 
workload assessment  
evaluation of the amount of work assigned to a specific worker  
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
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 3.2 Abbreviations  
 
AIA approved inspection authority  
COP  code of practice  
EAP employee assistance programme  
HF human factors  
HFID  human factors in design  
NIHL  noise induced hearing loss  
OHP  occupational health practitioner  
OMP  occupational medicine practitioner  
OHS  occupational health and safety  
RA railway administration  
SARA  Southern African Railway Association  
 
4 Human  factors  in design (human -system  interface)  
 
4.1 General  
 
4.1.1  Human Factors in Design ( HFID) includes the match ing of  tools, equipment, 
machines, systems, tasks, jobs , work processes, work stations,  and environments 
to the physical and psychological capabilities and limitations of people. In doing so 
it seeks to safeguard safety, health,  and well -being whilst optimi zing efficiency and 
perform ance.  
 
NOTE  Specialists such as ergonomists/ HF specialists, engineers, physiologists, medical 
practitioners, psychologists, industrial designers,  and occupational hygienists 
contribute to HF information.  
 
4.1.2  HFID should apply to tasks and the life  cycle  of tools, machines, equipment,  and 
systems.  
 
NOTE  The life  cycle includes a feasibility study, design, construction/manufacturing, 
commissioning, operations, monitoring and maintenance, modification, and 
decommissioning and disposal (see SA RA 001 and SARA  002) 
 
4.1.3  HFID should take into account the 5th percentile of female and 95th percentile of 
male anthropometrics and biomechanics  including  variations of physical strength, 
reaching distance and body size . Thus it should account for the smallest female to 
the largest male . 
 
4.1.4  HFID should take into account the cognitive ability, short - and long -term memory, 
and the decision -making and problem -solving abilities of employees.  
 
4.1.5  Poor design might expose employees to hazards that could impact on safe  railway 
operations . The results of poor design  includ e the following : 
 
a) awkward body positions – stretching, bending and crouching;  
 
b) sustained body positions;  
 
c) excessive forces required to perform tasks – hand grip, lifting, pushing or pulling;  
 
d) excessive manual materials handling  – holding, carrying, lifting or lowering, pushing or 
pulling ; MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
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e) repetitive movements and strain – number, duration and frequency;  
 
f) unsafe work procedures; and  
 
g) environmental issues – excessive noise, vibration,  and radiation, thermal discomfort, 
poor air quality, poor lighting and exposure to toxic substances.  
 
4.1.6  The effects of poor design that might impact on safe railway operations include  the 
following : 
 
a) impaired cognitive functioning – reduced concent ration and vigilan ce, irritability and 
confusion;  
 
b) impaired vision;  
 
c) changes in reaction time;  
 
d) burnout, stress and fatigue;  
 
e) drowsiness (even with proper rest);  
 
f) lower back pain;  
 
g) muscular -skeletal , vascular and neurological disorders ; 
 
h) unsafe work practices; and  
 
i) noise induced hearing loss.  
 
4.1.7  RA‟s  and employees have a mutual responsibility to ensure that HFID do not 
impact on safe railway operations.  
 
4.1.8  The employee shall report unsafe working conditions as a result of poo r design.  
 
4.2 Requirements for the management of human  factors  in design  
 
4.2.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and procedures for the manage ment of  HFID in accordance 
with the relevant nation al legislation  (see foreword) . 
 
4.2.2  The requirements to manage HFID shall include  the following : 
 
a) roles and responsibilities;  
 
b) education and training;  
 
c) risk assessment s; 
 
d) controls; and  
 
e) monitoring, evaluation and review.  
 
4.3 Roles and res ponsibilities  
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
9 
 4.3.1  The RA shall 
 
a) appoint a person  with the relevant authority and responsibility to manage HFID,  and 
 
b) define the roles and responsibilities of the appointed person . 
 
4.3.2  The appointed person  shall, where relevant, use the services  of authorities and 
professionals , including  the following : 
 
a) ergonom ists/HF specialists;  
 
b) engineers;  
 
c) physiologists;  
 
d) occupational medic ine practitioners  (OMP s); 
 
e) psychologists;  
 
f) biokineticists;  
 
g) industrial designers; and  
 
h) occupatio nal hygienists.  
 
4.3.3  The RA shall ensure that employees are subjected to risk -based medical 
surveillance  (as defined in the relevant legislation (see foreword)) as specified in 
6.3. 
 
4.4 Education and training  
 
The RA shall establish, develop or adopt, d ocument, implement and maintain policies, 
processes,  and procedures to educate and train management and employees in matters 
that relate to HFID , including  the following : 
a) the relevant national legislation  (see foreword) , policies, processes and procedur es; 
 
b) roles and responsibilities;  
 
c) health effects and safety risks at work and off  the job; 
 
d) the purpose of risk assessment s; 
 
e) the purpose of the medical surveillance  programme ; and 
 
f) controls . 
 
4.5 Risk assessment s 
 
4.5.1  The RA shall establi sh, develop or adopt, document, implement and maintain 
policies, processes and procedures for conducting risk assessment s that relate to 
HFID in accordance with the relevant national  legislation  (see foreword) . 
 
4.5.2  Risk assessments  shall include  the fol lowing : 
 
a) identifying jobs/task s/activities /tools/equipment  and work environments where 
employees are exposed to hazards due to poor design  as detailed in annex  A; 
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
10 
 b) identifying and listing of hazards related to specific jobs/tasks/activities /tools/equ ipment  
and the employees who are exposed;  
 
 EXAMPLE  Hazards include poor layout of work environments, inconsistent control 
design and contradicting controls.  
 
c) determining the level of risk during the life  cycle;  
 
 NOTE  The risk asses sment  should conside r the additive or synergistic effect of 
exposure to hazards.  
 
d) determining the HFID requirements for machines, systems, 
jobs/task s/activities /tools/equipment  and work environments in consultation with the 
relevant employees;  
 
e) evaluating control measur es; 
 
f) determining the potential impact on health and safety; and  
 
g) summarizing findings and recommendations.  
 
4.5.3 The risk assessments  shall be reviewed on a regular basis at intervals not exceeding 
24 months or when  
 
a) evidence suggests that the risk assessments  are no longer valid , or 
 
b) changes have been made to the  machines, systems , 
jobs/tasks/activities /tools/equipment , work environment or existing controls.  
 
4.6 Controls  
 
4.6.1  The RA shall establish, develop or adopt, document, implement and  maintain 
policies, processes and procedures for the implement ation of  controls  to manage 
HFID . 
 
4.6.2  Controls shall include  the following : 
 
a) determining the HFID  requirements of tools, equipment, machines and systems  during 
the life cycle;  
 
b) ensuring  that tools, equipment, machines and systems  comply with HFID  
requirements;  
 
c) establishing  standards for the procurement of tools, equipment , machines and systems 
to comply with HFID requirements ; 
 
d) redesigning, modifying and refurbishing work processe s, work stations, tools, 
equipment, machines and systems  in accordance with HFID requirements ; 
 
e) training in the correct implementation of controls; and 
 
f) manag ing employees who might be or who are adversely affected  (see 6.3). 
 
4.7 Monitoring, evaluat ion and review  
 
The RA shall establish, develop or adopt, document, implement and maintain policies, 
processes and procedures to monitor, evaluate and review the management of HFID . MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
11 
  
5 Physical environment al factors  
 
5.1 Noise  
 
5.1.1 General  
 
5.1.1 .1 Noise  refers to any unwanted or disturbing sound that interferes with the detection 
and hearing of wanted sounds.  
 
NOTE  Wanted sounds include warning signals and verbal commands.  
 
5.1.1.2 The effect of noise on employees that might impact on sa fe railway operat ions 
includes  the following : 
 
a) noise -induced fatigue;  
 
b) temporary or permanent NIHL;  
c) impaired concentration;  
 
d) interference with communication, decision  making and thought processes;  
 
e) the masking of wanted sounds essential for operation al critical communication; and  
 
f) a negative impact on health and lifestyle.  
 
5.1.1.3  RA‟s  and employees have a mutual responsibility to ensure  that noise does not 
impac t on safe railway operations.  
 
5.1.2 Requirements for the management of  noise  
 
5.1.2.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and procedures for the manage ment of  noise in accordance 
with the relevant national  legislation  (see foreword) . 
 
5.1.2.2  The requirements to manage noise shall include  the following : 
 
a) roles and responsibilities;  
 
b) education and training;  
 
c) risk assessments ; 
 
d) controls; and  
 
e) monitoring, evaluation and review.  
 
5.1.3 Roles and responsibilities  
 
5.1.3.1  The RA shall 
 
a) appoint a person  with the relevant authori ty and responsibility to manage noise , and 
 
b) define the roles and responsibilities of the appointed person . 
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
12 
 5.1.3.2  The appointed person  shall, where relevant, use the services of authorities and 
professionals , including  
 
a) an approved noise inspection  authority in accordance with  the relevant national  
legislation  (see foreword),  
 
b) health practitioners , 
 
c) audiometrists , and 
 
d) acoustic (sound) engineers.  
 
5.1.3.3  The RA shall ensure that employees are subjected to risk -based medical 
surveillance as  specified in 6.3. 
 
5.1.4 Education and training  
 
The RA shall establish, develop or adopt, document, implement and maintain policies, 
processes and procedures to educate and train management and employees in matters 
that relate to noise, including  the fol lowing : 
 
a) the relevant national  legislation  (see foreword) , policies, processes and procedures;  
 
b) health and safet y risks as detailed in 5.1 .1.2 at work and off -the-job; 
 
c) roles and responsibilities;  
 
d) the purpose of noise surveys;  
 
e) the purpose of the medical surveillance programme;  and 
 
f) controls . 
 
5.1.5 Risk assessment s 
 
5.1.5.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and procedures for conducting risk assessments that relate to 
noise , in accordance with  the relevant national  legislation  (see foreword) . 
 
5.1.5.2  Risk assessments shall include  the following : 
 
a) identifying  the jobs/tasks/activities /tools/equipment  and work environments where 
noise might impact on safe railway op erations as  specified in 5. 1.1.2; 
 
b) determining the inherent hearing requirements employees should meet to undertake 
specific safety -related jobs/tasks/activities;  
 
 NOTE  Requirements in respect of ability to hear are specified in 6.3. 
 
c) describ ing the nature and  level (extent) of interference as a result of noise;  
 
 NOTE  This describes the way in which  employees subjectively experience 
interference as a result of noise  in their working environments.  
 
d) identifying noise sources;  
 
e) determining noise levels;  MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
13 
  
f) determining the frequency of exposure; and  
 
g) evaluating control measures.  
 
5.1.5.3  Risk assessments shall be reviewed on a regular basis at intervals not exceeding 
24 months or , when  
 
a) evidence suggests that the risk assessment is no longer valid , or 
 
b) changes have been made to the  jobs/tasks/activities /tools/equipment , work 
environment or existing controls.  
 
5.1.6 Controls  
 
5.1.6.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and procedures for the implement ation of  controls to manage 
noise in accordance with  the relevant national  legislation  (see foreword) . 
 
NOTE  The management of noise includes implementing controls during the design phase 
of equipment and work environments to minimize noise, preven t NIHL and to 
ensure accurate and effective communication.  
 
5.1.6.2  Controls shall include  the following : 
 
a) implementing recommendations of relevant specialists to prevent the effect of noise 
that might impact on safe railway opera tions in accordance wit h 5.1.1.2; 
 
b) implementing engineering control measures during the design phase of the life cycle 
(see SADC  SARA  HT 89  and SADC  SARA HT 90 ) to achieve ambient noise levels to 
below  an equivalent continuous rating level ( LReq.T) of 75  dB in order to ensure  accurate 
and effective operational critical communication in relevant w ork environments;  
 
c) implementing a hear ing conservation programme;  
 
d) ensuring that all employees working in noise zones are subjected to audiometric 
testing at pre -employment -, during transfer, periodic - and at exit medical examinations 
in accordance with  6.3; and  
 
e) providing appropriate hearing protective equipment , taking the following factors into 
consideration:  
 
1) suitability for the work being carried out ; 
 
2) the noise attenuatio n offered by the equipment ; 
 
3) operational critical communication and the hearing of warning sounds that are not 
compromised ; 
 
4) compatibility with other safety equipment ; and 
 
5) the pattern of the noise exposure.  
 
5.1.7 Monitoring, evaluation and review  
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
14 
 The RA shall establish, develop or adopt, document, implement and maintain policies, 
processes and procedures to monitor  evaluate and review the management of noise.  
 
5.2 Vibration  
 
5.2.1  General  
 
5.2.1.1  In the context of this clause vibration refers to whole -body vibration and hand -arm 
vibration.  
 
5.2.1.2  The physiological effects as a result of vibration on employees that might impact on 
safe railway operations include  
 
a) blurred vision , 
 
b) reduced coordination , 
 
c) drowsiness (even with proper rest) , 
 
d) lower back pain , 
 
e) insomnia , 
 
f) headaches , and 
 
g) neurological, muscul o-skeletal  and vascular disorders . 
 
NOTE  Vibration might impact on pregnancy outcome s (see 6.7). 
 
5.2.1.3  The physiological effects of vibration might be delayed between 1  to 16 years . This 
period is referred to as the latency period . 
 
5.2.1.4  RA‟s  and employees have a mutual responsibility to ensure that vibration does not 
impact on safe railway operations.  
 
5.2.2  Requirements  for the management of vibration  
 
5.2.2.1 The RA shall estab lish, develop or adopt, document, implement and maintain 
policies, processes and procedures for the manage ment of  vibration  in accordance 
with the relevant national legislation  (see foreword) . 
 
5.2.2.2 The requirements to manage vibration shall include  the following : 
 
a) roles and responsibilities;  
 
b) education and training;  
 
c) risk assessments ; 
 
d) controls; and  
 
e) monitoring, evaluation and review.  
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
15 
 5.2.3  Roles and responsibilities  
 
5.2.3.1 The RA shall 
 
a) appoint a person  with the relevant authority and responsibility to manage vibration , and 
 
b) define the roles and responsibilities of the appointed person . 
 
5.2.3.2 The appointed person  shall use, where relevant, the services of authorities and 
professionals , including:  
 
a) an AIA in accordance with the relevant national  legislation  (see foreword) ; 
 
b) occupational health practitioners (OHP s); and  
 
c) engineer s. 
 
5.2.3.3 The RA shall ensure that employees are subjected to risk -based medical 
surveillance as specified in 6.3. 
 
5.2.4  Education and traini ng 
 
The RA shall establish, develop or adopt, document, implement and maintain policies, 
processes,  and procedures to educate and train management and employees in matters 
that relate to vibration, including  the following : 
 
a) the relevant national  legisla tion (see foreword) , policies, processes and procedures;  
 
b) health and safety risks at work and off -the-job; 
 
c) roles and responsibilities;  
 
d) safe working practices;  
 
e) possible sources of vibration;  
 
f) the purpose of a medical surveillance  programme ; and 
 
g) controls . 
 
5.2.5  Risk assessment s 
 
5.2.5.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and procedures for conducting  risk assessments  that relate to 
vibration in accordance with the relevant nati onal legislation  (see foreword) . 
 
5.2.5.2  risk assessments shall include  the following : 
 
a) identifying jobs/task s/activities /tools/equipment  and work environments where 
employees are exposed to vibration;  
 
b) identifying the type of vibration and the numb er of employees exposed;  
 
c) evaluating vibration hazards and  risk level s; 
 
d) determining the potential impact on health and safety;  and 
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
16 
 e) evaluating control measures.  
 
5.2.5.3  Risk assessments shall be reviewed on a regular basis at intervals not excee ding 
24 months , or when  
 
a) evidence suggests that the risk assessment is no longer valid , or 
 
b) changes have been made to the jobs/tasks/activities /tools/equipment , work 
environment or existing controls.  
 
5.2.6  Controls  
 
5.2.6.1  The RA shall establish, d evelop or adopt, document, implement and maintain 
policies, processes and procedures for the implement ation of  controls to manage 
vibration in accordance with the relevant national legislation  (see foreword) . 
5.2.6.2  Controls shall include  
 
a) recommendati ons from relevant professionals , 
 
b) the management of employees who are or who might be affected in accordance 
with 6.3; and  
 
c) measures that comply with the relevant national legislation  (see foreword) . 
 
5.2.6.3  The RA shall ensure that vibration levels  are managed during the life cycle of  tools, 
machinery and equipment.  
 
NOTE  The life  cycle includes a feasibility study, design, construction/manufacturing, 
commissioning, operations, monitoring and maintenance, modification, 
decommissioning and disposal a s specified in SA RA 001 and SARA 002)  
 
5.2.7  Monitoring, evaluation and review  
 
The RA shall establish, develop or adopt, document, implement and maintain policies, 
processes and procedures to monitor, evaluate and review the management of vibration.  
 
5.3 Lighting  
 
5.3.1  General  
 
5.3.1.1  In the context of this clause lighting from natural or artificial sources (or both)  is 
included . 
 
5.3.1.2  Good lighting, in terms of quantity and quality, plays an important role in 
contributing to a healthy and safe work e nvironment through  
 
a) enabling employees to see hazards , 
 
b) reducing the likelihood of occurrences , and 
 
c) reducing visual fatigue and discomfort.  
 
5.3.1.3  RA‟s  and employees have a mutual responsibility to ensure that poor lighting does 
not impact on s afe railway operations.  MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
17 
  
5.3.1.4  The RA has the responsibility to ensure good lighting of the work environment 
whereas the employee‟s responsibility includes reporting of poor lighting that leads 
to unsafe working environments.  
 
5.3.2  Requirements for the management of lighting  
 
5.3.2.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and procedures for the manage ment of  lighting in accordance 
with the relevant na tional legislation  (see foreword) . 
 
5.3.2.2  The r equirements to manage lighting shall include  the following : 
 
a) roles and responsibilities;  
 
b) education and training;  
 
c) risk assessments ; 
 
d) controls; and  
 
e) monitoring, evaluation and review.  
 
5.3.3  Roles and responsibilities  
 
5.3.3.1  The RA shall 
 
a) appoint a person  with the relevant authority and responsibility  to manage lighting , and 
 
b) define the roles and responsibilities of the appointed person . 
 
5.3.3.2  The appointed person shall use, where relevant, the services of experts and 
specialists.  
 
5.3.4  Education and training  
 
The RA shall establish, develop or adopt, document, implement and maintain policies, 
processes and procedures to educate and train management and employees in matters 
that relate to lighting, including  the following : 
 
a) the relevant national  legislation  (see foreword) , policies, processes and procedures;  
 
b) potential risks of poor lighting at work and off -the-job; 
 
c) roles and responsibilities;  
 
d) the purpose of lighting surveys;  and 
 
e) the purpose of implementing a sched uled maintenance programme . 
 
5.3.5  Risk assessment s 
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
18 
 5.3.5.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and procedures for conducting  risk assessments that relate to 
lighting in accordance with the releva nt national legislation  (see foreword) . 
 
5.3.5.2  Risk assessments shall include  the following : 
 
a) identifying safety -related jobs/tasks/activities, and the  environments in w hich these will 
be undertaken;  
 
b) determining the inherent lighting requirements for employees to see adequately to 
perform their jobs ; and 
 
c) evaluating the existing lighting for each job/task/activit y and environment.  
 
 NOTE  Lighting refers to the nature of light sources, as well as the quantity and quality 
of light.  
 
5.3.5.3  In cas es where the relevant national legislation  (see foreword)  or relevant national 
standards do not specify requirements  
 
a) the RA shall use the services of  relevant experts such as lighting specialist s to assess 
jobs/tasks/activities and work environments and to make recommendations , and 
 
NOTE  1 Relevant experts should determine speciali zed lighting requirements where 
safety -related work is undertaken owing to the dynamic technical and 
environmental conditions encountered during railway operations.  
 
NOTE  2 People are deemed lighting specialist s if they have been graded as “member s” 
by the relevant national authority.  
 
b) recommendations made by the lighting specialist should be accepted as requirements 
for the specific jobs/tasks/activities and work environmen ts. 
 
5.3.5.4  Risk assessments shall be conducted by a competent person . 
 
5.3.5.5  Risk assessments shall be reviewed on a regular basis at intervals not exceeding 
24 months or , when  
 
a) evidence suggests that the risk assessment is no longer valid , or 
 
b) changes have been made to the  jobs/tasks/activities, work environment or existing 
controls.  
 
5.3.6  Controls  
 
5.3.6.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and procedures for the implement ation of  controls to provide 
and ensure good quality and quantity lighting  in accordance with the relevant 
national  legislation  (see foreword) . 
 
5.3.6.2  Controls shall include  the following : 
 
a) a maintenance programme for the  
 
1) regular inspection of luminaires and l amps,  
 
2) scheduled replacement of lamps,  MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
19 
  
3) prompt replacement of broken or defective luminaires and lamps, and  
 
4) regular cleaning of windows, luminaires and lamps ; and 
 
b) engineering measures , such as  
 
1) correct spacing and mounting height,  
 
2) uniform lighting in terms of quantity and quality,  
 
3) prevention of large lighting differenc es between adjacent work areas,  
 
4) fitting of luminaires in such a way that the light emanating from them is not 
obscured, and  
 
5) prevention of  glare, stroboscopic e ffects and flickering.  
 
5.3.7  Monitoring, evaluation and review  
 
The RA shall establish, develop or adopt, document, implement and maintain policies, 
processes and procedures to monitor , evaluate and review the lighting management 
programme.  
 
5.4 Thermal e nvironment  
 
5.4.1  General  
 
5.4.1.1  In the context of this clause the thermal environment refers to thermal stress and 
thermal comfort.  
 
5.4.1.2  Thermal stress focuses on the physiological and psychological response of a 
person  when his/her  coping mechanism  cannot cope with temperature extremes.  
 
5.4.1.3  Thermal comfort focuses on the psychological state of mind in terms of the 
person ‟s perception of his /her environment. The person  might experience 
discomfort if the personal  and environmental factors that in fluence the thermal 
environment fall outside the person ‟s comfort zone . 
 
NOTE  Annex  B provides detail s of measures to provide thermal comfort in enclosed 
spaces.  
 
