Taxi driver heart tests are essential for drivers who have suffered from a variety of different cardiac disorders. All taxi drivers in Essex are required to undergo heart tests before resuming driving. Most licencing agencies adhere to the DVLA Group 2 requirements. These rules are tightly enforced on drivers of Heavy Goods Vehicles (HGV), and the standards that must be met are designed to safeguard the public's and drivers' safety. Private hire and taxi licencing bodies, including Transport For London (TFL), have required their licenced drivers to meet the HGV DVLA Group 2 criteria. This is to ensure that drivers who have had a heart attack are fit and safe to operate a private rental vehicle, so safeguarding the safety of the travelling public (and themselves) on the road.
Coronary artery disease and heart failure are the two most common heart disorders that require further cardiac tests. Heart exams for taxi drivers are required for any driver who has previously been diagnosed with one of these heart disorders, as well as for any new drivers who have a family history of one of these heart conditions.
A Bruce Protocol Exercise ECG (exercise stress test) is a mandatory necessity for drivers with angina, a recent heart attack, and/or coronary stent implantation. There must be a minimum of six weeks between treatment completion and they must be symptom-free during that time. Drivers must complete three steps of the Bruce Protocol (9 minutes in total). All routine medications are permitted prior to the test. There should be no symptoms or ECG abnormalities during testing that indicate a severe constriction of the cardiac arteries (ischaemia). Similarly, during the recovery phase, the ECG must be normal, as well as the heart rate and blood pressure.
An echocardiography is also required for some drivers. This heart test is an ultrasound of the heart and is used to determine the heart's pumping function. This is referred to as the 'ejection fraction,' and it must be at least 40% to qualify for re-licensing. Echocardiograms may be necessary following a heart attack and are a mandatory procedure following coronary artery bypass graft surgery. All drivers must retake these tests every three years.
Drivers who have received coronary artery bypass graft surgery must undergo testing a minimum of three months after the procedure (as opposed to the 6-week interval following a heart attack or coronary stent insertion). Drivers must have an echocardiography and demonstrate a left ventricular ejection fraction of at least 40% (the heart's pumping motion). After that, drivers must perform three stages (9 minutes) of an ECG test called the Bruce Protocol Exercise.