Should hearing impairment stop you from driving?
Bleckly (2008) lists some possible issues for deaf or hearing-impaired drivers:
• using hands to sign, especially if using two-handed sign language
• lip reading a passenger while driving
• hearing emergency sirens, car alarms and other important sounds
• knowing where a sound is coming from
• communicating with the police or with road assistance personnel.

She notes that hearing drivers can have similar problems through activities such as playing loud music and using hand-held mobile phones or other devices. In fact, some countries have laws to reduce drivers’ distractions (for instance, no hand-held mobile use in Australia).

However, disregarding these comparisons, are the hearing impaired more dangerous drivers? Bleckly says: ‘Research shows that deaf drivers do not have more accidents or fines than hearing drivers, so there should be no reason why the deaf cannot drive.’ As she doesn’t describe specifically what research has been done about the relationship between hearing loss and road crashes, I thought I’d have a closer look. (I’m also personally interested as I am a moderate to severely deaf person with a hearing aid who drives. I don’t sign but I can converse in cars without lipreading, provided there are good conditions for listening).

Hearing loss and road crash statistics
Dobbs (2005) reviewed research from 1960 to 2000 on medical conditions and driving. She found that few studies have ‘examined the relationship between hearing impairment and risk of motor vehicle crash’. Two reasons for this come to my mind. Firstly, statistical analysis would need to analyse many factors involved in the ability to drive, such as managing environmental factors (heavy rain, for example). Secondly, as there are so many factors to consider, identifying explanatory variables (such as hearing loss) with a statistically high correlation to road crashes can be difficult to obtain.
Of the studies found, Dobbs noted one study suggesting that the use of hearing aids could place the hearing-impaired driver at a higher risk of motor vehicle crashes, as feedback from a hearing aid could cause distractions to the driver. Other studies had mixed and often inconclusive correlations between hearing impairment and risk of vehicular crashes. Based on so few studies, Dobbs concluded that there is little evidence of hearing loss being a potentially higher risk factor contributing to car crashes. I’ve checked the internet for more recent research, but couldn’t find much to add to Dobbs’ conclusion.

Fitness to drive guidelines
Despite the limited research, guidelines and standards do exist for health professionals to assess patients for their ‘fitness to drive’. Australia’s guidelines are produced by Austroads, an organisation whose members are the Australian and New Zealand road authorities. Every few years, Austroads reviews the ‘fitness to drive’ guidelines by consulting representatives from academia, governments, industry and the community about various medical conditions (including hearing loss) and their implications for driving. This review process would take into account up-to-date anecdotal and statistical evidence and professional opinions.

I was pleased to find that Australian road safety policymakers do not consider hearing loss to be an impediment to safe driving in the 2006 Austroads guidelines. In fact, the guidelines state that ‘mild to moderate hearing loss does not appear to affect a person’s ability to drive safely. It may be that a loss of hearing is well compensated for since most people who are hard of hearing are aware of their disability and therefore tend to be more cautious and to rely more on visual cues.’

However, these same guidelines recommend that people who have ‘vestibular disorders’ or difficulties with conditions such as ‘acute labyrinthitis, vertigo, Meniere’s disease, recurrent vertigo or horizontal head movement’ should not drive while these symptoms are present, whether temporary or not. Unfortunately, these conditions are often associated with hearing loss. If present, affected people are advised not to drive, as the driver may unexpectedly lose ability to take evasive action or use defensive driving tactics.

The guidelines place no restrictions on a hearing-impaired or deaf person driving a private car (unless they also have a vestibular disorder). Austroads comments that ‘while hearing loss is not considered to preclude driving a private car, persons with severe hearing losses should be advised regarding their loss and their limited ability to hear warning signals, etc. Persons with hearing aids should be encouraged to wear them when driving. Engineering solutions such as additional mirrors (as mentioned above) might also be recommended upon consideration of the needs of the individual driver.’

Conclusions
Detailed attention to safety makes for good driving. I liked the finding that hearing-impaired and deaf people who use their eyes can often make safer drivers and that this is reflected in the Austroads guidelines. However, as road safety is paramount, lipreading or signing while driving can become an issue if they are not managed well by the hearing-impaired or deaf driver. For myself, I feel comfortable as a hearing-impaired driver, as I do use my visual cues well. I also ensure road safety for myself and my passengers by not having a conversation with them if I cannot understand what is being said, or when driving conditions are poor.

Now that I am happy driving as a deaf person, are there other factors to consider, such as carbon emissions from my car? How can I reduce my environmental footprint? Now these are much harder questions to answer!

References
Austroads (2006). Assessing Fitness to Drive: Austroads guidelines for health professionals, Sydney.
Bleckly, F. (2008). ‘Can A Deaf Person Drive?’ BellaOnline, 22 November 2008, www.bellaonline.com/articles/art7765.asp.
Dobbs, B. M. (2005). Medical Conditions and Driving: A review of the literature 1960-2000, National Highway Traffic Safety Administration, Washington, DC.
Useful websites
www.austroads.com.au/aftd Up-to-date Austroads guidelines for health professionals in assessing fitness to drive.

This article is copyright to Rowena Vnuk. The purpose of this information to help people manage and live with their hearing loss. However, this information is intended only to provide a perspective on matters of interest and to enable people to seek other advice; information found in these essays is not to be relied on, and thus readers should seek other advice where necessary. For the purposes of BellaOnline website, I give Felicity Bleckly permission to publish this information on the internet.