5.4.1.4  The effect s of thermal stress and discomfort that might impact on safe railway 
operat ions include  the following : 
 
a) impaired cognitive functioning – reduc ed concentration and vigilance;  
 
b) impaired vision;  
 
c) dehydration, exhaustion and fatigue;  
 
d) a reduced work rate;  
 
e) changes in reaction time;  
 
f) irritability and co nfusion;  MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
20 
  
g) shivering;  
 
h) hyperthermia; and  
 
NOTE  Hyperthermia includes heat -related conditions such as heat stroke, heat cramps, 
heat stress and heat syncope.  
 
i) hypothermia.  
 
5.4.1.5  RA‟s  and employees have a mutual responsibility to ensure that the thermal  
environ ment does not impac t on safe railway operations.  
 
5.4.2  Requirements for the management of the thermal environment  
 
5.4.2.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies , processes and procedures for the manage ment of  the thermal 
environment in accordance with the relevant national  legislation  (see foreword) . 
 
5.4.2.2  The requirements to manage the thermal environment shall include  the following : 
 
a) roles and responsibilities;  
 
b) education and training;  
 
c) risk asses sments ; 
 
d) controls; and  
 
e) monitoring, evaluation and review.  
 
5.4.3  Roles and responsibilities  
 
5.4.3.1  The RA shall 
 
a) appoint a person  with the relevant authority and responsibility to manage the thermal 
environment , and 
 
b) define the roles and res ponsibilities of the appointed person . 
 
5.4.3.2  The appointed person shall use, where relevant, the services of authorities and 
professionals , including  the following : 
 
a) an AIA in accordance with  the relevant national  legislation  (see foreword) ; 
 
b) OHP s; 
 
c) engineers; and  
 
d) physiologists.  
 
5.4.3.3  The RA shall ensure that employees are subjected to risk -based medical 
surveillance as specified in 6.3. 
 
5.4.4  Education and training  
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
21 
 The RA shall establish, develop or adopt, document, implement and maint ain policies, 
processes and procedures to educate and train management and employees in matters 
that relate to the thermal environment , including  the following : 
 
a) the relevant national  legislation  (see foreword) , policies, processes and procedures;  
 
b) health and safety risks at work and off -the-job; 
 
c) roles and responsibilities;  
 
d) safe working practices;  
 
e) emergency procedures;  
 
f) the purpose of monitoring  the thermal environment ; and 
 
g) controls.  
 
5.4.5  Risk assessment s 
 
5.4.5.1  The RA shall est ablish, develop or adopt, document, implement and maintain 
policies, processes and procedures for conducting risk assessments that relate to 
the thermal environment in accordance with the relevant national legislation  (see 
foreword) . 
 
5.4.5.2  Risk assessme nts shall include  the following : 
 
a) identifying jobs/tasks/activities and work environments where thermal stress and 
discomfort might impact on employees;  
 
b) identifying thermal environmental stressors and the number of employees exposed;  
 
c) determining  levels of exposure;  
 
d) determining the frequency of exposure;  
 
e) determining the potential adverse health effects; and  
 
f) evaluati ng control measures.  
 
5.4.5.3  Risk assessments shall be reviewed on a regular basis at intervals not exceeding 
24 months , or when  
 
a) evidence suggests that the risk assessment is no longer valid , or 
 
b) changes have been made to the  jobs/tasks/activities /tools/equipment , work 
environment or existing controls.  
 
5.4.6  Controls  
 
5.4.6.1  The RA shall establish, develop or adopt,  document, implement and maintain 
policies, processes and procedures for the implement ation of  controls to manage 
the thermal environment in accordance with the relevant national legislation  (see 
foreword) . 
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
22 
 5.4.6.2  Controls shall include  the following : 
 
a) management of employees who might be or who are aff ected;  
 
b) implementing recommendatio ns from relevant professionals;  
 
c) implementing measures that comply with the relevant national legislation  (see 
foreword) ; and  
 
d) implementing meas ures to ensure t hermal comfort.  
 
5.4.7  Monitoring, evaluation and review  
 
The RA shall establish, develop or adopt, document, implement and maintain policies, 
processes and procedures to monitor  evaluate and review the management of the thermal 
environment . 
 
5.5 Hazardous  substances and agents  
 
5.5.1  General  
 
5.5.1.1  In the context of this clause hazardous substances and agents that might impact on 
safe railway operations include  the following : 
 
a) toxic or haz ardous chemical substances; and  
 
 EXAMPLE S Asbestos, silica, le ad, benzene, manganese and grain dust.  
 
b) hazardous biological agents.  
 
 NOTE  Hazardous biological agents cause diseases such as hepatitis  A and B, malaria 
and tuberculosis . 
 
5.5.1.2  Exposure to hazardous substances and agents might cause adverse health e ffects 
in employees who undertak e safety -related work , which could impact on safe 
railway operations.  
 
5.5.1.3  Adverse health effects might be immediate or delayed. Immediate health effects 
can result in sudden incapacitation with an immediate impact on sa fe railway 
operations.  
 
EXAMPLE  1 Immediate effects such as asphyxiation, severe allergic reaction 
(anaphylactic shock) or drowsiness.  
 
EXAMPLE  2 Delayed effects such as nervous system toxicity, cancer of the lungs or 
chemically -induced hearing loss.  
 
5.5.1.4 RA‟s  and employees have a mutual responsibility to ensure that hazardous 
substances and agents do not impact on  safe railway operations.  
 
5.5.2  Requirements  for the management of hazardous substances and agents  
 
5.5.2.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies , processes and procedures for the manage ment of  hazardous substances MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
23 
 and agents , impacting on safe railway operations , in accordance with the relevant 
national  legislation  (see foreword) . 
 
5.5.2.2  The req uirements to manage hazardous substances and agents shall include  the 
following : 
 
a) roles and responsibilities;  
 
b) education and training;  
 
c) risk assessments ; 
 
d) controls; and  
 
e) monitoring, evaluation and review.  
 
5.5.3  Roles and responsibilities  
 
5.5.3.1  The RA shall 
 
a) appoint a person  with the relevant authority and responsibility to manage hazardous 
substances and agents , and 
 
b) define the roles and responsibilities of the appointed person . 
 
5.5.3.2  The appointed person  shall, where relevant, use the services of authorities and 
professionals , including  the following : 
 
a) an AIA in accordance with the relevant national  legislation  (see foreword) ; 
 
b) an OHP ; and  
 
c) engineers.  
 
5.5.3.3  The RA shall ensure that employees are subjected to risk -base d medical 
surveillance as specified in 6.3. 
 
5.5.4  Education and training  
 
The RA shall establish, develop or adopt, document, implement and maintain policies, 
processes,  and procedures to educate and train management and employees in matters 
that relate t o hazardous substances and agents , including  the following : 
 
a) the relevant national  legislation  (see foreword) , policies, processes and procedures;  
 
b) health effects and safety risks at work and off -the-job; 
 
c) roles and responsibilit ies; 
 
d) the purpo se of hygiene surveys;  
 
e) the purpose of medical surveillance and biological monitoring programmes;  and 
f) controls . 
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
24 
 5.5.5  Risk assessments  
 
5.5.5.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and proced ures for conducting risk assessments that relate to 
hazardous substances and agents in accordance with the relevant national  
legislation  (see foreword) . 
 
5.5.5.2  Risk assessments shall include  the following : 
 
a) identifying safety -related jobs/tasks/activi ties and work environments  where employees 
are exposed to hazardous substances and agents;  
 
b) identifying the hazardous substances and agents related to specific 
jobs/tasks/activities a nd the number of employees exposed;  
 
c) identifying the source of  haza rdous substances and agents;  
 
d) evaluating hazardous substances and agents in terms of their na ture, form and routes 
of entry;  
 
e) determining exposure levels;  
 
f) determining frequency and duration of exposure;  
 
g) determining the potent ial adverse healt h effects; and  
 
h) evaluating control measures.  
 
5.5.5.3  Risk assessments shall be reviewed on a regular basis at intervals not exceeding 
24 months , or when  
 
a) evidence suggests that the risk assessment is no longer valid , or 
 
b) changes have been made to  the jobs/tasks/activities, work environment or existing 
controls.  
 
5.5.6  Controls  
 
5.5.6.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and procedures for the implement ation of  controls to prevent, 
elimina te or mitigate the negative health effects of hazardous substances and 
agents in accordance with the relevant national  legislation  (see foreword) . 
 
5.5.6.2  Controls shall include  the following : 
 
a) management of employees who are adversely affected; and  
 
b) implementation of measures that comply with the relevant national legislation  (see 
foreword) . 
 
5.5.7  Monitoring, evaluation and review  
 
The RA shall establish, develop or adopt, document, implement and maintain policies, 
processes and procedures to monit or, evaluate and review the management of hazardous 
substances and agents.  MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
25 
  
6 Organizational and psychological factors  
 
6.1 Recruitment and selection  
 
6.1.1  General  
 
6.1.1.1  The recruitment and selection of employee s with appropriate safety competencies 
are essential requirement s for safe railway operations.  
 
6.1.1.2  In the context of this clause staffing means the process from recruitment to 
placement.  
 
6.1.1.3  The staffing process shall be well  designed and reviewed  
 
a) on a regular basis at intervals not  exceeding 36 months , 
 
b) when human factors  caused the RA‟s ‟ safety performance to dete riorate or remain 
stagnant , and 
 
6.1.1.4  Recruitment and selection shall form part of the skills development programme . 
 
6.1.1.5  The prospective employee (applicant) shall provide honest, relevant,  and accurate 
information . The RA shall follow transparent processes and make unbiased, fair 
decisions.  
 
6.1.2  Requirements for the management of recruitment and selection  
 
6.1.2.1  The RA shall establish, develop or adopt, docu ment, implement and maintain 
policies, processes and procedures for the management of recruitment and 
selection of employees in accordance with  the relevant national legislation  (see 
foreword) . 
 
6.1.2.2  The requirements to manage recruitme nt and selection shall include  the following : 
 
a) recruitment and selection principles;  
 
b) recruitment and selection criteria;  
 
c) a sourcing strategy;  
 
d) selection methods;  
 
e) assessment procedures;  
 
f) appointment and placement  procedures ; and  
 
g) monitoring, evaluati on and review.  
6.1.3  Recru itment and selection principles  
 
6.1.3.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes,  and procedures to reflect staff ing requirements within the 
different organi zational structure s. 
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
26 
 6.1.3.2  Staffing requirements within the different organizational structures shall be 
calculated using established methods, taking current and expected operational 
requirements , including absences due to leave  and training , into account . 
 
6.1.3.3  The RA shall 
 
a) manage vacancy rates to ensure that operational safety is not compromised , 
 
b) identify natural and possible career paths with minimum movement time frames, 
minimum competency requ irements, and training periods , 
 
NOTE  A natural career path is t he movement from an entry grade to a next higher 
grade (vertical movement on the organogram) whilst a possible career path can 
be a horizontal movement to be able to move to the next higher grade . 
 
c) have a recruitment st rategy based on staffing needs  and minimum job requirements , 
 
d) be transparent in the recruitment process regarding minimum job requirements,  
selection cr iteria, and working conditions , 
 
e) maintain all rec ords in a safe and confidential  manner , and 
 
NOTE  Documented data relating to an in dividual applicant should include the date, 
time of test , assessor, type and result of tests, and decisions taken based on 
results.  
 
f) manage the selection procedures that include  
 
1) a panel consisting of at least two competent person s to ensure that all  procedures 
are followed fairly and consistently, and  
 
2) restrictions that prevent the same test from being used within a 12 -month period for 
candidates  who apply for the same position . 
 
6.1.4  Development of recruitment and selection criteria  
 
6.1.4.1  The RA shall perform structured and documented job ana lyses to develop job 
profiles.  
 
6.1.4.2  A job analysis shall include  the following : 
 
a) the determination of the job title;  
 
b) a description of all tasks and acti vities linked to the job title;  
 
c) a desc ription of the working environment;  
 
d) the determination of the complexity, in tensity and frequency of tasks;  
 
NOTE  The task complexity refers to the degree of difficulty in performing the task whilst 
intensity refers to the rate at which tasks are perfor med and the level of 
concentration required.  
 
e) a description of the equipment and tools used to perform tasks;  MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
27 
  
f) identification and description of physical and psychological demands of tasks;  
 
NOTE  1 Physical demands might include actions such as awkwa rd body positions, 
lifting, stretching and strength required to use the pantograph hook stick, 
operation of hand -operated points, coupling and uncoupling of vacuum  hoses  
or air hoses  (or both) , opening and closing of high tension doors and end 
doors, able to reach equipment that is placed in high and confined spaces 
(driving cabs and corridors), alignment of couplers, carrying of a fully equipped 
“kit box” or coupler over a distance , and climbing and d escending from the 
“foot plate”.  
 
NOTE  2 Psychological d emands might include the level of concentration, ability to 
tolerate frustration and fatigue, ability to make decisions, and dealing with 
difficult passengers (tolerate externally exerted pressures).  
 
g) identification of human factor hazards and associate d risks; and  
 
h) the competencies , and physical and psychological requirements  to perform the job 
successfully.  
 
6.1.4.3  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and pro cedures for selection criteria.  
 
6.1.4.4  Recruitment and s election criteria shall be valid  and based on  the following : 
 
a) competency profiles ; 
 
b) inherent physical job requirements , including anatomical,  anthropometric al, 
biomechanical and physiological abilities , to perform tasks;  
 
c) inherent psycho -social requirements, including  an absence of current substance 
abuse, sleep disorders and disturbed sleeping patterns;  
 
d) core mental and behavioural criteria necessary for adequate job performance , 
including  the following : 
 
1) cognitive : vigilance, attention and concentration, memory, perception, reasoning 
and judgment, communication and literacy ; 
 
2) psychomotor : reaction time and coordination ; and 
 
3) behavioural : emotional stability and self -control, reliability and conscientiousness ; 
and 
 
NOTE  There are other criteria that may be included in terms of importance to job 
outputs which  might differ between the grades.  
 
e) minimum entry requirements , which  shall be based on qualifications, certification and 
requir ed experience , where applica ble. 
 
NOTE  Minimum requirements may be the age requirement of 18 years, matriculation,  
or equivalent with a pass in mathematics and science , and a  valid driver‟s 
licence.  MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
28 
  
6.1.5  Sourcing strategy  
 
6.1.5.1  The RA shall establish, develop or adopt, document,  implement and maintain 
policies, processes,  and procedures to source staff.  
 
6.1.5.2  Advertisements shall stipulate required information to be submitted for  
consideration and include the  
 
a) minimum req uirements of the job , 
 
b) selection criteria , and 
 
c) working conditions.  
 
6.1.5.3  Job application forms shall be designed to  include the following information:  
 
a) relevant skills programmes, qualifications and credits for unit standards;  
 
b) medical  and psychological conditions;  
 
c) any criminal records;  
 
d) safety -related experience;  
 
e) other railway work experience;  
 
f) previous applications within the last year for similar position (including other rail RA‟s  or 
other organi zations);  
 
g) the safety record (accidents and injuries);  
 
h) the employment hist ory; and  
 
i) contact details of references.  
 
NOTE  1 The RA may design application forms specific for i nternal and external applicants.  
 
NOTE  2 The RA may decide at what stage in the selection process the application form is 
completed.  
 
6.1.5.4  Applicants s hall be requested to give written consent for verification purposes.  
 
6.1.6  Selection methods  
 
6.1.6.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and pr ocedures for selection methods.  
 
6.1.6.2  The RA shall appoint a person  with the relevant responsibility, authority,  and 
accountability to manag e the selection process.  
 
6.1.6.3  The choice  or development (or both) of selection  methods shall be undertaken by 
competent persons  in accordance with the relevant n ational legislation  (see 
foreword) . 
 
NOTE  The competent persons  may include registered psychologists, OMPs or any other 
person  or professional deemed necessary by the appointed person . MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
29 
  
6.1.6.4  The appointed  person  shall ensure that the selection methods  are reliable, valid 
and fair.  
 
NOTE  The term "r eliable " refers to consistency of results, "valid" refers to the accurate 
measurement of criteria, and "fair" refers to the absence of bias.  
 
6.1.6.5  Selection methods shall be standardi zed for each safety -related position and shall 
be based on  
 
a) selection c riteria as specified in 6.1.4, 
 
b) appropriate selection technology , and 
 
c) the ability to predict safety performance.  
 
NOTE  Selection methods for employees who undertak e safety -related work may include 
psychometric tests, biomechanical ability and physical strength tests, simulation 
exercises (such as report writing, role plays, in -basket, and electronic simulators), 
job samples, knowledge tests, competency -based interviews, and medical and 
mental fitness examinations.  
 
6.1.7  Assessment procedures  
 
6.1.7.1  General  
 
6.1.7.1.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and procedures to assess candidates.  
 
6.1.7.1.2  During pre -scree ning the following shall a pply:  
 
a) applications  shall be assessed against minimum requirements as advertised; and  
 
b) short -listed applications shall be assessed against the requi rements as specified in 
6.1.4. 
 
NOTE  Internal candidates who apply for promotion or lateral movement s hould be 
considered based on work performance , which  include s attendance, discipline,  and 
safety records.  
 
 
6.1.7.2  Testing  
 
6.1.7.2.1  The RA shall establish, develop or adopt, document, implement and 
maintain policies, processes and procedures to test can didates as part of  the 
assessment process in accordance with the relevant national legislation  (see 
foreword) . 
 
6.1.7.2.2  The following principles shall apply:  
 
a) the administration of tests and interpretation of results shall comply with  the relevant 
national legislation  (see foreword) ; 
 
b) standardi zed administration procedures shall apply during all tes ting; 
 
c) all tests administered shall be directly linked to selection criteria; and  MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
30 
  
d) the final selection of candidates shall not be exclusively based  on the results of any 
single psychometric test.  
 
6.1.7.2.3  The following tests shall be administered at entry level:  
 
a) psychometric tests , which may include cognitive functioning tests (vigilance, 
concentration, attention, memory and reasoning), ability  or aptitude tests (reading, 
mechanical and numerical), psychomotor tests (reaction speed and coordination), and 
personality  tests; and  
 
NOTE  Computer -based reaction tests should be included to test psychomotor 
performance, vigilance, concentration, perfor mance under p ressure, perception, 
etc. 
 
b) biomechanical and physical strength tests on candidates who apply for positions where 
these tests have been identifie d as inherent job requirements.  
 
6.1.7.2.4  The following testing shall apply at the next higher level:  
 
a) screening of core selection  criteria in accord ance with  6.5.4.2; 
 
NOTE  Where entry level test results are not available , the applicable entry level battery 
of tests  or part thereof  may be administered.  
 
b) knowledge tests , including tests on  subject matter, safety and applicable organi zational 
procedures; and  
 
c) simulation exercises or job samples (or both).  
 
NOTE  1 Simulation exercises or job samples may include report writing or communication 
(or both) or conflict han dling role plays.  
 
NOTE  2 Simulation exercises or job samples for supervisory grades should include 
assessment centre technology such as in -baskets, performance interviewing and 
analytical problem reports.  
 
NOTE  3    Training and assessment should be included in simulation exercise s. 
 
6.1.7.3  Interviewing  
 
The RA shall use competent employee s to conduct competency based interviews with 
candidates  who passed preceding tests to  
 
a) confirm whether the results obtained from preceding tests provide a true reflection of 
the candidate , and 
 
b) gain additional information that could not be measu red by other selection methods.  
 
NOTE  1 Competency based interviews are structured interviews that measure specific 
knowledge, skills and attitudes identified as important criteria for success in a 
specific job. Scoring criteria are predetermined as part of the design process.  
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
31 
 NOTE  2 Where high volumes of candidates are subjected to interviews , at least three 
versions of any specific interview should be available for each specific grade in 
order to m inimize the learning of interview questions.  
 
6.1.7.4  Medical and psychological fitness examinations  
 
6.1.7.4.1  Candidates shall be subjected to a physical health assessment to determine 
fitness  for duty in accordance with 6.3 and 6.4. 
 
6.1.7.4.2  Candidate s shall be subjected to an assessment to determine mental 
fitness  for duty in accordance with 6.3 and 6.4. 
 
NOTE  Apart from assessing psycho -social functioning, emphasis should also be on the 
screening of core criteria as confirmation to other assessment t ools used, or where 
these criteria are not adequately included in the tests of especially mid and 
supervisory level candidates.  
 
6.1.7.5  Verification  
 
6.1.7.5.1  Applicants shall be requested to give written consent for verification 
purposes.  
 
6.1.7. 5.2 Short-listed applicants shall undergo reference checks that incorporat e the 
verification of qualifications, work experience,  and criminal records.  
 
NOTE  1 Reference checks can be done at any stage in the recruitment and selection 
process.  
 
NOTE  2 There should  be cooperation between RA‟s, where relevant, to  provide 
information regarding the performance history of candidates who apply  for safety -
related positions. The p erformance history may include attendance records, 
disciplinary records, safety -related occurr ences and unproductive work behaviour 
(sexual harassment, verbal abuse, bullying).  
 
6.1.8  Appointment and placement  
 
Successful candidates  shall be appointed and placed.  
 
6.1.9  Monitoring, evaluation and review  
 
The RA shall establish, develop or adopt, do cument, implement and maintain policies, 
processes and procedures to monitor , evaluate and review the recruitment and selection 
programme.  
 
6.2 Training and development  
 
6.2.1  General  
 
6.2.1.1  Training and development are implemented and managed subsequent  to the 
recruitment, selection;  appointment and placement of a  person  (see 6.1). 
 
6.2.1.2  Training and development,  including education and experience, are essential 
requirements to achieve and maintain competence to undertake safety -related 
work.  MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
32 
  
6.2.1.3  Training and development shall be a continual process and aligned with the safety -
related functional competenc y requirements of the job/task.  
 
NOTE Functional competency refers to applied competence  that consists of foundational 
and practical  competence . 
 
6.2.1.4  Training  and development shall address  the following : 
 
a) safety -related functional c ompetency requirements through  
 
1) training  that is accredited by a national  education and training quality assurance 
body  (if relevant) , 
 
2) equipment -specific t raining based on accreditation principles and agreed 
standards , 
 
3) refresher courses based on accreditation principles and agreed standards , 
 
4) on-the-job observation and corrective action , 
 
5) scheduled safety briefings , and 
 
6) ad hoc training.  
 
NOTE  Computer -based and simulation technology should be considered where 
relevant.  
 
b) relevant non -functional job -related competencies ; and 
 
 NOTE  Relevant non -functional job -related competencies should be determined by the 
RA, and these should includ e communic ation skills, leadership development, 
decision making, conflict ha ndling and negotiation skills.  
 
c) relevant education and training related to other clauses in this standard , relevant 
national legislation and standards  and other SARA standards.  
 
6.2.1.5  Training and development  shall be a dynamic and risk -driven process.  
 
6.2.1.6  Training, assessment, moderation, evaluation or certification may be pr ovided by 
an external provider.  
 
6.2.1.7  RA‟s  and employees have a mutual responsibility to ensure that training and 
development requirements for employees who undertak e safety -related work are 
met. 
 
6.2.2  Requirements for the management of training and development  
 
The RA shall establish, develop or adopt, document, implement and maintain policies, 
processes procedures,  and plans for the manage ment of  training and development , which 
shall include  the following : 
 
a) roles and responsibilities;  
 
b) training and development elements , such as  MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
33 
  
1) safety -related functional competency,  
 
2) relevant education and train ing related to other clauses in this part of SARA 004, 
relevant national legislation and standards , and  
 
3) relevant non -functional job -related competencies ; 
 
c) assessment and moderation;  
 
d) certification and licensing;  
 
e) management information system s; and  
 
f) monitoring, evaluation and review.  
 
6.2.3  Roles and responsibilities  
 
6.2.3.1  The RA shall 
 
a) appoint a person  (for example . a skills development facilitator) with the relevant 
authority and responsibility to manag e training and development , and 
 
b) define the roles and responsibilities of the appointed person . 
 
 NOTE  The RA may combine responsibilities to coordinate the training and 
development requirements as detailed in 6.2.1.4. 
 
6.2.3.2  The appointed person  shall ensure that, where relevant, accredited training and 
development complies with the requirements of a  
 
a) relevant national qualific ation framework , which includes  
 
1) identification of existing unit standards,  
 
2) identification of  unit standards for review, and  
 
3) development of new  unit standards as required , and  
 
b) relevant education and training quality assurance body , which includes  
 
1) learning programmes aligned with unit standards , 
 
2) accreditation of training providers, based on their learning programmes, quality 
management  system and resources for financial, equipment and human 
requirements.  
 
NOTE  Human resources include qualified trainers , registered assessors,  and 
registered moderators.  
 
6.2.3.3  The appointed person  shall ensure that training and development be undertaken  by 
subject matter experts in respect of 6.2.1.4(a)(2 ) to (5), 6.2.1.4(b) and 6.2.1.4(c). 
 
6.2.3.4  The appointed person  shall manage , where relevant, the licensing of employees 
who undertak e safety -related work . 
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
34 
 6.2.4  Training and development elements  
 
6.2.4.1  The RA shall ensure that trainers are  
 
a) subject matter experts , and 
 
b) appropriately qualified.  
 
6.2.4.2  On-the-job trainers shall be employees  who can transfer  practical skills . 
 
6.2.4.3  Formal selection processes should be followed to select on -the-job trainers  and 
criteria shall include  
 
a) experience,  
 
b) competence,  
 
c) a safety profile, and  
 
d) disciplinary and attendance records.  
 
6.2.4.4  Training and development shall be aligned with task analyses and identified 
competencies for each job ca tegory to achiev e desired outcomes , and shall include  
the following : 
 
a) theoretical and practical training  to enable the employee to perform the speci fic safety -
related jobs/tasks;  
 
b) equipment -specific training, in addition to 6.2.4.3(a), related to area/depot specific 
operations to ensure compet ence to perform multiple tasks;  
 
c) compulsory refresher courses based on accreditation principles and agreed standards  
related to area/depot specific operations at int ervals not exceeding 24 months;  
 
d) ad hoc t raining resulting from  
 
1) an occurrence,  
 
2) a recommendation from a board of inquiry, and  
 
3) the absence from operational duty for a period exceeding six months in accordance 
with 6.4; 
 
e) on-the-job observations at intervals not exceeding  30 days, with  immediate corrective 
action in the case of any transgressions;  
 
f) scheduled safety briefings to be done at intervals not exceeding  30 days  and that 
include  
 
1) case study discussions of occurrences (incident recalls),  
 
2) risk issues resulting from on -the-job observations,  
 
3) discussions of important rules, and  
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
35 
 4) anticipated system/equipment changes ; 
 
g) daily safety briefings (green -area talks) done at sign -on or sign -off (or both)  to inform 
employees of operational issues;  
 
h) ad hoc safety br iefings  and incident awareness;  
 
i) education and training to ensure fitness  for duty and that promote safe working 
practices , including  
 
1) HFID , 
 
2) physical environmental factors, and  
 
3) organi zational and psychological factors ; and  
 
j) education and training  relevant to non -functional job -related competencies.  
 
k)   education and training of relevant national legislation and standards  
 
6.2.5  Assessment and moderation  
 
6.2.5.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies,  processes and procedures for assessment and moderation, where 
relevant, in accordance with  the relevant national legislation  (see foreword) . 
 
6.2.5.2  Assessors shall  
 
a) be appropriately qualified  and registered as assessor s where  required , 
 
b) be registe red, where required  against the specific unit standards for which the y can 
demonstrate pro of of subject matter expertise , 
 
c) where required have valid certificates of competence for areas of assessment , and 
 
d) be independent to prevent conflict of intere st and contamination.  
 
6.2.5.3  Moderators shall  
 
a) be appropriately qualifie d and registered as moderators  where required , 
 
b) have adequate working knowledge ( i.e. field expertise), where relevant, of the 
discipline being moderated , and 
 
c) be independen t to prevent conflict of interest and contamination.  
 
6.2.5.4  Employees involved in training and development shall be  
 
a) subjected to assessments on theoretical knowledge and practical skills , 
 
b) allowed a maximum of three attempts to be deemed competent  in all forms of training 
and development required for  certification , 
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
36 
  NOTE  Certification refers to obtaining a qualification or skills programme from a  
national educational  and training quality authority  or relevant body , as well as 
being declared compet ent and authorized to undertake safety -related work.  
 
c) required to comply with the minimum and maximum timeframes applicable to the 
relev ant training modules/programmes, and  
 
d) responsible for keep ing evidence of assessments and qualification . 
 
6.2.5.5  Employee s involved in training and developmen t shall be required to achieve  
 
a) 80% in theoretical assessments, on the understanding that the RA ensures that the 
knowledge gap be closed , and 
 
 NOTE  RA determined critical elements should be addressed during  the closing of the 
knowledge gap.  
 
b) competence  (100%)  in all practical assessments b ased on predetermined criteria.  
 
6.2.5.6  The RA shall ensure that  
 
a) desired outcomes for each employee involved in training and development are 
communicated to the tra ining provider for the purpose of feedback , and 
 
b) processes are in place to manage employees who are involved in training and 
development and who are declared not yet competent , as specified in 6.2.5.4(b) . 
 
 
6.2.6  Certification and licensing  
 
6.2.6.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and procedures to manage certification and licensing.  
 
6.2.6.2  The RA shall ensure that employees who undertake safety -related work are in 
possession of a  
 
a) valid certifica te of competence , 
 
b) qualification , where relevant , and 
 
c) valid license, where relevant.  
 
6.2.6.3  The education and training quality assurance body  or relevant body may issue a 
qualification or skills programme for accredited training to emplo yees  
 
a) who successfully completed basic theoretical safety -related functional training , and 
 
b) for whom the RA has submitted , where relevant, the final formative  or summative  (or 
both)  assessment of practical knowledge.  
 
6.2.6.4  The RA shall certify persons  competent to undertake safety -related work and , 
where appropriate , for specific safety -related tasks.  
 
6.2.6.5  The RA shall,  where appropriate, periodically certi fy a person  as competent.  MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
37 
  
6.2.6.6  A certificate of competence shall be valid for a perio d not exceeding 24 months.  
 
6.2.6.7  A certificate of competence shall lapse if the employee has not performed 
operational duties for a period exceeding six months.  
 
6.2.6.8  The RA shall not allow employees younger than 21  years of age to undertake train 
driver or train control duties.  
 
6.2.6.9  A licensing authority may issue a licence on condition that the employee  complies 
with pre determined  criteria . 
 
6.2.7  Management information system  
 
6.2.7.1  The RA shall implement and maintain a management informa tion system that shall 
include  the following : 
 
a) training and development data as described in 6.2.1.4; 
 
b) safety (risk) profile data  that contain  
 
1) occurrences,  
 
2) operational restrictions,  
 
3) findings from investigations and boards of inquiry,  
 
4) work attendance records, and  
 
5) fitness -for-duty outcomes ; and  
 
c) certification and licensing data  that include  
 
1) systems or types of equipment  (or both) , and 
 
2) areas and routes.  
 
6.2.7.2  The RA shall maintain a portfolio of evidence in the management i nformation 
system for each employee involved in training and development . This portfolio shall  
includ e the following : 
 
a) dates and venues of trainin g, assessments and moderations;  
 
b) names of trai ners, assessors and moderators;  
 
c) assessment questionnai res, results obtained, log books  and feedback given; and  
 
d) expiry dates of certificates  and due dates for refresher courses.  
 
NOTE  Data should be maintained in accordance with the document and data control 
requirements as specified in SARA 001  
 
6.2.8  Monitoring, evaluat ion and review  
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
38 
 6.2.8.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and procedures to monitor, evaluate and review the elements of 
training and development , including  the following : 
 
a) needs analyses;  
 
b) learning material;  
 
c) assessments;  
 
d) moderations;  
 
e) certifications; and  
 
f) evaluations.  
 
6.2.8.2  The RA shall ensure that education and training quality standards are met in 
accordance with the relevant national legislation  (see fore word) . 
 
 
 
 
6.3 Medical surveillance  
 
6.3.1  General  
 
6.3.1.1  In the context of this clause medical surveillance refer s to the planned programme 
that may include health assessments, clinical examinations, biological monitoring  
and medical tests performed by OHPs.  
 
6.3.1.2  Workplace health and safety ha ve a direct relationship with safe railway operations.  
 
6.3.1.3  Medical surveillance is used to determine, monitor and manage employees‟ health , 
which might impact on safe railway operations.  
 
6.3.1.4  The RA has a duty of care under the relevant national legislation (see foreword) to 
provide  a workplace that is safe and without risks thereby ensuring the health and 
safety of employees and the public.  
 
6.3.1.5  Health assessments may provide information on the  
 
a) physical and psychological health status of employees , 
 
b) effect of work on the health of employees , and 
 
c) fitness of employees to perform safety -related work.  
 
6.3.1.6  The RA shall include medical surveillance as an integral component of the railway 
safety management system.  
 
6.3.1.7  RA‟s  and employees have a mutual responsibility to ensure that the requirements 
for medical surveillance are adhered to.  
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
39 
 6.3.2  Requ irements for the management of medical surveillanc e 
 
6.3.2.1  The RA shall establish, develo p or adopt, document, implement and maintain 
policies, processes and procedures for the management of medical surveillance in 
accordance with the relevant national  legislation  (see foreword) . 
 
6.3.2.2  The medical surveillance programme shall include  the fo llowing : 
 
a) a Code of Practice (C OP); 
 
b) a declaration;  
 
c) education and training of management and employees;  
 
d) health assessments;  
 
e) roles and responsibilities;  
 
f) communication of health -related information;  and 
 
g) monitoring, evaluation and re view.  
 
6.3.3  Code of practice  
 
6.3.3.1  The RA shall establish, develop or adopt, document, implement and maintain a 
COP to  manage medical surveillance  (see annex  C). 
 
6.3.3.2  The COP shall include  the following : 
 
a) types of health assessment;  
 
b) frequenc y of health assessments; and 
 
c) action and exclusion criteria as detailed in annex  D. 
 
 NOTE  The action and exclusion criteria are guidelines that assist the OHP to determine 
fitness  for duty in relation to specific medical condition s. 
 
6.3.4  Declaration  
 
6.3.4.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and procedures for employees to declare medical matters that 
might impact on safe railway operations.  
 
6.3.4.2  The employee shall declare during medical  surveillance  
 
a) the existence of a medical condition , 
 
b) the use of medication , and 
 
c) any unwanted or undesirable effe cts caused by a medical condition or medication . 
 
6.3.4.3  The confidentiality of personal information  shall be maintained in accordan ce with 
the relevant national legislation  (see foreword ) 
 
6.3.4.4  The employee sh all be required to divulge the nature of the medical condition to the 
appointed OHP.  MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
40 
  
6.3.5  Education and training  
 
The RA shall establish, develop or adopt, document, impleme nt and maintain policies, 
processes,  and procedures to educate and train management and employees in matters 
that relate to medical surveillance , including  the following : 
 
a) the relevant national legislation  (see foreword) , policies, processes and procedu res; 
 
b) roles and responsibilities;  
 
c) the purpose of the medical surveillance programme and health assessments;  
 
d) requirements to declare to line management the existence of a medical condition or 
any unwanted or undesirable effects of the use of medi cation (or both) that they are 
experiencing;  
 
e) the potential impact of medical conditions and the use of medication and substances 
on safety -related work;  
 
f) the confidentiality of perso nal information; and  
 
g) the importance of pr oviding the appointed OHP with  
 
1) the nature of the existing medical condition s, 
 
2) the contact details of the employee‟s health practitioner,  
 
3) the names, doses and dosing schedules of all medication, and  
 
4) any unwanted or undesirable  effects caused by a medical conditio n or medication . 
 
6.3.6  Health assessments  
 
6.3.6.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and procedures for conducting health assessments in 
accordance with  the relevant national legislation  (see fo reword) . 
 
6.3.6.2  The outcomes of health assessments shall  
 
a) confirm whether employees are physically and psychologically fit to perform safety -
related work , and 
 
b) enable timely response s by the RA to deal with health concerns of  individual 
employees o r groups of employees , and be based on the  
 
1) inherent physical and psychological requirements of the jobs/task s/activities , 
 
NOTE  Inherent physical and psychological requirements should be defined as part of 
the recruitment and selection process  (see 6.1). 
 
2) hazards to health inherent to a job/task/activit y, and 
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
41 
 NOTE  Hazards to health should be determined and documented as part of the he alth 
risk assessment  process.  
 
3) medical surveillance matrix.  
 
NOTE  The m edical surveillance matrix is a guide for t he type, frequency and content 
of risk -based health assessments that are based on the findings  of the health 
risk assessment  
 
6.3.6.3  Health assessments shall be scheduled and conducted  
 
a) at pre -employment , 
 
b) periodically, at intervals not exceeding one year, 
 
c) on promotion or transfer , 
d) on termination of emplo yment (exit health assessment) , 
 
e) post railway occurrence s, 
 
f) on return to w ork following sick absenteeism , 
 
NOTE  The return to work process is part of the attendance management strategy a nd 
should include the period after which interventions are impl emented for health 
assessments.  
 
g) subsequent to changes in the nature of the work, work environment, work processes 
and control measures , 
 
h) on suspicion that the worker might have a medical  condition that could imp act on safe 
railway operations , 
 
i) on confirmation or suspicion that a worker might be pregnant as specified in 6.7.7; 
 
j) on confirmation that a worker is taking medication or is experiencing side effect s of 
medication as specifi ed in 6.6.1.4 and 6.6.1.5, 
 
k) on the voluntary request of a worker , and 
 
l) on recom mendation by the appointed OHP.  
 
NOTE  The appointed OHP may recommend more frequent assessments or monitoring 
where a worker has or might have a medical condition that cou ld impact on safe 
railway operations.  
 
6.3.6.4  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and procedures for the selection of medical and psychological 
tests in accordance with  the relevant national legis lation  (see foreword) . 
 
These tests may include questionnaires, diagnostic tests, functional measurements and 
biological monitoring , and shall 
 
a) be valid , 
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
42 
 b) have high sensitivity, specificity, reliability and predictive value , 
 
c) be relevant for their  intended purpose , 
 
d) be acceptable to employees , and 
 
e) comply with ethical guidelines and standards.  
 
6.3.7  Roles and responsibilities  
 
6.3.7.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and procedure s for the use of suitably qualified health 
professionals to conduct  health assessments in accordance with  the relevant 
national legislation  (see foreword) . 
 
6.3.7.2  Health professionals shall include  
 
a) OHP s, and 
 
b) psychologists  to perform accredited an d registered psychological tests  in accordance 
with the relevant national legislation  (see foreword) . 
 
6.3.7.3  The roles and responsibilities of t he appointed OHP shall include  the following : 
 
a) assuming and retaining overall responsibility of the medical  surveillance programme;  
 
b) developing a COP  (see annex  C); 
 
c) developing and designing the medical surveillance programme;  
 
d) implementing and managing the medical surveillance programme;  
 
e) communicating relev ant health -related information;  
 
f) maint aining professional independence and integrity; and  
 
g) maintaining the competence and skills necessary for performing duties in accordance 
with the relevant national legislation  (see foreword) . 
 
6.3.8  Communication of health -related information  
 
6.3.8.1  Communication of health -related information by health professionals shall include  
the following : 
 
a) providing the employee with the outcome of the health assessment;  
 
b) counselling the employee about the fitness for duty recommendation;  
 
c) providing the RA with a medical certificate  of fitness for the employee;  
 
NOTE  The medical certificate of fitness should only report on the employee‟s fitness to 
perform safety - related work . 
 
d) providing group reports on health trends, outcomes and recommendations; an d MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
43 
  
e) protecti ng the confidentiality of personal  health information.  
 
NOTE  1 The health professional should only report on relevant information. Medical 
information of a personal  nature should not be divulged without the informed 
written consent of the employee  concerned.  
 
NOTE  2        Employees have the right of acces s to their own medical records.  
 
NOTE  3 Third parties may have access to medical information with the informed written 
consent of the employee concerned.  
 
6.3.8.2  Medical records shall, in ac cordance with the relevant national legislation  (see 
foreword),  
 
a) be maintained and managed , 
 
b) remain the responsibility and property of the appointed OHP , 
 
c) be kept for a period not less than 40  years  or an agreed appropriate period, in the case 
of medical surveillance records , and 
 
d) be kept for a period not less than five years  or an agreed appropriate period in the 
case of primary healthcare records.  
 
6.3.9  Monitoring, evaluation and review  
 
The RA shall establish, develop or adopt, document, imp lement and maintain processes 
and procedures to monitor , evaluate and review the medical surveillance programme.  
 
6.4 Fitness  for duty  
 
6.4.1  General  
 
6.4.1.1  In the context of this clause, duty and work ha ve the same meaning and fitness  for 
duty means tha t the employee complies with speci fic job requirements , including  
the following : 
 
a) inherent psycholog ical and physical requirements;  
 
b) training and development requirements ; and  
 
c) absence of operational restrictions.  
 
NOTE  1    The employee should re port for work well rested,  sober, healthy and competent.  
 
NOTE  2 The RA should determine the operational restrictions  that would exclude an 
employee from undertaking safety -related work.  
 
6.4.1.2  Fitness  for duty is crucia l for safe railway operations.  
 
6.4.1.3  The RA shall ensure that employees who undertak e safety -related work are fit for 
duty.  
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
44 
 6.4.1.4  Many factors such as the following might impact on fitness  for duty and safe  railway 
operations:  
 
a) medical condition s – psychological and physical;  
 
b) fatigue;  
 
c) substance abuse;  
 
d) medication;  
 
e) pregnancy;  
 
f) training and  development; and  
 
g) employee wellness.  
 
NOTE  This clause should be read in conjunction with the relevant clauses in this standard.  
 
6.4.1. 5 RA‟s  and employees have a mutual responsibility to ensure fitness for duty of 
employees who undertak e safety -related work.  
 
6.4.2  Requirements  for the management of f itness  for duty  
 
6.4.2.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and pr ocedures for the management of fitness  for duty in 
accordance with the relevant national legislation  (see foreword) . 
 
6.4.2.2  The management of fitness  for duty shall be dynamic and risk driven.  
 
6.4.2.3  The programme  shall include  the following : 
 
a) roles  and responsibilities;  
 
b) a declaration;  
 
c) education and training;  
 
d) health assessments;  
 
e) training and development ; 
 
f) readiness  for duty;  
 
g) fitness  on duty;  
 
h) return  to work; and  
 
i) monitoring, evaluation and review.  
 
6.4.3  Roles and respons ibilities  
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
45 
 6.4.3.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and procedures to appoint a competent person  to manage 
fitness  for duty.  
 
6.4.3.2  The RA shall ensure that employees are fit for duty  
 
a) before placement (see 6.1), 
 
b) at the time of rostering , 
 
NOTE  Fitness  for duty at the time of rostering should consider competency requirements, 
medical requirements and rostering criteria.  
 
c) before starting duty (readiness  for duty on a daily basis) , 
 
NOT E Readiness  for duty means that an employee complies with the minimum 
requirements to be scheduled or rostered.  
 
d) whilst on duty (fitness  on duty) , 
 
e) before resuming duty following a period of absence (return  to work) , and 
 
f) periodically  as detailed in 6.2 and 6.3. 
 
NOTE  Periodically refers to the scheduled training and development and health 
assessme nts during medical surveillance.  
 
6.4.3.3  The RA shall define roles and responsibilites of  
 
a) line manag ement – first level supervisor , 
 
b) health profe ssionals , including psychologists and social workers , and 
 
c) any other professionals as required  to manage fitness  for duty.  
 
6.4.3.4  The employee shall comply with any instruction or rule (or both) issued by the RA in 
the interest of safe railway operati ons. 
 
6.4.3.5  The employee shall take  personal  responsibility to achieve and maintain fitness  for 
duty.  
 
6.4.4  Declaration  
 
6.4.4.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and procedures for employees to declare any problem that 
might impact on fitness  for duty.  
 
6.4.4.2  The declaration shall be made  
 
a) immediately, whilst on duty , or 
 
b) before commencement of duty.  
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
46 
 NOTE  The RA should  determine  how long before commencement of duty the declaration 
should be made.  
 
6.4.4.3  The RA shall ensure that the confidentiality of personal  information is maintained.  
 
6.4.4.4  The RA shall not allow any employee who has a problem that might impact on 
fitness  for duty to undertake safety -related work until such emplo yee has been 
declared fit for duty by the relevant competent person . 
 
6.4.5  Education and training  
 
The RA shall establish, develop or adopt, document, implement and maintain policies, 
processes,  and procedures to educate management and employees in fitnes s for duty, 
including  the following : 
 
a) the relevant national  legislation  (see foreword) , policies, processes  and procedures;  
 
b) a declaration;  
 
c) fitness  for duty assessments – competency, healt h and operational restrictions;  
 
d) confidentiality of personal  information; and  
 
e) readiness  for duty, fitness  on duty, and return  to work.  
 
6.4.6  Health assessments  
 
6.4.6.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies and procedures for health assessments in accordance w ith 6.3. 
 
6.4.6.2  The RA shall ensure that in matters of dispute on medical fitness  for duty, the final 
recommendation of the appointed OMP will take precedence. The appointed 
OMP‟s recommendation will be based on all relevant information , including report s 
and recommendat ions from health practitioners.  
 
NOTE A medical certificate of fitness should be issued by the OHP  (see table  D.1). 
 
6.4.7  Training and development  
 
The RA shall establish, develop or adopt, document, implement and maintain policies , 
proce sses,  and procedures to manage the training and development  of employees in 
accordance with  6.2. 
 
6.4.8  Readiness  for duty  
 
6.4.8.1 The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and procedures to manage read iness  for duty in accordance 
with the relevant national legislation  (see foreword) . 
 
6.4.8.2  Management of r eadiness  for duty shall include  the following : 
 
a) evaluation of readiness  for duty when  
 
1) employees  are scheduled or rostered, and  MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
47 
  
NOTE  Fitness  for duty at the time of rostering will consider competency requirements, 
medical requirements and rostering criteria.  
 
2) employees sign on  and sign off ; and  
 
       NOTE  RA‟s  should make use of a checklist , which is to be signed by bo th the 
employee and s upervisor.  
 
b) procedures and process es when an employee is not allowed to continue with normal 
duties.  
 
6.4.8.3  The assessment of readiness  for duty shall include  the following : 
 
a) verifying competencies against  the requirements for the  specific duty;  
 
b) checking compliance with the rostering rules;  
 
c) confirming whether any formal operational restrictions apply;  
 
d) observing unusual behaviour or mood s, and signs or symptoms of any impairment that 
might affect safe railway operations ; 
 
e) arranging for  substance abuse testing in accordance with the RA‟s policies; and  
 
f) obtaining a written declaration of readiness  for duty in respect of fatigue, medication, a 
chronic medical condition , pregnancy and stress experienced by  the employee.  
 
6.4.9  Fitness  on duty  
 
6.4.9.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and procedures to manage employees who, whilst on duty, 
experience problems that might impact on fitness  for duty, in accordance with the 
relevant  national legislation  (see foreword) . 
 
6.4.9.2  Management of f itness  on duty shall include  the following : 
 
a) substance abuse testing;  
 
b) direct behavioural observation;  
 
c) monitori ng of train handling and speed;  
 
d) monitoring of radio communication;  
 
e) immediate post -occurrence investigations or tests; and  
 
f) adherence to rules pertaining to workload limits.  
 
6.4.10  Return  to work  
 
6.4.10.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and procedures to  manage employee s who return  to work 
after a period of absence , in accordance with the relevant national legislation  (see 
foreword) . These shall include  the following : 
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
48 
 a) injury or sick absence;  
 
b) annual leave;  
 
c) unauthori zed absence;  
 
d) maternity le ave; 
 
e) other absences; and  
 
f) operational restrictions.  
 
NOTE  The RA should determine the period of absence after which a n assessment of  
return  to work is required . 
 
6.4.10.2  Employees returning to work after more than six  months absence shall be 
subjec ted to compulsory refresher training and assessment in accordance with 
6.2. 
 
6.4.11  Monitoring, evaluation and review  
 
The RA shall establish, develop or adopt, document, implement and maintain policies, 
processes and procedures to monitor  evaluate and rev iew the management of fitness  for 
duty.  
 
6.5 Chronic medical conditions  
 
6.5.1  General  
 
6.5.1.1  In the context of this clause, chronic diseases or chronic medical conditions refer to 
medical condition s that are present for at least six  months.  
 
6.5.1.2  Chronic medical conditions might be incompatible or potentially incompatible with 
safety -related work owing to their effects particularly on the central nervous system , 
cardiovascular system , sensory organs and the musculo -skeletal system  (see 
annex  D). 
 
NOTE  1 Incompatible chronic medical conditions refer to chronic medical conditions that 
prohibit  the employee from undertaking safety -related work.  
 
NOTE  2 Potentially incompatible chronic medical conditions  refer to chronic medical 
conditions that may be cont rolled where t he level of control determine fitness to 
undertake safety -related work.  
 
6.5.1.3  RA‟s  and employees have a mutual responsibility to mitigate the unwanted and 
undesirable effects of chronic medical conditions to ensure safe railway operations.  
 
6.5.2  Requirements for the management of chronic medical condition s 
 
6.5.2.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and procedures for the manage ment of  employees with chronic 
medical condition s in accordance with  the relevant national legislation  (see 
foreword) . 
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
49 
 6.5.2.2  Management of chronic medical conditions shall form part of the medical 
surveillance programme and shall include  the following : 
 
a) a COP  (see annex  C); 
 
b) action and exclusion cri teria (see annex  D); 
 
c) a declaration;  
 
d) education and training of management and employees;  
 
e) health assessments; and  
 
f) monitoring, evaluation and review.  
 
6.5.2.3  The chronic medical condition management programme shall be dynamic and risk 
driven.  
 
6.5.3  Code of practice  
 
6.5.3.1  The RA shall adopt, document, implement and maintain a COP to manage chronic 
medical conditions in accordance with  the relevant national legislation  (see 
foreword) . (See annex es C, D and E.) 
 
6.5.3.2  The COP  shall include  the following : 
 
a) the type of assessments;  
 
b) the frequency of assessments; and  
 
c) action and exclusion criteria (see annex  D). 
 
6.5.3.3  The action and exclusion criteria shall serve as guidelines for the appointed OHP to 
determine fitness  for duty (see annex  D). 
 
6.5.4  Declaration  
 
6.5.4.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and procedures for employees to declare whether they have a 
chronic medical condition and any side effects related thereto . 
 
6.5.4.2  The employee shall declare before the commencement of duty  
 
a) any existing chronic medical condition if it has not been declared before , 
 
b) a newly diagnosed chronic medical condition , and 
 
c) any side effects that he/she is experiencing.  
 
NOT E The RA should de termine  how long before commencement of duty the declaration 
should be made.  
 
6.5.4.3  The confidentiality of personal information shall be maintained in accordance with 
the relevant national legislation  (see foreword) . 
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
50 
 6.5.4.4  The employ ee shall only be required to divulge the nature of the chronic medical 
condition to the appointed OHP.  
 
6.5.5  Education and training  
 
The RA shall establish, develop or adopt, document, implement and maintain policies, 
processes,  and procedures to educate and train management and employees in matters 
that relate to chronic medical conditions , including  the following : 
 
a) the relevant national legislation  (see foreword) , policies, processes and procedures;  
 
b) requirements to declare to line management any existing chronic medical condition , a 
newly diagnosed chronic medical condition , and any side effects that employees  are 
experiencing;  
 
c) the potential impact of chronic medical conditions on the employee‟s ability to 
undertake safety -related work;  
 
d) the purpose of health assessments;  
 
 NOTE  See 6.3, 6.4, 6.5.6, 6.6, 6.7, 6.8, 6.9, 6.10  and 6.11. 
 
e) the importance of discussing with the employee's health practitioner the impact of the 
chronic medical condition on safety -related work ; 
 
f) the importance o f requesting information  from the employee‟s health practitioner  about 
any potential effects of a chronic medical condition ; 
 
g) the confidentiality of personal information; and  
 
h) the importance of the employee providing the appointed OHP with  
 
1) the na ture of the existing chronic medical condition , 
 
2) the contact details of the employee‟s health practitioner,  
 
3) the names, doses and dosing schedules of all medications, and  
 
4) any side effects that he/she is experiencing.  
 
6.5.6  Health assessments  
 
6.5.6.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and procedures for the health assessments of employees with 
chronic medical conditions in accordance with the relevant national legislation (see 
foreword) to determine fitness  for duty. (See 6.3 and 6.4.) 
 
6.5.6.2  The RA shall ensure that no employee is allowed to perform safety -related work 
unless he/she  has been declared fit for duty by the appointed OMP subsequent to 
health assessments , when the employee  
 
a) has a chronic medical condition , 
 
b) is on medication with potential ly unwan ted or undesirable effects , and MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
51 
  
b) is experiencing unwanted or undesirable effects  caused by medical conditions or 
medication  (see annex  E). 
 
6.5.6.3  Health assessments shall determine  
 
a) the nature and level of control of the chronic medical condition , 
 
b) the efficacy of medication and compliance with the treatment regime , 
 
c) the frequency of follow -up assessments , and 
 
d) whether the employee is physically and psychologica lly fit to undertake safety -related 
work.  
 
6.5.6.4  The RA shall ensure that in matters of dispute on safety and fitness for work, the 
final decision of the appointed OMP take s precedence.  
 
6.5.6.5  The ongoing treatment and management of chronic medical con dition s should be 
the responsibility of the employee‟s health practitioner.  
 
6.5.6.6  The appointed OMP sh all communicate and consult with the employee‟s own 
health practitioner to ensure the effective management of the chronic medical 
condition . 
 
6.5.6.7  The appointed OHP shall provide the RA with a medical certificate of fitness for 
duty for employees  (see table  D.1 for an example  of such a certificate) . 
 
6.5.7  Monitoring, evaluation and review  
 
The RA shall establish, develop or adopt, document, implement  and maintain policies, 
processes and procedures to monitor  evaluate and review the management programme of 
chronic medical condition s. 
 
6.6 Medication  
 
6.6.1  General  
 
6.6.1.1  In the context of this clause , medication, substances,  and medicine have the sam e 
meaning.  
 
6.6.1.2  Medication taken by individual employees for the prevention, treatment or cure of 
medical conditions might have unwanted and undesirable effects , which could 
affect work performance and impact on safe railway operations  (see annex  E). 
 
6.6.1.3  Medication includes medicines  that are  
 
a) taken by the employee  as prescribed by a health practitioner , and 
 
b) bought over the counter . 
 
6.6.1.4  Effects of medication include  the following : 
 
a) effects that are predictable and usually dose relate d; MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
52 
  
b) effects that are unpredic table and not dose related; and  
 
c) effects that might result from interaction with other medication , alcohol  and other 
chemical substances.  
 
6.6.1.5  The u nwanted and undesirable effects of medication on organ systems includ ing 
the central nervous system , cardiovascular system , sensory organs and the 
musculo -skeletal system are of particular concern.  
 
NOTE  Potential side effects of certain  medication are detailed in annex  E. 
 
6.6.1.6  RA‟s  and employees have a mutual responsib ility to mitigate the unwanted or 
undesirable effects of medication to ensure safe railway operations.  
 
6.6.2  Requirements for the manage ment of employees on medication  
 
6.6.2.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and procedures for the manage ment of  employees who are on 
medication , in accordance with the relevant national legislation  (see foreword) . 
(See 6.3, 6.4 and 6.5.) 
 
6.6.2.2  The policies, processes,  and procedures shall include  the following : 
 
a) a declaration ; 
 
b) education and training of management and employees;  
 
c) health assessments;  and 
 
d) monitoring, evaluation and review.  
 
6.6.3  Declaration  
 
6.6.3.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies,  processes and procedures for employees to declare the use of medication 
and any unwanted or undesirable  effects  that they are experiencing.  
 
6.6.3.2  The employee shall declare before the commencement of duty  
 
a) the possession of, inten t to use, or use of , medication , 
 
b) any unwanted or undesirable  effects that he/she is experiencing , and 
 
c) any changes that have been made to the treatment regime.  
 
NOTE  The RA should de termine  how long before commencement of duty the declaration 
should be made.  
 
6.6.3.3  The confidentiality of personal information  shall be maintained in accordance with 
the relevant national legislation  (see foreword) . 
 
6.6.3.4  The employee shall be required to divulge the names of the medication or the 
nature of the medical condition bein g treated only to the appointed OHP.  MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
53 
  
6.6.4  Education and training  
 
The RA shall establish, develop or adopt, document, implement and maintain policies, 
processes,  and procedures to educate and train management and employees in matters 
that relate to medica tion, including  the following : 
 
a) the relevant national legislation  (see foreword) , policies, processes and procedures;  
 
b) requirements to declare to line management the possession of, intent to use or use of 
medication , and any unwanted or undesirable  effects that employees  are e xperiencing;  
 
c) any unwanted or undesirable  effects of medication and the impact thereof on the 
employee‟s ability to undertake safety -related work;  
 
d) the purpose of health assessments;  
 
e) the importance of discussing with th e employee's health practitioner the impact of 
medication on safety -related work ; 
 
f) the importance of requesting information  from the employee‟s health practitioner  about 
any unwanted or undesirable  effects of medication ; 
 
g) the confidentiality of perso nal information; and  
 
h) the importance of the employee providing  the appointed OHP with  
 
1) the contact details of the employee‟s health practitioner,  
 
2) the names, doses and dosing schedules of all medications, and  
 
3) any unwanted or undesirable  effect s that he/she is experiencing.  
 
6.6.5  Health assessments  
 
6.6.5.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and procedures for the referral of employees to the appointed 
OHP to determine fitness  for duty (see 6.3 and 6.4). 
 
6.6.5.2  The RA shall ensure that no employee is allowed to perform safety -related work 
unless he/she  has been declared fit for duty by the appointed OMP subsequent to a 
health assessment when the employee is  
 
a) on medication with pote ntial unwan ted or undesirable effects , and 
 
b) experiencing unwanted or undesirable effects.  
 
6.6.5.3  The RA shall ensure that in matters of dispute on safety and fitness for duty, the 
final decision of the OMP take s precedence.  
 
6.6.5.4  The treatment and management of employees on medication shall be the 
responsibility of the employee‟s health practitioner . 
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
54 
 6.6.5.5  The appointed OHP sh all communicate and consult with the employee‟s health 
practitioner to ensure the effective management of the employee on medication . 
 
6.6.5. 6 The appointed OHP  shall provide the RA with a medical certificate of fitness for 
employees.  
 
6.6.6  Monitoring, evaluation and review  
 
The RA shall establish, develop or adopt, document, implement and maintain policies, 
processes and pr ocedures to monitor , evaluate and review the managem ent of employees 
who are on medication.  
 
6.7 Pregnancy  
 
6.7.1  General  
 
6.7.1.1  In the context of this clause  
 
a) a suspected and confirmed pregnancy sh all be treated the same , and 
 
b) breastfeeding is not  specifically addressed as it does not directly impact on safe 
railway operations.  
 
6.7.1.2  Pregnancy might have a direct impact on the ability of an employee to undertake 
safety -related work.  See the relevant national legislation , (see foreword) for the 
aspects of pregnancy that m ight affect work.  
 
6.7.1.3  Safety -related work might have an impact on the outcome of a pregnancy . See the 
relevant national legislation (see foreword) for the aspects of work that might affect 
pregnancy.  
 
6.7.1.4  RA‟s  and employe es have a mutual responsibility to  
 
a) mitigate the impact of pregnancy on safe railway operations , and 
 
b) protect the health and safety of the pregnant employee and the foetus in accordance 
with the relevant national legislation  (see foreword) . 
 
6.7.2  Requirements for the program me to manage pregnant employees  
 
6.7.2.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and procedures for the manage ment of  pregnant employees in 
accordance with the relevant nation al legislation  (see foreword)  and regulations.  
 
6.7.2.2  The programme  to manage pregnant employees  shall include  the following : 
 
a) recruitment and selection;  
 
b) risk management;  
 
c) a declaration;  
 
d) education and training;  
 
e) health assessments;  MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
55 
  
f) deployment;  
 
g) workplace arrangements; and  
 
h) monitor ing, evaluat ion and review.  
 
6.7.3  Recruitment and selection  
 
The RA shall ensure that recruitment and selection procedures do not unfairly discriminate 
against pregnant employees in accordance with the relevant national legislation  (see 
foreword)  and as specified in  6.1. 
 
6.7.4  Risk ma nagement  
 
The RA shall establish, develop or adopt, document, implement and maintain policies, 
processes and procedures to manage pregnant employees in accordance with the relevant 
national legislation  (see foreword) , including  the following : 
 
a) identification of hazards in safety -related jobs/task s/activities /tools/equipment  and 
working conditions that might be uns uitable for pregnant employees;  
 
b) education and training  of management and employees  in the hazards and risks that 
might impact on pregnancy ; 
 
c) the elimination or mitigation of exposure to hazards  (or both)  that might impact on the 
health and safety of pregnant employees; and  
 
d) identification of alternative  work that might be suitable for employees who are 
temporarily unable to undertake safety -related work during pregnancy.  
 
6.7.5  Declaration  
 
6.7.5.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and procedur es 
 
a) for employees to declare  pregnancy and suspected pregnancy as early as possible , 
and 
 
b) to maintain  a list of all pregnancy notifications.  
 
6.7.5.2  The confidentiality of personal information shall be maintained in accordance with 
the relevant nati onal legislation  (see foreword) . 
 
6.7.6  Education and training  
 
The RA shall establish, develop or adopt, document, implement and maintain policies, 
processes and procedures to educate and train manage ment and employees in the 
following : 
 
a) the relevant n ational legislation  (see foreword) , policies and procedures;  
 
b) requirements to declare as early as possible pr egnancy and suspected pregnancy;  
 
c) the purpose of health assessments;  
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
56 
 d) the importance of discussing with the employee‟s health practitioner  the impact of 
pregnancy on safety -related work and vice versa ; 
 
e) confidentiality of personal  information; and  
 
f) the importance of providing  the appointed OHP with the contact details of the 
employee‟s health practitioner.  
 
6.7.7  Health assessments  
 
6.7.7.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and proced ures for health assessments to  
 
a) confirm pregnancy , and 
 
NOTE  Tests to confirm pregnancy may be performed by the employee‟s health 
practitioner  or the appointed OHP.  
 
b) determine whether the pregnant employee is physically and psychologically fit to  
undertake safety -related work.  
 
6.7.7.2  Health assessments shall be done  
 
a) before placement in the case where a pregnant woman is recruited or sel ected , 
 
NOTE  The health assessment should be performed subsequent to recruitment, when a 
decision about the employment of a n employee  has been taken in principle, 
subject to the r esult of the health assessment.  
 
b) as soon as is reasonably practicable from  the date of the declaration or notification in 
the case of pregnant employees who are currently employed , 
 
c) at intervals stipulated by the appointed OHP for follow -up assessment , 
 
d) on return to work following maternity leave , 
 
e) at any time during pr egnancy when the employee is present ed with a pregnancy 
related condition or problem that might affect her ability to undertake safety -related 
work , and 
 
f) by the appointed OHP as detailed in 6.3. 
 
6.7.7.3  The RA shall ensure that in matters of dispute on  safety and fitness for work, the 
final decision of the OMP take s precedence.  
 
6.7.7.4  The ongoing treatment and management of pregnancy sh all be the responsibility of 
the employee‟s health practitioner.  
 
6.7.8  Deployment  
 
6.7.8.1  The RA shall ensure that no employee is allowed to undertake safety -related work 
unless she has been declared fit for duty by the appointed OHP , subsequent to a 
health assessment in accordance with the relevant national legislation  (see 
foreword) , when the employee  
 
a) is pregnant , or 
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
57 
 b) suspects pregnancy.  
 
6.7.8.2  The RA shall, in accordance with  the relevant national legislation  (see foreword)  
 
a) temporarily deploy employees into suitable alternative work when employees are 
declared at risk to continue safety -related work;  and 
 
b) redeploy employees into safety -related work when employees are declared fit to return 
to work.  
 
6.7.9  Workplace arrangements  
 
The RA shall establish, develop or adopt, document, implement and maintain policies, 
processes and procedures for workplace a rrangements in accordance with the relevant 
national legislation  (see foreword)  to 
 
a) acco mmodate pregnant employees , and 
 
b) ensure that these  arrangements do not impact negatively on safe railway operations.  
 
6.7.10  Monitoring, evaluation and review  
 
The RA shall establish, develop or adopt, document, implement and maintain policies, 
processes and procedures to monitor , evaluate and review the management of pregnant 
employees.  
 
6.8 Employee wellness  
 
6.8.1  General  
 
6.8.1.1  An integrated and comprehensive  approach to workplace wellness is a powerful 
strategy for promoting positive and healthy lifestyles , which will contribute to safe 
railway operations  (see annex  F). 
 
6.8.1.2  The management of employee wellness requires understanding, commitment and 
partic ipation at all levels within railway operations . 
 
6.8.1.3  Employee s have the responsibility to manage their own well -being , including 
participating in workplace programmes . RA‟s  have the responsibility to create and 
maintain a safe and healthy workplace in  accordance with the relevant national 
legislation  (see foreword) . 
 
6.8.2  Requirements to manage employee wellness  
 
6.8.2.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and procedures for the management of employee wellness.  
 
6.8.2.2  The employee wellness management programme shall be dynamic and risk -driven 
and shall include  the following : 
 
a) roles and responsibilites;  
 
b) education and training;  
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
58 
 c) interventions; and  
 
d) monitor ing, evaluat ion and review . 
 
6.8.3  Roles and responsibilities  
 
6.8.3.1  The RA shall 
 
a) appoint a person with the relevant authority and responsibilty to manage employee 
wellness , and  
 
b) define the roles and responsibilities of the appointed person.  
 
6.8.3.2  The appointed person s hall, where relevant, use the services of  
 
a) health professionals , including psychologists and social workers , and 
 
b) any other professionals as needed for  the workplace wellness programme.  
 
6.8.4  Education and training  
 
The RA shall establish, develop o r adopt, document,  implement and maintain policies, 
processes and procedures to educate and train management and employees in matters 
that relate to employee wellness , including  the following : 
 
a) relevant p olicies, processes and procedures;  
 
b) roles and responsibilities; and 
 
c) hazards  to employee wellness , including  
 
1) unhealthy lifestyle s – inadequate rest, smoking, substance abuse, lack of exercise; 
unhealthy eating habits,  
 
2) chronic diseases – high blood pressure , diabetes , epilepsy , obesity , depression , 
HIV infection , tuberculosis , 
 
3) fatigue as specified in 6.10, and 
 
4) stress as specified in 6.11. 
 
6.8.5  Interventions  
 
The RA shall establish, develop or adopt, document, implement and maintain policies, 
processes,  and procedures to  provide inte rventions , including  the following : 
 
a) health promotion to  encourage a healthy lifestyle;  
 
b) absenteeism and attendance management;  
 
c) wellness assessments such as screening for lifestyle risk factors, chronic diseases and 
health assessments  as specifie d in 6.3; 
 
d) employee assistance, support and rehabilitation relating  to substance abuse, and 
emotional, financial and legal issues;  and MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
59 
  
e) appropriate referral of employees with identified  problems or conditions.  
 
6.8.6  Monitoring, evaluation and review  
 
The RA shall establish, develop, adopt, document, implement,  and maintain policies, 
processes and procedures to monitor, evaluate and review the employee wellness 
management programme.  
 
6.9 Substance abuse  
 
6.9.1  General  
 
6.9.1.1  Substance abuse in the c ontext of this clause refers to the  use of illegal drugs as 
defined in the relevant national legislation (see foreword) and the sustained, 
inappropriate,  or sporadic excessive use  of alcohol and legal drugs.  
 
6.9.1.2  The term "s ubstance abuse " refers to any substance that  
 
a) is misused for purposes other than intended , 
 
b) has an undesirable effect on the central nervous system , 
 
c) has the potential to create  social problem s through physical or psychological addiction , 
and 
 
d) is restricted by law in acco rdance with the relevant national legislation  (see foreword) . 
 
6.9.1.3  The effect s of substance abuse on employees , which might impact on sa fe railway 
operations , include  the following : 
 
a) increased risk taking;  
 
b) carelessness;  
 
c) inadequate attention to detail or not paying attention to detail;  
 
d) acting  without thinking about consequences;  
 
e) decreased concentration;  
 
f) reaction -time increase resulting in slower reactions;  
 
g) forgetfulness;  
 
h) poor judgement of distance and speed of moving object s; 
 
i) impaired coordination;  
 
j) impaired sensory perception;  
 
 EXAMPLE S Less sensitivity in fingertips, affected hearing, b lurred vision, loss of 
balance.  
 
k) violent and aggressive behaviour;  MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
60 
  
l) sleep  deprivation; and  
 
m) impaired communication due to slurred speech.  
 
6.9.1.4  RA‟s  and employees have a mutual responsibility to  contribute to safe railway 
operations by  
 
a) striving to  eliminat e substance abuse , and 
 
b) mitigating the impact of substance abuse.  
 
6.9.2  Requirements for the management of subs tance abuse  
 
6.9.2.1  The RA shall establish, develop or adopt, document,  implement and maintain 
policies, processes and procedures for the manage ment of  substance abuse in 
compliance  with the relevant national legislation  (see foreword) . 
 
6.9.2.2  The RA shall adopt a zero -tolerance approach to substance abuse by ensuring that  
 
a) any employee who contravenes policies or procedures (or both)  faces a predetermined 
disciplinary process, irrespective of the employee‟s title, position or status in the 
organi zation; 
 
b) no employee ha s in his /her possession, or partake s of, or offer s any other employee , a 
substance of abuse;  
 
c) no employee hand s over his /her duties to another employee if such employee is or is 
suspected of being under the influence of, in possess ion of, partaking of, or offering 
any other employee , a substance o f abuse while in the workplace;  
 
d) no employee who is, or appears to be , under the influence of any substance of abuse 
as detailed in table 1 enter s the workplace; and  
 
e) no person is all owed entry into the workplace or to remain in the workplace if such a 
person i s, or appears to be , under the influence  of, in possession of, partaking in the 
use of, or offering any employee , a substance of abuse in accordance with  the relevant 
national le gislation  (see foreword) . 
 
6.9.2.3  The following criteria shall require action by the RA in terms of  the substance abuse 
programme:  
 
a) a blood alcohol concentration exceeding 0 ,02% (milligram per hundred millilitres of 
blood);  
 
b) any positive screening t est for an illegal drug followed by a positive confirmatory test; 
and 
 
c) any positive screening test for a legal drug followed by a positive confirmatory test.  
 
NOTE  1 A screening test is a rapid test performed to check for the presence of the 
subtance at  the time of testing. Screening tests should be specific and sen sitive. 
The confirmatory test is used to confirm the screening test. The c onfirmatory test 
should be a laboratory test ( i.e. a different test  from the first or screening test). 
Confirmatory te sts can also test for evidence of  long-term use.  MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
61 
  
NOTE  2 Legal drugs include prescription and over -the-counter  drugs,  which impair the 
ability of the employee  to undertake safety -related work.  
 
6.9.2.4  The substance abuse programme shall be dynamic and  risk driven.  
 
6.9.2.5  The substance abuse programme shall include  the following : 
 
a) roles and responsibilites;  
 
b) education and training;  
 
c) testing;  
 
d) treatment and rehabilitation; and  
 
e) monitor ing, evaluat ion and review . 
 
6.9.3  Roles and responsibili ties 
 
6.9.3.1  The RA shall 
 
a) appoint a person with the relevant responsibil ity and a uthority to manage substance 
abuse , and  
 
b) define the roles and responsibilites of the appointed  person . 
 
6.9.3.2  Employees shall  
 
a) not enter the workplace when under the influence of a substance of abuse , 
 
b) not have in their possession, or partake of, or offer any other employee , a substance o f 
abuse while in the workplace , 
 
c) be responsib le for declar ing the under taking  of safety -related work  to, and to discuss 
possible effects of prescribed medication  with, the health practitioner , and 
 
d) notify the RA if safe railway operations  might be affected because they or other 
employees are or are suspected of being under the influence of, in possession of, 
partaking of, o r offering any other employee , a substance o f abuse while in the 
workplace.  
 
 NOTE  See 6.3, 6.4 and 6.5. 
 
6.9.4  Education and training  
 
The RA shall establish, develop or adopt, document,  implement and maintain policies, 
processes and procedures to educate  and train management and employees in the 
subst ance abuse programme , including  the following : 
 
a) the relevant national legislation  (see foreword) , policies, processess and procedures;  
 
b) health risks at work and off the job , such as  
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
62 
 1) the physical, ps ychological and social  effects of substance abuse, and  
 
2) the signs and symptoms of intoxication, potential substa nce abuse and related 
problems ; 
 
c) roles and responsibilities;  and 
 
d) commonly used substances of abuse . 
 
6.9.5  Testing  
 
6.9.5.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and procedures to manage the testing of substance abuse in 
accordance with the relevant national legislation  (see foreword) . 
 
6.9.5.2  Testing for substance abuse shall inc lude screening for evidence of  the following : 
 
a) illegal drugs;  
 
b) legal drugs;  
 
c) alcohol; and  
 
d) chronic substance abuse.  
 
NOTE  Screening for chronic substance abuse refers to laboratory testing to identify the 
use of substances over a period of time  irrespective of whether the person  is, at the 
time of testing , under the influence of the substance.  
 
6.9.5.3  Testing shall be performed under the following circumstances:  
 
a) post occurence , including a n incident ; 
 
b) based on cause for suspicion (see table 1); 
 
c) on voluntary request by an employee;  
 
d) testing scheduled before re -certification and during health assessments in accordance 
with 6.2 and 6.3; 
 
e) random testing; and  
 
NOTE  The RA should define the approach to random testing and include the s tatistical 
method of determining the percentage of employees to be tested and the time of 
testing.  
 
f) routine testing.  
 
NOTE     The RA should define the approach to routine testing.  
 
6.9.5.4  The RA shall ensure that testing is performed by a competent pe rson.  
 
NOTE  Only a health practitioner may test for chronic substance abuse.  
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
63 
 6.9.5.5  The RA shall ensure that  
 
a) equipment is used and maintained according to the manufacturer's specifications,  
 
b) records of testing are maintained in a safe and confiden tial manner,  
 
c) the confidentiality of personal information be maintained, and  
 
d) only the test result (screening and confirmatory) be divulged.  
 
NOTE  The report on substance abuse testing may include the type of substance, and 
value – positive or negat ive. 
 
Table 1 — Observations of causes for reasonable suspicion  
 
1 2 
Aspect  Observation  
Breath  Smell of intoxicating liquor /alcohol  
Skin colour  Pale, flushed  
Attitude  Uncooperative, talkative, anxious, excited, dreamy, relaxed, sedated, 
antagonistic, h ostile, irritable, cocky, unable to follow instructions, 
depressed, aggressive, has difficulty staying awake, restless, alert, 
unresponsive, vague, argumentative, agitated  
Actions  Swearing, hiccupping, belching, vomiting, fighting, drooling, restless, 
runny nose, loss of emotional control, itching, scratching, repetitive 
behavio urs, disorganized  
Eyes  Watery, glazed, bloodshot, eyelids drooping, pupils pinpointed, pupils 
wider than normal, glassy  
Breathing  Normal, short, jerky, shallow, slow  
Speech  Incoherent, slurred, confused, fast, slow, repetitious, difficulty with 
pronunciation or forming sentences  
Balance  Unsteady, swaying, sagging, falling, staggering, needing support, 
stumbling  
Movements  Clumsy, jerky, sluggish, tremor, running or jumping aroun d, slow, 
fidgeting  
Level of sobriety  Slightly affected/moderately affected/ extremely affected by alcohol or 
other substances  
Additional 
indicators  Presence of drug paraphernalia (such as syringes, swabs, tourniquets 
and devices for smoking drugs)  
Admissi on of consumption of alcohol or drug -taking  
Clinical dehydration  
 
 
6.9.6 Treatment and rehabilitation interventions  
 
The RA shall establish, develop or adopt, document,  implement and maintain policies, 
procesess and procedures to provide  access to  treatme nt and rehabilitation for employees 
with substance abuse related problems.  Access to treatment and rehabilitation sh all be in 
compliance with the relevant national legislation (see foreword) and in accordance 
with 6.8. MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
64 
  
6.9.7  Monitoring, evaluation and rev iew 
 
The RA shall establish, develop or adopt, document,  implement and maintain policies, 
procesess and procedures to monitor, evaluate and review the substance abuse 
programme.  
 
6.10 Fatigue management  
 
6.10.1  General  
 
6.10.1.1  In the context of this clause fatigue refer s to the accumulated physical and 
psychological condition s when the employee‟s  maximum physical and mental 
limits have been exceeded.  
 
6.10.1.2  The major factors that might  contribute to fatigue include  the following : 
 
a) individual factors ; 
 
 EXAMPLE S Age, personality , body clock (circadian rhythms), diet, fitness and 
general health.  
 
b) social facto rs; 
 
 EXAMPLE S Travel arrangements (i.e. mode, duration, time of day, distance) to 
and from work, lifestyle, stress, marital status, children, leisure  interests and 
moonlighting.  
 
c) job factors;  and 
 
 EXAMPLE S Workload , includ ing over and under workload , and r ostering 
practices.  
 
d) organizational factors.  
 
 EXAMPLE S Job design, management practises and supervision, policies and 
procedures.  
 
6.10.1.3  The major effects of fatigue on the employee  that might impact on safe railway 
operations include  the following : 
 
a) impaired cognitive functioning;  
 
 EXAMPLE S Impaired vigilance, alertness, memory and concentration.  
 
b) impaired affective functionin g; 
 
 EXAMPLE S Irritability, lethargy, apathy and depressed mood and state.  
 
c) changes in behavioural functioning;  and 
 
 EXAMPLE S Drowsiness, increased errors, reduced reaction time, paralysis, 
automatic behaviour and impaired decision -making.  
 
d) changes in physical functioning.  
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
65 
  EXAMPLES  Reduced reaction time, for example speed, head/neck 
bobbing/"micro sleeps", reduced hand -eye coordination, digestive problems, giddiness, 
restless leg syndrome, increased or decreased blood pressure.  
 
6.10.1.4  The effect s of fatigue are cumulative and might impact on the employee‟s  health.  
 
6.10.1.5  RA‟s  and employees have a mutual responsibility to ensure  that fatigue is 
understood and managed.  
 
6.10.2  Requirements to manage fatigue  
 
6.10.2.1  The RA shall establish, deve lop or adopt, document, implement and maintain 
policies, processes and procedures to manage fatigue  in accordance with the 
relevant national legislation  (see foreword) . 
 
6.10.2.2  The fatigue management programme shall be a dynamic and risk -driven process 
and shall include  the following : 
 
a) roles and responsibilities;  
 
b) education and training;  
 
c) RAs; 
 
d) controls;  and 
 
e) monitoring, evaluation and review.  
 
6.10.3  Roles and responsibilities  
 
6.10.3.1  The RA shall 
 
a) appoint a person with the relevant a uthority and responsibility to manage the fatigue 
management  programme , and 
 
b) define the roles and responsibilities of the appointed person . 
 
6.10.3.2  The appointed person  shall use, where relevant , resources , including  the 
following : 
 
a) employees and t heir representative structures;  
 
b) line management;  
 
c) OHP s; 
 
d) social worker s; 
 
e) psychologists ; and  
 
f) human factor specialists/ergonomists.  
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66 
 6.10.4  Education and training  
 
The RA shall establish, develop or adopt, document, implement and maintain p olicies, 
processes,  and procedures to educate and train management and employees in fatigue 
management , including  the following : 
 
a) the relevant national legislation  (see foreword) , policies, processes and procedures;  
 
b) health effects and safety risks a t work and off -the-job, such as  
 
1) causes and effects of fatigue,  
 
2) circadian rhythms,  
 
3) sleep hygiene, sleep physiology and sleep disorders , and 
 
4) lifestyle management,  
 
c) roles and responsibilities;  
 
d) the purpose of workload assessments, health  assessments and risk assessments ; 
 
e) shift work;  
 
f) rostering – principles and best practices;  
 
g) fatigue monitoring;  and 
 
h) controls . 
 
6.10.5  Risk management  
 
The RA shall establish, develop or adopt, document, implement and maintain policies, 
proces ses, and procedures to identify fatigue risk factors , including  the following : 
 
a) identifying jobs/tasks/activities and work environments where factors that might 
contribute to fatigue are prevalent  (see 6.10.1.2); 
 
b) conducting workload a ssessments to d etermine  
 
1) a worker‟s capability and limitations to meet the physical and psychological  
demands of his/her jobs/tasks/activities , 
 
2) capacity or potenti al to take on additional tasks,  
 
3) ability to cope with emergency situations, and  
 
4) whether tasks,  equipment or environment can be altered to achieve optimal 
performance ; 
 
c) determining the level of risk; and  
 
d) evaluating control measures.  
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67 
 6.10.6  Controls  
 
6.10.6.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies,  processes and procedures for the implement ation of  controls to manage 
fatigue that comply with the relevant national legislation  (see foreword) . 
 
6.10.6.2  Controls shall include  the following : 
 
a) rostering prac tices;  
 
b) fatigue monitoring; and  
 
c) fatigue-counter  strategies.  
 
6.10.6.3  Rostering practices shall aim to 
 
a) minimi ze the cumulative effect s of fatigue by restricting the number of consecutive 
night or early  morning shifts , 
 
b) prevent undue fatigue of employees whose work time exceeds normal d aily and 
weekly shift limits owing to abnormal circumstances , 
 
c) ensure adequate rest periods between shifts – work -to-rest ratio , 
 
 NOTE  A shift diagram may be used to illustrate the pattern of consecutive shifts.  
 
d) minimi ze interruption of rest period s, 
 
 NOTE  Organi zed labour may negotiate the duration of the book -off system rest period . 
 
e) allow workers returning from a period of absence that exceed s three  days (72  h) to 
start with a day shift commencing before midday , and 
 
f) allow line management to assess readiness  for work in accordance with 6.4.8 at the 
start of the shift , especially for employees who undertak e permanent night  duty.  
 
6.10.6.4  Rostering principles shall include strategies to  
 
a) obtain input from employees and their representativ e structures , 
 
b) prevent deviations from working time  (shifts) requirements , 
 
c) monitor staff availability , 
 
d) prevent shift swapping , 
 
e) provide for abnormal working conditions , and 
 
f) assess and manage fatigue risk periods in work schedules.  
 
6.10.6 .5 Rostering polic ies shall specify the  
 
a) maximum length of shift or period on duty , 
 
b) minimum rest interval s between shifts or periods on duty , 
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
68 
 c) maximum number of hours to be worked in seven consecutive days , 
 
d) minimum frequency and number of res t days , 
 
e) maximum number of consecutive day shifts , 
 
f) maximum number of consecutive night shifts and early  morning shifts , and 
 
g) number and duration of rest periods during the shift according to the workload.  
 
6.10.6.6  Fatigue monitoring methods shal l include  the following : 
 
a) behavioural observation for signs and symptoms of fatigue while performing tasks;  
 
b) qualitative techniques;  
 
 EXAMPLE S Questionnaires and interviews.  
 
c) quantitative techniques; and  
 
 EXAMPLE  Occurrences data analysis.  
 
d) a fatigue reporting process.  
 
 NOTE  The RA should establish a system to report fatigue.  
 
6.10.6.7  Fatigue -counter  strategies shall include  the following : 
 
a) optimizing workload management  with respect to  
 
1) the staff complement,  
 
2) task allocation (frequ ency and duration),  
 
3) rostering practices,  
 
4) working time,  
 
5) rest periods,  
 
6) physical environmental factors, and  
 
7) HFID;  
 
b) providing education and training; and  
 
c) conducting health assessments to determine fitness  for duty as described in 6.3 and 
6.4. 
 
6.10.7  Monitoring, evaluation and review  
 
The RA shall establish, develop or adopt, document, implement and maintain policies 
processes and procedures to monitor , evaluate and review the fatigue management  
programme.  
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69 
 NOTE  In order to assess the  effectiveness of the fatigue management programme , an 
adequate data base reflecting fatigue -related incidents and near misses should be 
established for trend analysis.  
 
6.11 Stress management  
 
6.11.1  General  
 
6.11.1.1  Stress is a person ‟s adverse physical , physiological, and psychological reaction to 
pressure or other types of demand  that a person  is unable to cope with or control.  
 
6.11.1.2  The dynamics of work stress are illustrated in figure  1. The model in figure  1 
provides some examples of hazards, symptoms,  and outcomes.  
 
6.11.1.3  Major factors that might contribute to stress include the following:  
 
a) demands on the employees;  
 
 EXAMPLE S Work caused by abnormal working conditions, under and over 
workload, specific task induced stress, night work, shi ft rostering, deadlines, resource 
availability or lack thereof, conflicting priorities, technology.  
 
b) the employees' level of control with regard to carrying out the work;  
 
 EXAMPLE  Organizational processes or bureaucracy.  
 
c) the level of support (encou ragement) and resources provided to the employees;  
 
 EXAMPLE  The organization, line management and colleagues may provide or withhold 
support and resources.  
 
d) the level of conflict that the employees experience;  
 
 EXAMPLE  Conflict might be related to wor k, family and social relationships.  
 
e) the employees‟ ability to understand and manage their roles and responsibilities; and  
 
f) the level of organizational change that the employees experience and their perception 
of how well the change is managed.  
 
6.11.1.4 The effect of stress on employees‟ work performance might impact on safe 
railway operations as described in annex  G. 
 
6.11.1.5  Stress might have negative outcomes on the individual and the organization as 
illustrated in figure  1. 
 
6.11.1.6  RA‟s  and em ployees have a mutual responsibility to anticipate, identify and 
manage stress.  
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
70 
 
IndividualPotential stress-
related hazardsSymptoms of stress Negative outcomes
Demands
ChangeRoleRelationshipsSupportControlIndividual
●  Raised blood pressure
●  Depressed mood
●  Excessive drinking
●  Irritability
●  Chest pains
Organizational
●  High absenteeism
●  High labour turnover
●  Industrial relations    
  difficulties
●  Poor quality controlIndividual 
●  Coronary heart disease
●  Clinical anxiety and          
    depression
●  Burnout
●  Fatigue
Organizational
●  Prolonged strikes
●  Frequent and severe 
    occurrences
●  Apathy
●  Increased litigation
●  Reduced profits 
 
NOTE  This model was adapted from A Model of Work Stress  to underpin the health and 
safety executive advice for tackling work -related stress and stress risk 
assessments . 
 
Figure 1 — The dynamics of work stress  
 
 
6.11.2  Requirements to manage stress  
 
6.11.2.1  The RA shall establish, develop or adopt, document, implement and maintain 
policies, processes and procedures to manage stress.  
 
6.11.2.2  The stress management programme shall include  the following : 
 
a) roles and responsibilities;  
 
b) education and training;  
 
c) risk assessments ; 
 
d) controls;  and 
 
e) monitor ing, evaluat ion and review.  
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
71 
 6.11.3  Roles and responsibilities  
 
6.11.3.1  The RA shall 
 
a) appoint a person with the relevant authority and responsibility to manage the stress 
management programme , and 
 
b) define the roles and responsibilities of the appointed person . 
 
6.11.3.2  The appointed person shall, where relevant, use the services of pr ofessionals , 
such as  
 
a) OHP s, 
 
b) social worker s, and 
 
c) psychologist s. 
 
6.11.4  Education and training  
 
The RA shall establish, develop or adopt, document, implement and maintain policies, 
processes and procedures to educate and train management and empl oyees in matters 
that relate to stress , including  the following : 
 
a) the relevant national legislation  (see foreword) , policies, processes and procedures;  
 
b) health effects and safety risks at work and off -the-job; 
 
c) roles and responsibilities;  
 
d) the purpose of risk assessments ; 
 
e) the purpose of the medical surveillance programme ; and 
 
f) controls . 
 
6.11.5  Risk management  
 
The RA shall establish, develop or adopt, document, implement and maintain policies, 
processes,  and procedures to identify stress  by using  
 
a) quantitative methods , and 
 
 EXAMPLE S Data on p roductivity and performance, individual risk profile s, 
absenteeism, employee wellness, staff turnover, stress audits, health assessment s, 
and questionnaires . 
 
b) qualitative meth ods. 
 
 EXAMPLE S Focus groups, performance appraisals, informal discussion s with 
employees, return -to-work interviews, questionnaires, exit interviews.  
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
72 
 6.11.6  Controls  
 
The RA shall establish, develop or adopt, document, implement and maintain policies, 
processes,  and proce dures for the implementation of control s to manage  stress , including  
the following : 
 
a) the organizational development to im plement improved work and managemen t 
systems;  
 
b) the application of HFID principles to improve or replace equipment;  
 
c) the develo pment of strategies to ensure continual and active communication with all 
stakeholders on the stress management programme;  and 
 
d) the management of adversely affected employees through  
 
1) conducting health assessments , 
 
2) referr ing employees to speciali sts such as psychologists  and social workers , and 
 
3) developing appropriate rehabilitation and return -to-work programmes.  
 
NOTE  See 6.3, 6.5 and 6.8. 
 
6.11.7  Monitoring, evaluation and review  
 
The RA shall establish, develop or adopt, document, implement and maintain policies, 
processes and procedures to monitor  evaluate and review the stress management 
programme . 
 
Annex A  
(informative )  
 
General human -factors -in-design checklist s 
 
Table s A.1 to A.3 provide examples of checklists regarding HFID, train cab in design and 
office design , which may be used during risk assessments  to identify hazards due to poor 
design.  
 
Table A.1— Checklist for human  factors  in design  
 
Area:  
Number of workers:   
1  Manual material handling  Yes No Comments  
- 1.1 Is there lifting  of loads, tools or equipment?    
 - 1.2 Is there lowering of loads, tools or equipment?    
- 1.3 Is there overhead reaching for loads, tools or 
equipment?    
- 1.4 Is there bending at the waist to handle loads, tools 
or equipment?    
- 1.5 Is there twisting at  the waist to handle loads, tools 
or equipment?    MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
73 
 Table A.1  (concluded ) 2  Physical energy demands  Yes No Comments  
- 2.1 Do tools and equipment used weigh more than 25 
kg?   
 - 2.2 Is reaching more than 55 cm?    
- 2.3 Is bending, stooping or squatting a primary 
task/activity?    
- 2.4 Is lifting or lowering loads a primary task /activity?    
- 2.5 Is walking or carrying loads a primary task /activity?    
- 2.6 Is stair or ladder climbing with loads a primary 
task/activity?    
- 2.7 Is pushing or pulling of loads a primary 
task/activit y?   
- 2.8 Is reaching overhead a primary task /activity?    
- 2.9 Is operating equipment or tools above shoulder 
height a primary task /activity?    
3  Other musculo -skeletal demands  Yes No Comments  
- 3.1 Do manual tasks require frequent, repetitive 
motions?     
- 3.2 Does work posture require frequent bending of 
neck, shoulder, elbow, wrist or finger joints?     
- 3.3 Does the worker kneel (on one or both knees)?     
- 3.4 Is the worker unable to change body position 
often?     
- 3.5 Does the work involve forceful, quick or sudden 
motions?     
- 3.6 Does the work involve whole -hand grasping with 
straight elbows?     
- 3.7 Does job posture involve sustained muscle 
contraction of any limb for periods of more than 
30 min?     
- 3.8 Does the worker stand continuously for perio ds of 
more than 30  min?     
4  Environment  Yes No Comments  
- 4.1 Is the temperature too hot or too cold?     
- 4.2 Is there dust?     
- 4.3 Is the workplace poorly lit?     
- 4.4 Is the environment  noisy ?    
- 4.5 Is the worker working with vibrating hand tools o r 
equipment?     
- 4.6 Is the worker working with hazardous chemicals?     
- 4.7 Is the worker subjected to whole -body vibration?     
5  General workplace  Yes No Comments  
- 5.1 Are the walkways uneven?     
- 5.2 Is the floor surface flat and free of obstacles?     MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
74 
 - 5.3 Is the workplace at a gradient?     
- 5.4 Is the ceiling height less than 2 , 4 m?    
- 5.5 Is there adequate accessibility for performing the 
task?     
- 5.6 Is housekeeping poor?     
 
Table A.2 — Checklist for t rain cabin design  
 
Area:  
Number of worker s:  
Area for consideration  Yes No Comments  
- 1 Is the seat height adjustable?     
- 2 Can the seat be adjusted horizontally?     
- 3 Is the seat set at the proper height?     
- 4 Does the seat have proper back support?     
- 5 Does the seat have a lumbar support?     
- 6 Are there armrests available?     
- 7 Are the armrests adjustable?     
- 8 Are the armrests set at the proper height?     
- 9 Do you feel any vibration from the equipment 
through the seat?     
- 10 Do you feel any vibration from the equipment 
through the flo or?    
- 11 Do you feel any vibration from the equipment 
through the controls?     
- 12 Is the seat mounted to the floor of the cab?     
- 13 Can the seat be tilted backwards?     
- 14 Can the seat swivel?     
- 15 Is the location of the controls or levers adjustab le?    
- 16 Can you easily reach the levers or controls?     
- 17 Can you easily operate the levers or controls?     
- 18 Can you easily operate the pedals?     
- 19 Is the cab in area large enough ( i.e. is the area 
uncramped) for you?     
- 20 Do you have sufficien t upward visibility?     
- 21 Is your view of the operation obstructed (e.g. by 
cabin guards, pipes/hoses)?     
- 22 Do you feel the cab in is noisy?     
- 23 Can you control the temperature of the cab in?    
- 24 Does the equipment have steps?     
- 25 Does the equipment have  handrails?     MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
75 
 - 26 Can you easily open/close the cab in doors?     
- 27 Does the equipment have proper means for 
entering the cab in?    
- 28 Does the equipment have proper means for exiting 
the cab in?    
- 29 Do you have a good general view of the gro und?     
- 30 Are the cab in windows free from distracting 
reflections?     
 
Table  A.3 — Checklist for o ffice design  
 
1  Desk/Workstation  Yes No Comments  
- 1.1 Do you have enough room on your work surface 
for all your computer accessories?     
- 1.2 Is your desk  surface deep enough to provide at 
least 45  cm between your eyes and the computer 
screen?     
- 1.3 Are your most frequently accessed items (e.g. 
phone  and manuals) easy to reach?     
- 1.4 If your desk has a fixed height, is the keyboard 
tray adjustable?     
- 1.5 Have you removed all under -desk obstructions?     
- 1.6 Do you have a document holder to hold paper for 
prolonged computer inputting?     
- 1.7 Do your arms rest on, or contact any sharp or 
square edges on your work surfaces?     
- 1.8 If a large percentage of your time involves using a 
phone , do you use a phone headset?     
- 1.9 Is your source light out of your line of sight?     
2  Chair  Yes No Comments  
- 2.1 Is your chair height adjustable?     
- 2.2 Is your chair back adjustable up and down?     
- 2.3 Is your c hair back contoured to support the lower 
back?     
- 2.4 Is your backrest large enough to support your 
entire back, without interfer ing with the use of 
your arms?     
- 2.5 Is your lumbar support a minimum of 30  cm 
wide?     
- 2.6 Is there room (5  cm to  10 cm) b etween the front 
edge of the seat pan and the back of your 
knees?     
- 2.7 If your feet do not rest flat on the floor when your 
chair is properly adjusted, do you use a footrest?     
- 2.8 Is the top of your footrest covered with non -skid 
material to reduce s lippage?     MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
76 
 - 2.9 Do your armrests  interfere with you r getting close 
to your work?     
- 2.10 Do your arm rests allow you to sit with your 
shoulders relaxed and not elevated?     
- 2.11 Does your chair have removable armrests?     
- 2.12 Is the distance between yo ur armrests 
adjustable?     
- 2.13 Are your knees bent forming approximately a 90 ° 
or greater angle?     
- 2.14 Does the chair have a stable base supported by 
five legs with castors?     
3  Monitor  Yes No Comments  
- 3.1 Is the viewing distance to your computer monitor 
between 45  cm to  75 cm?    
- 3.2 Is the top of your computer screen at or just below 
eye level?     
- 3.3 If you wear bifocals or trifocals, can you see the 
computer monitor without having to tilt your head 
back to read the screen or other items in yo ur 
work area?     
- 3.4 Is your computer monitor free of glare or 
reflections?     
- 3.5 Is the monitor screen clean?     
- 3.6 Is the character size easy to read?     
- 3.7 Do you have blinds on the windows near your 
computer?     
- 3.8 Do you use a glare screen to  reduce glare on your 
monitor?     
4  Keyboard  Yes No Comments  
- 4.1 With your chair adjusted properly is your work 
surface at approximately elbow level?     
- 4.2 Are your shoulders relaxed and not elevated when 
you work at your work surface?     
- 4.3 Is the height of your keyboard low enough so that 
your arms are relaxed at your side?     
- 4.4 When you type or write on your work surface , is 
there an angle of approximately 90 ° between your 
forearms and upper arms and are your elbows 
close to your body?     
- 4.5 When you type , are your wrists in line with your 
forearms and not bent upwards, downwards or 
side to side?     
- 4.6 Do you have a wrist rest to support your wrists in a 
straight and neutral position?     
5  Mouse, trackball or other input device  Yes No Comm ents 
- 5.1 Is your mouse, trackball or other input device ( e.g.    MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
77 
 touch -pad) located directly in your immediate 
reach zone?  
- 5.2 Is your mouse or trackball positioned next to your 
keyboard?     
- 5.3 Is your mouse or trackball placed together with 
your keybo ard on an adjustable work surface or 
tray?     
- 5.4 Is your mouse work surface stable?     
- 5.5 Is the mouse or trackball at the same level as your 
keyboard?     
6  Work habits  Yes No Comments  
- 6.1 Do you take short and frequent breaks every 
20 min to  30 min?    
- 6.2 Do you frequently change body positions while working?     
- 6.3 Do you provide your eyes with vision breaks every half hour?     
- 6.4 Are you free from experiencing any pain or discomfort while 
working?     
 
 
Annex B  
(informative )  
 
Thermal enviro nmental conditions for enclosed space s 
 
B.1 In enclosed spaces the following conditions will contribute to thermal comfort : 
 
a) in summer a dry -bulb temperature range of 23  °C to 28  °C at a relative humidity of 
between 40% and 70% ; and  
 
b) in winter a temp erature range of 20  °C to 25 , 5 °C at a relative humidity of above 30% . 
 
B.2 Thermal environmental parameters i n enclosed working environments may be 
maintained by using the following:  
 
a) air-conditioning units that do not dis charge directly onto occupant s; 
 
b) thermally insulated floors ; and 
 
c) windows provided with movable visors and tint ed shades.  
 
 
 
Annex C  
(normative )  
 
Essential guidelines for the development of a code of practice for medical 
surveillance  
 
C.1 A COP shall  
 
a) provide minimum standa rds of occupational health and is designed to assist the RA in 
meeting its legal obligations,  MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
78 
  
b) provide practical guidance on consistent occupational health practices by describing 
the preferred methods or courses of actions,  
 
c) assist the RA in impleme nting a risk -based medical surveillance programme,  
 
d) provide a framework for consistency in fitness for duty certification, and  
 
e) reflect contemporary medical knowledge, which keeps pace with the current 
understanding of the impact of certain condition s on the ability of employees to 
undertake safety -related work.  
 
C.2 The following shall be considered when drafting the COP:  
 
a) the relevant national legislation (see foreword);  
 
b) relevant international and national standards and guidelines;  
 
c) health  risk assessments ; 
 
d) occupational hygiene reports and measurements;  
 
e) man-job-specifications; and  
 
f) an occupational health matrix.  
 
C.3 The COP shall include the following:  
 
a) roles and responsibilities;  
 
b) information on employees who require heal th assessments;  
 
c) types and frequency of health assessments – pre-employment, transfer, periodic and 
exit health assessments;  
 
d) action and exclusion criteria;  
 
e) fitness for duty classifications;  
 
f) case management procedures;  
 
g) RA‟s ‟ relevant occu pational health policies, processes and procedures;  
 
h) document and data control; and  
 
i) monitoring, evaluation and review.  
 
Annex D  
(normative )  
 
Medical action and exclusion criteria for employees  
who undertak e safety -related -work  
 
D.1 General  
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
79 
 D.1.1  The medical action and exclusion criteria for 
 
a) cancer,  
 
b) cardiovascular diseases,  
 
c) diabetes,  
 
d) drugs,  
 
e) epilepsy,  
 
f) gastrointes tinal and hepatic disorders,  
 
g) hearing,  
 
h) musculo -skeletal disorders,  
 
i) neurological disorders,  
 
j) psychiatr ic disorders,  
 
k) renal failure,  
 
l) respiratory and speech disorders,  
 
m) syncope/blackouts,  
 
n) vestibular disorders,  and 
 
o) vision and eye disorders  
 
are detailed in tables  D.2 to D.16, respectively . Tables  D.2 to D.17 form an integral part of 
the fitness-for-duty adjudication . This annex provides essential guidance on the more 
important clinical issues that might impact on the ability of employees to undertak e safety -
related work. Employees shall be referred for further assessments, where relevant, to 
assist clinical judgement on fitness  for duty on a case -by-case basis.  
 
D.1.2  Health assessments will be  based on the following critical factors:  
 
a) a review of occupational risk profile;  
 
b) the history – family, medical and occupational;  
 
c) a physical examination;  
 
d) completing (where relevant) questionnaires ; 
 
e) special tests and investigations ; and 
 
f) reports from specialists . 
 
The OHP‟s experience, knowledge of the working environment and the nature of the work 
are still the best deciding factors.  Where action and exclusion criteria are not explicit or 
where specialists ‟ opinions differ , it might be advisable to seek an opinion from a  third 
party.  
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
80 
 After the health assessment , the OHP sh all make a recommendation on the fitness  for 
duty of the emplo yee. A medical certificate is then issued by an OHP and is valid for one 
year. The medical certificate of fitness  shall be forwarded to the RA and a copy thereof 
kept in the employee‟s medical file . Employees who are not fit for duty may be considered 
for redeployment into a non -safety -related job. See table  D.1 for an example  of a medical 
certificate of fitness . 
 
D.2 Fitness -for-duty c lassifications  
 
D.2.1 General  
 
The employee‟s fitness  for duty is determined for a specific job description  at the time of 
the health assessment and may be classified as  one of the following:  
 
a) fit for duty , 
 
b) fit for duty subject to specific conditions , 
 
c) temporarily unfit for duty , or 
 
d) unfit for duty . 
 
D.2.2 Fit for duty  
 
Fit for duty indicates that t he employee  has complied with the applicable criteria . The 
employee shall be subjected to periodic review s as determined in the medical surveillance 
programme . 
 
D.2.3 Fit for duty subject to specific conditions  
 
Fit for duty subject to specific conditions indicates that the employee  has complied with the 
applicable criteria , but with specific conditions , including exclusions . The O MP shall 
recommend the conditions  that, where reasonably practicable, allow the employee to 
continue to undertake the current safety -related jo b/task/activity . The employee shall  be 
subject ed to periodic review s as determined by the OMP . 
 
D.2.4 Temporarily unfit (fit for d uty pending r eview ) 
 
Temporarily unfit for duty indicates that t he employee has not complied with the applicable 
criteria and is temporarily unfit to undertake safety -related work.  The employee shall be 
subjected to periodic review s as determined by the OMP . 
 
D.2.5 Unfit for duty 
 
Unfit for duty indicates that the employee has not complied with the applicable criteria  to 
undertak e safety -related work . 
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
81 
 Table D.1 — Medical certificate of fitness  
 
Medical  certificate of fitness  
Medical 
centre   Date   
Name   Pension/ID No .  
Surname   SAP No .  
Job 
description   Company   
Safety -critical   Safety -related   Department   
Fitness for du ty recommendation (a ccording to the available information)  
Classification  (select one)   Comments  
Fit for duty    
Fit for duty subject to specific conditions    
Temporarily unfit for duty    
Unfit for duty    
Referral  
Employee‟s h ealthcare practitioner   Hospital/Municipal Clinic   
Specialist   Social worker/EAP/Psychologist   
Optometrist/ Ophthalmologist   X-ray/Radiologist   
Audiologist   Other   
Special tests performed  Comments  
  
  
  
Exclusions  
None   Driving – trains   
Noise zones   Driving – road vehic les  
Respiratory risk zone  Safety -related w ork  
Heat stress zone  Other   
    
I herewith give permission that the above information may be forwarded to my 
supervisor/manager and acknowledge that this certificate of fitness has been handed 
to me to take  to my employer/ line manager  
 
 
_____________________________________
__ 
Signature of employee   
 
___________________________________  
Signature of OHP  
If exposed to sound levels above 105  dB, the employee shall return within 6 (six) 
months from date of sign ature for audiometry testing  
Retest/Return date   
 
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
82 
 Table D.2 — Medical action and exclusion criteria for cancer  and intracranial 
tumours  
 
1 2 
Exclusion criteria  Action criteria  
Cancera 
Unfit for duty if diagnosed with cancer . 
 Fit for duty subject to specific conditions, 
which may include the following:  
 
a) the employee has been assessed by a 
specialist;  
 
b) the condition is under control;  
 
c) the prognosis  is favourable ; 
 
d) the employee is compliant in terms of 
follow -up assessments and treatment;  
and 
 
e) at any stage of the disease it is 
determined by the OHP that there is no 
functional impairment to work . 
Intracranial tumours  
Unfit for duty if the employee has evidence 
of primary or secondary cancer within the 
brain . 
 Fit for duty subject to speci fic conditions , 
which may include:  
 
a) the employee has been assessed by a 
specialist;  
 
b) it is three months after successful 
treatment of the tumour; and  
 
c) the employee is likely to remain stable 
and physical and mental abilities are 
judged by the trea ting specialist to be 
adequate to undertake work . 
a The site and degree of advancement of the cancer is a prime consideration because the 
cancer might affect various bodily functions. Cases shall be assessed on an individual 
basis regarding the site of th e cancer, the response to chemotherapy and radiotherapy 
and any side effects of these treatmen ts. This will also involve assessing the employee‟s 
functional capacity and what medication the patient is taking.  
NOTE  Neuro -psychologist and driver trainer ass essment might be helpful . 
 
 
Table D.3 — Medical action and exclusion criteria for cardiovascular diseases  
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
83 
 1 2 3 
Cardiovasc
ular disease  Exclusion 
criteria  Action criteria  
1 Cardiac 
risk score  
 
The cardiac 
risk score is 
calculated by 
using 
table  C.17 
and is 
associated 
with the 
probability of 
a 
cardiovascul
ar event in 
the next 5 to 
10 years. 
The higher 
the score the 
higher the 
probability. 
The 
management 
of employees 
is 
determined 
by their 
cardiac risk 
score (as 
calculated) 
and the 
overall 
cardiac RA.  ≥ 32 
(probability 
≥ 25% in 
five years)  ≥ 32 
(probability 
≥ 25% in five 
years)  22-31 
(probability 
11% to 24% in 
five years)  15-21 
(probability 
5% to 9% in 
five years)  < 15 
(probability 
< 5% in five 
years)  
Unfit for 
duty. Should be 
referred for a 
stress EC G 
and 
reassessed 
following a 
report from a 
specialist . 
 
Fit for duty, 
subject to 
specific 
conditions:  
  
 a) no 
evidence of 
ischaemia;  
  
b) with 
adequate 
modification 
and control of 
risk factors . 
 Fit for duty, 
subject to 
specific 
conditions 
depending on 
an ov erall 
cardiac RA  
  Fit for duty 
subject to 
specific 
conditions  
depending on 
an overall 
cardiac RA.  
The employee 
may be 
managed by 
referral to a 
specialist for a 
risk factor 
modification or 
a stress ECG 
or other tests 
(or any 
combination of 
these) as 
clinica lly 
appropriate, 
which should 
be reviewed 
annually.  Fit for duty 
subject to 
specific 
conditions  
depending on 
an overall 
cardiac RA.  
2 Acute 
myocardial 
infarct ion 
(AMI)  
 
See also 
angioplasty, 
coronary 
artery and 
bypass 
grafting 
(CABG)  a) Unfit for 
duty if the 
employee 
has had an 
AMI. 
 
b) Should 
not perform 
safety -
related work 
for at least 
three 
months after 
an AMI.  
 Temporarily unfit for duty if  
 
a) in myocardial ischaemia a coronary angiogram shows 
lumen diameter:  
 1) reduction of equal to or greater than 70% in a major 
coronary branch ; and  
 2) less than 50% in the left main coronary artery , and  
 
b) in myocardial ischaemia  a coronary angiogram is not 
conducted and  there is  
 1) an exercise tolerance of =  90% of the age/sex predicted 
exercise capacity on the Bruce Treadmill Test (or 
equivalent protocol) , 
 2) no evidence of severe ischaemia, that is less than 2  mm 
ST segment depression on an exercise ECG and 
absence of a large defect on a stress perfusion scan , 
and 
 3) an ejection fraction of 40%.  
 
Fit for duty  subject to specific conditionsa if 
 
a) it is at least three months after an uncomplicat ed acute 
myocardial infarction if  MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
84 
 Table D.3  (continued ) 1 2 3 
Cardiovasc
ular disease  Exclusion 
criteria  Action criteria  
1) the clinical history is one of minimal symptoms,  
2) assessments show no evidence of myocardial 
ischaemia, and  
3) there is an ejecti on fraction of 40% or over.  
b) in myocardial ischaemia a coronary angiogram shows 
lumen diameter  
 1) reduction of less than 70% in a major coronary branch, 
and 
 2) less than 50% in the left main coronary artery.  
a This action may be recommended, taking in to account the opinion of a cardiologist and 
the nature of the work.  
b This action may be recommended, taking into account the opinion of an appropriate 
specialist and the nature of the work.  
c This action may be recommended, taking into account the opinio n of a cardiologist or 
haematologist and the nature of the work.  
d This action may be recommended, taking into account the opinion of a transplant 
cardiologist and the nature of the work.  
3 Pulmonary 
embolism  
 
The non -
working period 
following a 
pulmonary  
embolism shall 
be determined 
by the treating 
specialist.  Temporarily 
unfit for duty if 
the employee 
has suffered a 
pulmonary 
embolism . Fit for duty subject to specific conditionsb  
 
a) following an appropriate non -working period, and  
 
b) depending on the cause of the embolus and the response 
to treatment.  
 
4 Syncope due 
to hypotension  
(vasovagal and 
autonomic 
dysfunction)  a) Unfit for 
duty.  
 
b) The 
employee shall 
not perform 
safety -related 
work for at 
least three 
months after 
syncope.  Temporarily unfit f or dutyb depending on  
 
a) identification of the underlying cause, or  
 
b) institution of satisfactory treatment (or both).  
5 Aneurysms:  
abdominal and 
thoracic  Unfit for duty if 
the employee 
has aortic, 
thoracic or 
abdominal 
aneurysm.  
The employee 
shall not  
perform safety -
related work for 
at least three 
months post 
repair . Temporarily unfit for dutya at least three  months after recovery . 
 
Fit for duty  subject to specific conditions if  
 
a) the condition is  minor, or  
 
b) the condition has been adequately treat ed. 
6 Anticoagulant 
therapy   Fit for duty subject to specific conditionsc if 
 
a) the therapy is managed, and  
 
b) the therapy is controlled.  
7 
Angioplasty  a) Unfit for 
duty if the 
employee Temporarily unfit for dutya for at least four weeks after the 
angioplasty.  
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
85 
 Table D.3  (continued ) 1 2 3 
Cardiovasc
ular disease  Exclusion 
criteria  Action criteria  
has had 
coronary 
angioplasty.  
 
b) The 
employee 
shall not 
perform 
safety -
related work 
for at least 
four weeks 
after the 
angioplasty . Fit for duty subject to specific conditionsa if 
 
a) the clinical history is one of minimal symptoms , 
 
b) there is an exercise tolerance of = 90% of the age/sex 
predicted exercise capacity on the Bruce Treadmill Test (or 
equivalent protocol) , 
 
c) there is no evidence of severe isch aemia, and 
 
d) there is an ejection fraction of 40% or over.  
a This action may be recomm ended, taking into account the opinion of a  cardiologist  and 
the nature of the work.  
b This action may be recommended, taking into account the opinion of an appropriate 
specialist and the nature of the work.  
c This action may be recommended, taking into ac count the opinion of a cardiologist or 
haematologist and the nature of the work.  
d This action may be recommended, taking into account the opinion of a transplant 
cardiologist and the nature of the work.  
8 Angina  
 
The 
presence of 
other risk 
factors shall  
be 
considered. 
Where 
surgery or 
angioplasty 
is 
undertaken 
to relieve the 
angina, the 
criteria listed 
in the cardiac 
risk score in 
table  C.17 
apply.   Fit for duty subject to specific conditionsa if 
 
a) there is no evidence of severe ischaemia,  
 
b) there is  an ejection fraction of 40% or over,  
 
c) a Bruce Treadmill Test (or equivalent protocol) is = 90% of 
the age/sex predicted exercise capacity , and 
 
d) a thallium or sestamibi scan show s no evidence of 
myocardial isch aemia . 
9 Cardiac 
arrest  
 
The non -
workin g 
period 
following a 
cardiac 
arrest shall Unfit for duty 
if the 
employee 
has suffered 
a cardiac 
arrest . 
 Temporarily unfit for dutya  
 
a) following an appropriate non -working period,  
 
b) depending on the cause of t he cardiac arrest, and  
 
c) depending on the response to treatment.  MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
86 
 1 2 3 
Cardiovasc
ular disease  Exclusion 
criteria  Action criteria  
be 
determined 
by the 
treating 
specialist.  
10 
Arrhythmia  
 
If the 
employee is 
taking 
anticoagulant
s see item  6. Unfit for duty 
if the 
employee 
has a history 
of recurrent 
or persistent 
arrhythmia, 
which might 
result in 
syncope or 
incapacitatin
g symptoms.  Fit for duty subject to specific conditionsa if 
 
a) the condition has been cured surgically (e.g. Wolff -
Parkinson -White syndrome), or  
 
b) the condition has been successfully treated medically for at 
least three months.  
11 Cardiac 
defibrillator 
(AICD)  Unfit for duty 
if the 
employee 
has a 
cardiac 
defibrillator 
implanted 
for 
ventricular 
arrhythmias.   
a This action may be recommended, taking into account the opinion of a cardiologist and 
the nature of the work.  
b This action may be recom mended, taking into account the opinion of an appropriate 
specialist and the nature of the work.  
c This action may be recommended, taking into account the opinion of a cardiologist or 
haematologist and the nature of the work.  
d This action may be recommend ed, taking into account the opinion of a transplant 
cardiologist and the nature of the work.  MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
87 
 Table D.3  (continued ) 
1 2 3 
Cardiovasc
ular disease  Exclusion 
criteria  Action criteria  
12 Coronary 
artery 
bypass 
grafting 
(CABG)  Unfit for duty 
following 
CABG.  
 
The 
employee 
should not 
undertake 
safety -
related work 
for at least 
three 
months after 
CABG . Temporarily unfit for dutya for at least three  months after 
CABG.  
 
Fit for duty subject to specific conditions:  
 
a) if there is minimal residual musculo -skeleta l pain after the 
chest surgery;  
 
b) if the clinical history is one of minimal symptoms;  
 
c) if there is an exercise tolerance of =90% of the age/sex 
predicted exercise capacity on the Bruce Treadmill Test (or 
equivalent protocol);  
 
d) if there is no evidence of severe isch aemia;  
 
e) if there is an ejection fraction of 40% or over; and  
 
f) the pr esence of other risk factors shall also be considered.  
13 Deep 
vein 
thrombosis 
(DVT)  
 
The non -
working 
period 
following 
DVT shall be 
determined 
by the 
treating 
specialist. 
See also 
item 6. Unfit for duty 
if the 
employee 
suffers DVT, 
which is 
liable to 
recur or to 
cause an  
embolus  
 Temporarily unfit for dutyb  
 
a) following an  appropriate non -working period , and 
 
b) depending on the cause of the thrombosis and the 
response to treatment.  
14 Heart 
failure  Unfit for duty 
if the 
employee 
has had 
heart failure.  
 Fit for duty subject to specific conditionsa if 
 
a) there is an exercise tolerance of = 90% of the age/sex 
predicted exercise capacity on the Bruce Treadmill Test (or 
equivalent protocol) , 
 
b) there is an ejection fraction of 40% or over , 
 
c) there is a s atisfactory response to treatment , and 
 
d) the underlying cause of the heart failure is considered.  
15 
Heart/lung 
transplant  Unfit for duty 
if the 
employee 
has had a 
heart or 
heart/lung 
transplant.  Temporarily unfit for dutyd at least three months after the  
transplant.  MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
88 
 1 2 3 
Cardiovasc
ular disease  Exclusion 
criteria  Action criteria  
 
The 
employee 
shall not 
undertake 
safety -
related work 
for at least 
three 
months after 
the 
transplant.  
a This action may be recommended, taking into account the opinion of a cardiologist and 
the nature of the work.  
b This action may be recom mended, taking into account the opinion of an appropriate 
specialist and the nature of the work.  
c This action may be recommended, taking into account the opinion of a cardiologist or 
haematologist and the nature of the work.  
d This action may be recommend ed, taking into account the opinion of a transplant 
cardiologist and the nature of the work.  MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
89 
 Table D.3  (concluded ) 
1 2 3 
Cardiovasc
ular disease  Exclusion 
criteria  Action criteria  
16 
Hypertensio
n 
 
The 
presence of 
other risk 
factors shall 
also be 
considered.  Unfit for duty 
if 
 
a) the 
employee‟s 
sitting blood 
pressure is 
consistently 
160/110  mm
HG or 
greater 
(treated or 
untreated),  
 
b) there is 
end organ 
damage 
(cardiac, 
cerebral or 
retinal), 
which will 
impair the 
employee‟s 
ability to 
undertake 
safety -
related work, 
and 
 
c) treatment 
results in 
marked 
postural 
hypotension 
or impaired 
alertness . Fit for duty subject to specific conditions i f 
 
a) treatment is satisfactory with blood pressure controlled at 
140 systolic pressure or less and 90  diastolic pressure or 
less, and  
 
b) treatment does not cause side effects that impact on 
functional abilit y. 
17 Valvular 
heart 
disease  Unfit for duty 
if 
a) the 
employee 
has any 
history or 
evidence of 
valve 
disease, 
with or 
without 
surgical 
repair or 
replacement
, associated 
with 
symptoms or 
a history of 
embolism, 
arrhythmia, Fit for duty subject to specific conditionsa  
 
a) if the employee‟s cardiological assessment shows mild 
valvular disease of no hemodynamic significance;  
 
b) for three months following succe ssful surgery, or  
 
c) if there is no other cardiac condition that would render the 
employee unfit to undertake safety -related work.  MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
90 
 1 2 3 
Cardiovasc
ular disease  Exclusion 
criteria  Action criteria  
cardiac 
enlargement 
abnormal 
ECG, h igh 
blood 
pressure, 
and 
b) the 
employee is 
taking 
anticoagulan
ts. 
a This action may be recommended, taking into account the opinion of a cardiologist and 
the nature of the work.  
b This acti on may be recommended, taking into account the opinion of an appropriate 
specialist and the nature of the work.  
c This action may be recommended, taking into account the opinion of a cardiologist or 
haematologist and the nature of the work.  
d This action m ay be recommended, taking into account the opinion of a transplant 
cardiologist and the nature of the work.  
Table D.4 — Medical action and exclusion criteria for diabetes  mellitus  
 
1 2 
Exclusion criteria  Action criteria  
1 Diabetes controlled by diet alo ne 
 Fit for duty (including the undertaking of 
safety -related work)  
 
a) if there are no severe complications, and  
 
b) if the employee is reviewed periodically 
regarding progression of the illness.  
2 Non -insulin -dependent type 2 diabetes mellitus  
Unfit f or duty if the employee has 
uncontrolled non -insulin -dependent diabetes 
mellitus with or without treatment.  
 Fit for duty subject to specific conditionsa if 
 
a) the condition is well controlled and the 
employee  is compliant with treatment,  
 
b) there is an absence of defined 
hypoglycaemic episodes as assessed by 
the specialist , 
 
c) the employee has an awarene ss 
(sensation) of hypoglycaemia,  
 
d) the employee is taking agents that 
provide the minimum risk of 
hypoglycaemia , 
 
e) there is an absence of end organ 
damage that might affect functional 
capacity , and 
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
91 
 f) there is an absence of side effects from 
medication that might  impact on 
functional capacity.  
3 Insulin -dependent diabetes mellitus (types 1 and 2)  
Unfit for duty if the employee has insulin -
dependent  diabetes mellitus.  
 Temporarily unfit for duty in the event of a 
defined hypoglycaemic episode occurring in 
an employee with previously well -controlled 
diabetes. The employee shall not perform 
safety -related work for a period determined 
by a specialist. A voidance of collapse is 
particularly important in safety -related work.  
 
Fit for duty subject to specific conditionsa if 
 
a) the condition is well controlled and the 
employee is compliant with treatment , 
 
b) there is an absence of defined 
hypoglycaemic epis odes as assessed by 
the specialist , 
 
c) the employee has an awareness 
(sensation) of hypoglycaemia , 
 
d) the employee is taking agents that 
provide the minimum risk of 
hypoglycaemia , and 
 
e) there is an absence of end organ 
damage that might affect function al 
capacity.  
a This action may be recommended, taking into account the opinion of a specialist in 
diabetes or endocrinology and the nature of the work.  
 
Table D.5 — Medical action and exclusion criteria for d rugs  
 
1 2 
Exclusion criteria  Action criteria  
Drugs  
 
Drugs include prescription and over -the-counter medication (see annex  E for side effects 
of medication), illicit drugs and alcohol. Impairment due to the effects of drugs results in 
employees being unfit for duty. Avoidance of sudden incapacity is particularly important.  
Unfit for duty if there is evidence of drug and 
alcohol use or dependence.  
 Fit for duty subject to specific conditionsa if 
 
a) employees are compliant with treatment 
for drug and alcohol addiction, and  
 
b) the severity of the addi ction(s), the 
response to treatment and the working 
requirements are taken into account.  MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
92 
 a This action may be recommended, taking into account the opinion of an appropriate 
specialist and the nature of the work.  
 
 
Table D.6 — Medical action and exclusion  criteria for e pilepsy  and seizures  
 
1 2 
Exclusion criteria  Action criteria  
1 Initial or isolated seizures  
 
An isolated seizure is not synonymous with epilepsy. Avoidance of collapse is particularly 
important. Withdrawal of anti -epileptic medication is n ot compatible with continued safety -
related work (unless advised by a specialist).  
Unfit for duty if the employee has had a 
seizure due to any cause.  Fit for duty subject to specific conditionsa if 
 
a) the employee has had a single provoked 
seizure event,  
 
b) provocative factors can be avoided 
reliably,  
 
c) the employee has been seizure -free for 
one year,  
 
d) the employee takes no anti -epileptic 
medication, and  
 
e) the employee„s EEG shows no 
epileptiform activity.  
2 Epilepsy  
Unfit for duty if the employ ee has epilepsy.  
 
 Fit for duty subject to specific conditionsa if 
the employee  
 
a) has a history of febrile seizures or of 
benign childhood epilepsy , 
b) does not take anti -epileptic med ication,  
and 
c) undergoes an EEG that shows no 
epileptiform activity , 
 
or 
d) has a history of a single seizure event or 
of seizures occurring only under 
provocative circumstances that can be 
avoided reliably , 
e) has been seizure -free for five years , 
f) takes no anti -epileptic medication , and 
g) undergoes an EEG that shows no  
epileptiform activity , 
 
or 
h) has epilepsy and is taking anti -epileptic 
medication , 
i) maintains at least an annual review and 
compliance , 
j) has been seizure -free for five years , MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
93 
 k) has had no more than three seizures in 
the preceding ten years , and 
l) undergoes an EEG that shows no 
epileptiform activity , 
 
or 
m) has epilepsy and has had surgical 
treatment , 
n) maintains at least an annual review , 
o) has been seizure -free for five years , and 
p) undergoes an EEG that shows no 
epileptiform activity.  
a This a ction may be recommended, taking into account the opinion of a specialist in 
epilepsy and the nature of the work.  
 
Table D.7 — Medical action and exclusion criteria for gastrointestinal and hepatic 
disorders  
 
1 2 
Exclusion criteria  Action criteria  
1  Hepatic failure  
 
If an employee has chronic liver disease and if there is no overt evidence of hepatic 
encephalopathy, he/she might still have impaired cognitive and motor skills and will need 
to be assessed by a specialist.  
Unfit for duty if the employee h as chronic 
liver disease and clinical evidence of hepatic 
encephalopathy.   
2  Liver transplants  
Unfit for duty after a liver transplant.  Fit for duty subject to specific conditionsa if 
noting  
 
a) the reason for the transplant,  
 
b) the stability of the tr ansplant, and  
 
c) the biochemical and hemodynamic 
response.  
a This action may be recommended, taking into account the opinion of an appropriate 
specialist and the nature of the work.  
 
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
94 
 Table D.8 — Medical action and exclusion criteria for hearing  
 
1 2 
Exclusion criteria  Action criteria  
Hearing  
 
No employee shall be required to work in a noise zone while wearing hearing aids or after 
a cochlear implant. Where relevant, a field test may be performed to assess the worker‟s 
ability to hear warning signals/a larms or verbal communication (or both) under operational 
conditions.  
Unfit for duty  
 
Pre-employment if the employee has an 
unaided average hearing threshold level 
worse than 40  dB measured in a diagnostic 
audiogram over frequencies of 500, 1  000 
and 2  000 in the better ear.  
 
Periodic assessments if  
 
a) the employee has an unaided average 
hearing threshold level of worse than 
40 dB measured in a diagnostic 
audiogram over frequencies of 500, 1  000 
and 2  000 in the better ear, and  
 
b) there is deterioration  in hearing threshold 
of >  15 dB in any/all frequencies from 
3 000 Hz, 4  000 Hz and 6  000 Hz from 
test to test  
 
Unfit for duty if   
 
a) the employee is wearing/using hearing 
aids, and 
 
b) the employee had a cochlear implant . Fit for duty subject to specific  conditions  
may be  considered taking into account  
 
a) the nature of the duties of the employee  
who undertak es safety -related work , 
including efficient and reliable use of 
communication devices, such as mobile 
phones and radio -communication 
devices, and the  need to reliably detect 
emergency alarms against background 
noise , and 
 
b) the nature of the relevant background 
occupational noise.  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Table D.9 — Medical action and exclusion criteria for musculo -skeletal disorders  
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
95 
 1 2 
Exclusion criteria  Action criteria  
Musculo -skeletal disorders  
 
The musculo -skeletal activities that are required for employees who undertake safety -
related work as identified in the task analysis for the specific/relevant job shall be carefully 
considered.  
Unfit for duty if  the ability to perform the 
activities required for safety -related work is 
inadequate.  
 Fit for duty subject to specific conditionsa. 
 
A practical assessment might be helpful.  
a This action may be recommended, taking into account the opinion of an appropr iate 
specialist or therapist and the nature of the work.  
 
Table D.10 — Medical action and exclusion criteria for neurological d isorders  
(excluding epilepsy and syncope)  
 
1 2 
Exclusion criteria  Action criteria  
1  Berry aneurysms and other vascular malfor mations of the brain  
Unfit for duty if the employee has a berry 
aneurysm or other vascular malformation.  Fit for duty subject to specific conditionsa 
after consideration of the risks and the 
benefits of any treatment.  
2  Cerebral palsy  
 
See also cognitiv e and neuromuscular disorders in items  3 and 5 , respectively . 
Unfit for duty if the capacity to perform 
safety -related work is impaired due to 
musculo -skeletal or cognitive or neurological 
causes.  
 Temporarily unfit for dutya and taking into 
account the  
 
a) the severity of the disabilities,  
 
b) the interaction between multiple 
disabilities,  
 
c) the response to treatments,  
 
d) suitable job modifications, where 
practical, and  
 
e) the result of a field test.  
3  Dementia and other cognitive impairments  
Unfit for duty  if the employee‟s dementia or 
cognitive impairment is confirmed . 
 Fit for duty subject to specific conditionsa 
and shall depend on  
 
a) the cause of the condition and likely 
response to treatment , 
 
b) any appropriate neuropsychological 
tests , and 
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
96 
 Table D.10  (concluded ) 1 2 
Exclusion criteria  Action criteria  
c) the result of a field test.  
4  Head injury/brain injury  
Unfit for duty if the employee has had a 
head injury causing chronic functional 
disturbances.  Fit for duty subject to specific conditionsa 
and shall depend on  
 
a) the result of neuropsychologica l testing,  
 
b) the result of a field test (see also 
cognitive impairment), and  
 
c) other disabilities that might  impair safety -
related work.  
5  Neuromuscular conditions  
 
Multiple sclerosis ( MS), Parkinson's disease, peripheral neuropathy  
Unfit for duty i f the employee has 
Parkinsonism, MS, degenerative peripheral 
neuropathy, Parkinson‟s progressive 
muscular dystrophy or any other severe 
neuromuscular disorder.  Fit for duty subject to specific conditionsb 
and shall depend on  
 
a) the response to treatments,  and 
 
b) the result of a field test.  
a This action may be recommended, taking into account the opinion of an appropriate 
specialist and the nature of the work.  
b This action may be recommended, taking into account the opinion of a neurologist or 
rehabilit ation specialist and the nature of the work.  
6  Stroke  
Unfit for duty if the employee has had a 
stroke.  
 Fit for duty subject to specific conditionsa if 
 
a) the stroke was caused by a condition that 
has subsequently  been satisfactorily 
treated, and  
 
b) the employee has recovered 
satisfactorily from the stroke  (including 
perceptual deficits ) and this has been 
demonstrated.  
7  Transient ischemic attacks (TIAs)  
Unfit for duty if the employee has had two or more 
TIAs.  Fit for duty subject to specific condi tionsa if 
 
a) the aetiology of the attacks has been identified,  
 
b) the underlying cause has been removed, and  
 
c) the employee has had a six -month period free of 
attacks.  
a This action may be recommended, taking into account the opinion of an appropriate  specialist and the 
nature of the work.  
 
 
Table D.11 — Medical action and exclusion criteria for psychiatric disorders  
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
97 
 1 2 
Exclusion criteria  Action criteria  
Psychiatric disorders  
 
See also alcohol dependence and impairment, drugs and neurological diso rders in 
tables  D.5 and D.10, respectively.  
Unfit for duty if  
 
a) the employee has an acute or chronic 
psychosis, whether schizophrenic, bipolar 
(manic or depressive phase) or other 
depressive psychosis , 
 
b) the employee has a reality or psychiatric 
disor der with features such as aggression 
or violence, which are hazardous to 
safety -related work , 
 
c) the employee is taking psychoactive 
drugs that will impair safety -related work 
performance on a long -term basis,  
 
d) the employee‟s judgement or perceptual, 
cognitive or motor function is affected by 
a mental disorder (e.g. ADHD), or  
 
e) the examining health professional 
believes that there is a significant risk of 
previous psychotic condition relapsing.  Fit for duty subject to specific conditionsa if 
 
a) the c ondition is well controlled and the 
employee is compliant with treatment 
over a substantial period,  
 
b) the employee is taking medication that 
minimizes the risk to cognitive functions 
or other side effects of medication that 
might  affect safety -related wo rk, 
 
c) the results of any appropriate 
neuropsychological tests are considered, 
and 
 
d) the result of a field test is considered.  
a This action may be recommended, taking into account the opinion of a psychiatrist and the nature of the 
work.  
 
 
 
 
 
 
 
 
 
 
 
Table D.12 — Medical action and exclusion criteria for renal failure  
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
98 
 1 2 
Exclusion criteria  Action criteria  
Renal failure  
Unfit for duty if the employee has end -stage 
renal failure (that requires dialysis) or 
advanced renal failure (GFR <  20% of 
normal) . Fit for duty subject to specific conditionsa if 
the employee‟s condition is stable with 
limited comorbidities.  
a This action may be recommended, taking into account the opinion of a renal specialist  
and the nature of the work.  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Table D.13 — Medical action and exclusion criteria for respiratory and s peech 
disorders  
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
99 
 1 2 
Exclusion criteria  Action criteria  
1  Laryngectomy and tracheotomy  
Unfit for duty if the employee has had a  
laryngectomy or tracheotomy.  Fit for  duty subject to specific conditions  
may be recommended after practical 
assessment such as with phones or radio -
communication devices . 
2  Long -term oxygen therapy  
Unfit for duty if the employee has an 
unstable disease that requires oxygen 
therapy .  
3  Respiratory failure  
Unfit for duty if the employee has severe 
respiratory failure.  Temporarily unfit for dutya after 
consideration of the severity of the 
employee‟s condition and the likelihood of 
control of the failure.  
4  Thoracotomy  
Unfit for duty for  at least four weeks after a 
thoracotomy  as determined by the treating 
surgeon.   
5  Sleep apnoea  
Unfit for duty if  
 
a) the employee has established sleep 
apnoea syndrome (sleep apnoea on a 
diagnostic sleep study and excessive 
daytime sleepiness) with mod erate to 
severe sleepiness, until treatment is 
effective, and  
 
b) there is a history suggestive of sleep 
apnoea in association with severe 
daytime sleepiness, until investigated and 
treated.  Fit for duty subject to specific conditionsb. 
6  Narcolepsy  
Unfit for duty if narcolepsy is confirmed.  
 Fit for duty subject to specific conditionsb if 
 
a) a clinical assessment has been made by 
a sleep physician or neurologist , 
 
b) cataplexy has not been a feature in the 
past, 
 
c) medication is taken regularly , 
 
d) there has been an absence of symptoms 
for six months , and 
 
e) normal sleep latency is present.  MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
100 
 a This action may be recommended, taking into account the opinion of a respiratory physician and the 
nature of the work.  
b This action may be recommended, taking  into account the opinion of a specialist in sleep disorders and 
the nature of the work.  
 
 
Table D.14 — Medical action and exclusion criteria for syncope/blackouts  
 
1 2 
Exclusion criteria  Action criteria  
Syncope/blackouts  
 
The employee shall not perform  safety -related work for six months following unexplained 
syncope/blackouts, although a shorter period may be advised by an appropriate specialist.  
Unfit for duty if the employee suffers from 
unheralded, recurrent syncope/blackouts, 
which do not respond t o treatment.   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Table D.15 — Medical action and exclusion criteria for vestibular disorders  
 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
101 
 1 2 
Exclusion criteria  Action criteria  
Vestibular disorders  
Unfit for duty if the employee has, or has 
had in the previous twelve months, any 
condition of recurrent vertigo. This includes 
confirmed Meniere‟s disease, recurrent 
unheralded vertigo or benign paroxysmal 
positional vertigo  (or both) , with or without 
treatment, or any other type of vertigo . Fit for duty subject to specific conditionsa for 
 
a) employees who have had vertigo caused 
by Meniere‟s; condition, or recurring 
unheralded attacks of vertigo, after at 
least twelve months free of vertigo , 
 
b) employees who have had one episode of 
vertigo caused by acute labyrinthitis 
(deafness and v ertigo), acute neuro -
labyrinthitis (vestibular neuronitis), after 
at least six months free of vertigo,  
 
c) employees who have any other type of 
vertigo, after at l east two months free of 
vertigo,  and 
 
d) employees who have had benign 
paroxysmal positional vertigo only, after 
at least two months free of symptoms 
and signs of benign paroxysmal 
positional vertigo.  
a This action may be recommended, taking into account the opinion of an ear, nose and 
throat (ENT) specialist  and the nature of the work.  The ENT s pecialist should regard the 
nature of the condition, response to treatment and the employee‟s jobs/tasks/activities.  
 
 
 
Table D.16 — Medical action and exclusion criteria for vision and eye disorders  
 
1 2 
Exclusion criteria  Action criteria  
1  Visual acu ity 
Unfit for duty if unaided acuity is <  6/9 
(20/30) in one  eye or both eyes.  Fit for duty subject to specific conditions  
may be recommended  
 
a) if the standard is met with corrective 
lenses , and 
 
b) after consideration of the stability of any 
underlying  disorder.  
2  Colour vision  
 
These standards may be varied subsequent to an RA of the network and on advice of a 
specialist in occupational medicine.  MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
102 
  Unfit for duty if the employee is colour blind, 
and where colour vision is an inherent 
requirement of t he job.  Fit for duty subject to specific conditions  
may be recommended, taking into 
consideration the opinion of an 
optometrist/ophthalmologist and include  
 
a) the degree/extent of the colour blindness,  
 
b) the nature of the work, and  
 
c) the result of a f ield test.  
3  Visual fields  
Unfit for duty if the employee‟s visual fields 
are equal to/worse than 70° temporal in 
either eye with or without refraction.   
 
 
 
  
103 
 SANS 3000 -4:201 1 
Edition 1  Table D.17—Coronary heart disease risk factor prediction chart 
 
1. Find points for each risk factor  
Age ( if female)  Age (i f male) HDL-cholesterol  Total -cholesterol  Systolic B P Other  Pts 
Age Pts Age Pts Age Pts Age Pts HDL-C Pts Total -C   SBP Pts     
30 -12 47-48 5 30 -2 57-59 13 0.65-0.68 7 3.60-3.99 -3 98-104 -2 Cigarettes  4 
31 -11 49-50 6 31 -1 60-61 14 0.69-0.76 6 4.00-4.30 -2 105-112 -1 Diabetic -male  3 
32 -9 51-52 7 32-33 0 62-64 15 0.77-0.84 5 4.31-4.60 -1 113-120 0 Diabetic -female  6 
33 -8 53-55 8 34 1 65-67 16 0.85-0.90 4 4.70-5.19 0 121-129 1 ECG -LVH 9 
34 -6 56-60 9 35-36 2 68-70 17 0.91-0.99 3 5.20-5.69 1 130-139 2     
35 -5 61-67 10 37-38 3 71-73 18 1.00-1.09 2 5.70-6.19 2 140-149 3     
36 -4 68-74 11 39 4 74 19 1.10-1.19 1 6.20-6.79 3 150-160 4 0 pts for each N o. 
37 -3     40-41 5     1.20-1.30 0 6.80-7.49 4 161-172 5     
38 -2     42-43 6     1.31-1.43 -1 7.50-8.19 5 173-185 6     
39 -1     44-45 7     1.44-1.56 -2 8.20-8.55 6         
40 0     46-47 8     1.57-1.70 -3             
41 1     48-49 9     1.71-1.89 -4             
42-43 2     50-51 10     1.90-2.07 -5             
44 3     52-54 11     2.08-2.25 -6             
45-46 4     55-56 12     2.26-2.49 -7             
2. Sum points for all risk factors: Age (  ) + HDL -C (  ) + Total C ( 0 ) + SBP (  ) + Smoker (  ) + Diabetes (  ) + ECG -LVH (  ) = Point Total ( ) NOTE: Mi nus points subtract from total  
3. Look up risk corresponding to point total  
Probability (%)  Probability (%)  Probability (%)  Probability (%)  Probability (%)  
Pts 5Yr 10Yr  Pts 5Yr 10Yr  Pts 5Yr 10Yr  Pts 5Yr 10Yr  Age Women  Men 
2 1 2 11 3 6 20 8 18 29 20 36 35-39 < 1 5 
3 1 2 12 3 7 21 9 19 30 22 38 40-44 2 6 
4 1 2 13 3 8 22 11 21 31 24 40 45-49 5 10 
5 1 3 14 4 9 23 12 23 32 25 42 50-54 8 14 
6 1 3 15 5 10 24 13 25    55-59 12 16 
7 1 4 16 5 12 25 14 27    60-64 13 21 
8 2 4 17 6 13 26 16 29    65-69 9 30 
9 2 5 18 7 14 27 17 31    70-74 12 24 MEDC 9 (2038) DTZS / SADC SARA HT 93 : 2017  
104 
 NOTE  This table was adapted and modified from the American Heart Association.  SADC HT 92: 2017  
 
105 
 Annex E  
(informative )  
 
Potential side effect s of certain  medication  
 
Table E.1 lists examples of some of the more important classes of  medication  that might 
impact on employees who undertak e safety -related work.  
 
Table E.1 — Certain classes of medication and their potential side effects  
 
1 2 3 
Medication  Use Side effects  
Anaesthetics  Is used d uring surgery  Prolonged anaesthesia for 
major procedures might  
have a detrimental influence 
on cognitive functions. This 
might last for many months.  
Analgesics  
(such as morphine, 
pethidine, opioids, codeine, 
dextropropoxyphene, 
tramadol)  
 Relieves pain  The powerful analgesics 
such as morphine and 
pethidine cause marked 
sedation. The milder 
opioids, codeine, 
dextropropoxyphene and 
tramadol are known to affect 
driving -related skills.  
Anti-cancer medication  
(such as tam oxifen)  
 Is used d uring 
chemotherapy  Many employees remain at 
work while on 
chemot herapy. The 
medication tamoxifen used 
in breast cancer is 
associated with light 
headedness and visual 
disturbances such as 
corneal opacities, cataracts 
and retinopathy.  
Anti-coagulants  
 Prevents clotting of blood 
(coagulation)  Injuries from blunt or sharp  
trauma might not stop 
bleeding.  
Anti-convulsants  
 Prevents or controls 
convulsions/epilepsy  Studies have shown that 
chronic anti -convulsant 
therapy impairs 
concentration and sustained 
attention. The impairment is 
greater if more than one 
drug is used.  
Anti-depressants  
 Helps to regulate mood  Some of the older 
generation anti -depressants 
tend to cause sedation, 
especially in the first weeks 
of therapy. Newer 
generation anti -depressants 
are non -sedating and 
appear to be safe.   
106 
 Table E.1  (continued ) 1 2 3 
Medication  Use Side effects  
Anti-diabetic drugs  
 Regulate s blood sugar  The main risk here is 
hypoglycaemia and 
confusion, or even loss of 
consciousness.  
Anti-histamines  
 Is i ncorporated in 
medications for colds and 
influenza  The older generation anti -
histamines cause significant 
drowsiness and sedation. 
The new er generation anti -
histamines are claimed to be 
non-sedating, but some 
individuals experience 
drowsiness.  
Antihypertensive drugs  
(such as  methyldopa, 
clonidine, guanethidine, 
bethanidine, debrisoquine, 
indoramin, methyldopa,  and 
beta blockers)  
 Helps to lower blood 
pressure.  Certain antihypertensive 
drugs might  cause 
intermittent postural 
hypotension and light 
headedness.  
The older generation 
antihypertensive drugs  
methyldopa , clonidine , 
guanethidine , bethanidine , 
debrisoquine , and indoramin 
are all seda ting drugs . 
Methyldopa impairs driving 
performance. Beta blockers 
can affect psychomotor 
function s temporarily. 
Around 5% of persons  using 
beta blockers report severe 
fatigue and have a 
demonstrably lower exercise 
tolerance.  
Anti-infective drugs  
(such as ethambutol, 
ciprofloxacin and other 
quinolone antibiotics, 
penicillin, cephalosporin, 
metronidazole, griseofulvin, 
itraconazole)  
 Serves as an antibiotic (or 
antibacterial), an antifungal 
or an antiviral agent.  Ethambutol might  cause 
loss of visual acuity,  colour -
blindness and restriction of 
visual fields. Ciprofloxacin 
and other quinolone 
antibiotics have central 
nervous system effects and 
might  impair skilled 
performance s/tasks. There 
is a (small) risk of 
convulsions if they are used 
with non -stero idal an ti-
inflammatory drugs. The 
penicillins, cephalosporins, 
metronidazole, quinolones, 
griseofulvin and itraconazole 
might  all cause sensations 
of light headedness . 
Anti-inflammatory  
 Reduces inflammation.  The non -steroidal anti -
inflammatories as a class SADC HT 92: 2017  
 
107 
 Table E.1  (concluded ) 1 2 3 
Medication  Use Side effects  
 
 can cause drowsiness, 
fatigue, blurred vision, 
dizziness and vertigo in 
some persons . 
Anti-migraine drugs  
(such as 5HT1 agonists, 
ergotamine, pizotifen, 
clonidine, and 
methysergide ) Reduces pain caused by 
migraines.  The 5HT1 agonists (the 
“triptans”) can ca use 
drowsiness, which might  
affect the performance of 
skilled performance/tasks. 
Ergotamine, pizotifen, 
clonidine, and methysergide 
are associated with 
dizziness, vertigo and 
postural hypotension.  
Anti-psychotics  
 Is used in the treatment of 
schizophrenia  and other 
psychosis -inducing 
diseases.  Anti-psychotics might  
produce sedation, which 
might  or might  not pass off 
after a week or so, on 
treatment. Most anti -
psychotics might cause 
notable tremors and a 
slowing and stiffness of 
movement.  
Barbiturates  
 Acts as central nervous 
system depressants.  Barbiturates might  cause a 
range of effects from mild 
sedation to anaesthesia.  
Benzodiazepines  
 Is commonly used both as 
sleeping pills and to treat 
anxiety.  The use of benzodiazepines 
during the day significantly 
increases the risk of road 
traffic accidents.  
Cardiovascular drugs  
 Is used in the treatment of 
heart failure and disorders of 
vascular tension.  Some of this medication 
might  cause visual 
disturbances, postural 
hypotension, light 
headedness and decreased 
mobility.  
Hypnotics, sedatives and 
tranquillisers  
(CNS depressants)  
 
 Induces sleep, relieves 
anxiety, calms  CNS depressants have all 
been shown to i nhibit 
psychomotor function, retard 
responsiveness, and impair 
motor skills, coordination 
and responses c oncerned 
with self -preservation.  
Malaria prophylaxis  
(such as mefloquine, 
chloroquine)  
 Is used in the prevention of 
malaria.  Mefloquine might  cause 
dizziness, poor balance and 
psychiatric reactions. 
Chloroquine might  cause 
visual disturbances.  
Ocular dr ugs 
(such as atropine, 
homatropine cyclopentolate ) Is used in the treatment of 
eye disorders.  Eye drops such as atropine, 
homatropine and 
cyclopentolate might  affect  
108 
 1 2 3 
Medication  Use Side effects  
 accommodation and 
produce blurred vision.  
Respiratory drugs  
 Is used in the treatment of  
disorders in the airways, the 
lungs, and the respiratory 
muscles that mediate the 
movement of air into and out 
of the body.  Asthmatic medication cause 
tremor s, light -headedness, 
anxiety, agitation, visual 
disturbances and even 
seizures.  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Annex F  
(informative )  
 
Guide lines for the  develop ment of an employee wellness programme  
 
F.1 The RA should consider integrat ing, where relevant, HF into the risk -based employee 
wellness programme. The programme should consist of the f ollowing elements:  SADC HT 92: 2017  
 
109 
  
a) education and training to promote health and wellness;  and 
 
b) interventions to manage identified health trends and risk s. 
 
F.2 Education and training to promote health and wellness  may include  the following 
elements:  
 
a) fitness  for duty; 
 
b) life skills ; 
 
c) back care ; 
 
d) stress management ; 
 
e) dealing with debt ; 
 
f) work -life balance ; 
 
g) healthy eating ; 
 
h) exercise ; 
 
i) fatigue management ; 
 
j) medication and substance abuse ; 
 
k) the purpose of health assessments ; and 
 
l) smoking -cessation  campaigns . 
 
F.3 Interventions to manage health and wellness risks may include  the following : 
 
a) screen ing for HIV infections , TB and other chronic disease s; 
 
NOTE  Health day s provide an opportunity for screen ings and questionnaires . 
 
b) vaccina ting to prevent influenza, hepatitis  and pneumonia ; 
 
c) trauma debriefing ; 
 
d) access ing employee support services and gymnasium facilities ; 
 
e) encouraging team participation in sporting events – fun walks, marathons or cycle 
races; and  
 
f) promoting part icipation in support groups such as walk -for-life, which might address 
stress  and depression.  
 
F.4 Identification of health and wellness risks may include a review of  the following : 
 
a) relevant reports ;  
110 
  
 EXAMPLE S Absenteeism, wellness trends, risk assess ments , substance abuse, 
employee  risk profile s. 
 
b) health assessment s; 
 
c) occurrences  related to human error ; 
 
d) workplace violence or bullying;  and 
 
e) poor performance owing to employees experienc ing personal  problems (hijack, 
assault, robbery ). 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Annex G  
(informative )  
 
Signs and symptoms of stress  
 
G.1 Employees who are experiencing stress might show physical signs or demonstrate 
changes in behaviour. The signs and symptoms listed below may be observed as 
the result of fac tors other than stress. The list below should not be used as a 
checklist to diagnose or label an employee . 
 
G.2 Physical signs of stress might include  the following : 
 
a) sweating ; SADC HT 92: 2017  
 
111 
  
b) hand tremors ; 
 
c) nervous stumbling speech ; 
 
d) tension headaches ; 
 
e) rapid weight loss or weight gain;  and 
 
f) constant  feelings of  coldness , sleep iness , tired ness , fatigue or letharg y. 
 
G.3 Behavioural  changes might includ e the following : 
 
a) inconsistent or declining work performance , including  uncharacteristic errors, los s of 
control over work, loss of motivation and commitment, indecisive ness , lapses in 
memory and increas ed time at work ; 
 
b) regress ive behaviour , such as crying, irritability, moodiness, sulking, arguing, undue 
sensitivity, overreaction to problems and personal ity clashes ; 
 
c) aggressi ve behaviour , such as shouting, bullying or harassing of colleagues, temper 
outbursts, criticism, vandalism, malicious gossiping ; 
 
d) withdraw n behaviour , including  arriving late for work, leaving early, taking extended 
lunche s, a resigned attitude, reduced social contact, elusiveness or evasiveness and 
absenteeism ; and  
 
e) other uncharacteristic behaviour , such as increased smoking, consumption of alcohol, 
lack of interest in appearance and personal  hygiene, reckless  driving , accidents at 
home or work , and difficulty to relax . 
 
 
 
 
 
 
 
 
 
 
Annex H 
 (informative)  
 
Glossary  
 
Overview  
 
Terms and definitions that can be found in general dictionaries, field specific dictionaries, 
national legislation, international and national standa rds are referred to as “commonly” 
known and therefore excluded from 3.1.  The following words/terms are defined in this 
glossary as S ARA 004  users may not have these references readily available.  
 
biomechanics   
112 
 application of mechanical principles to livin g organisms  
 
biological monitoring  
a planned, ongoing programme of periodic collection and analysis of body fluid, tissues, 
excreta or exhaled air in order to detect and quantify the exposure to or absorption of any 
substance or organisms by employees  
 
 
competent person  
a) having the knowledge, training, experience and where applicable, qualifications specific 
to the work or task being performed: Provided that where appropriate qualifications and 
training are registered in terms of the relevant national l egislation  
 
or 
 
b) declared competent by an accredited assessor or institution.  
 
 
engineer  
person who uses scientific knowledge to solve practical problems and who is skilled in the 
principles and practice of any branch of engineering  
 
ergonomics  
scienti fic discipline concerned with the understanding of interactions among humans and 
other elements of a system, and the profession that applies theory, principles, data, and 
other methods to design in order to optimize human well -being and overall system 
performance  
 
exposure time  
duration per day that a worker is exposed to an environmental stressor  
 
medical certificate of fitness  
certificate valid for one year issued by an occupational health practitioner  
 
medical condition  
abnormal condition of an organism  that impairs bodily functions, associated with specific 
symptoms  and signs  
 
medical fitness for duty  
determinatio n was made by the OMP, subject to any restrictions or requirements, that a 
employee has underwent the medical assessments required and that the employee meets 
all of the medical fitness for duty requirements for a specific job  
 
medical surveillance  
planne d, programme or periodic examination (which may include clinical examinations, 
biological monitoring or medical tests) of employees by an occupational health practitioner 
or in prescribed cases by a occupational medicine practitioner   
 
medication  
substance  intended for use in the medical diagnosis , cure, treatment , or prevention  of 
disease  
 
NOTE Also  referred to as medicine , or medicament, treatment, pills, drugs.  
 SADC HT 92: 2017  
 
113 
 moonlighting  
work at another job, often at night, in addition to one‟s regular job  
 
occupational exposure limit  
OEL 
limit value  for a stress facto r in the workplace  
 
occupational health  
OH 
promotion and maintenance of the highest degree of physical, mental and social wellbeing 
of workers in all occupations by preventing departures from health, controlling risks and 
the adaption of work to people, an d people to their jobs  
 
[ILO / WHO 1950]  
 
occupational health practitioner  
OHP  
occupational medicine practitioner or a person who holds a qualification in occupational 
health recognized as such by the  relevant health p rofessions or nursing council  
 
occu pational hygiene  
anticipation, recognition, evaluation and control of conditions arising in or from the 
workplace, which may cause illness or adverse health effects to employees  
 
occupational medicine practitioner  
OMP  
medical practitioner as defined by th e relevant health professions or nursing council  and 
who holds a qualification in occupational medicine which is recognized by the  relevant 
health professions or nursing council  
 
psychometric tests  
series of questions, problems, or practical tasks that pr ovide a measurement of aspects of 
somebody's personality, knowledge, ability, or experience; there are three main categories 
of psychometric tests: ability or aptitude tests, achievement tests, and personality tests  
 
side-effects  
secondary and usually adve rse effect of a drug or therapy  
 
staffing  
process whereby individuals are  recruited, selected, trained, deployed, and retained  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
114 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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