{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:04:00Z","timestamp":1777943040753,"version":"3.51.4"},"reference-count":19,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2016,7,20]],"date-time":"2016-07-20T00:00:00Z","timestamp":1468972800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Stroke"],"published-print":{"date-parts":[[2016,10]]},"abstract":"\n Background<\/jats:title>\n An acute medical condition following a previous stroke among those who operate trains, airplanes, and commercial vehicles can result in serious accidents. There are guidelines in place to assist physicians and employers in assessing the risks of returning to work after stroke but the extent and comprehensiveness across nations and among safety-critical occupations are not widely known.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Medical guidelines currently in place to regulate safety critical occupations including railway engineers, pilots and commercial vehicle drivers were systematically reviewed. Electronic and hand literature searches as well as review of grey literature for Canada, the USA, the UK, and Australia were conducted.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n There is no consistent set of guidelines that address the risk of a second catastrophic event after an initial cerebrovascular event in those employed in safety critical occupations in the four countries assessed. Some broad principles existed between the different countries and occupations but there was major variation in the approach to cerebrovascular disease and its impact on those working in safety-critical occupations.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n A synthesis of current knowledge would assist in establishing risks of a catastrophic event in those who have already suffered from cerebrovascular illness. This will allow the creation of medical guidelines which could be applied to any safety critical occupation in any nation.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/1747493016660101","type":"journal-article","created":{"date-parts":[[2016,7,14]],"date-time":"2016-07-14T00:58:17Z","timestamp":1468457897000},"page":"860-867","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Air, rail and road: Medical Guidelines for Employees with a History of Cerebrovascular Disease"],"prefix":"10.1177","volume":"11","author":[{"given":"Rebecca","family":"Klein","sequence":"first","affiliation":[{"name":"Department of Clinical Neurosciences, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada"},{"name":"Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bijoy K","family":"Menon","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada"},{"name":"Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Doreen","family":"Rabi","sequence":"additional","affiliation":[{"name":"Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada"},{"name":"Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada"},{"name":"Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Stell","sequence":"additional","affiliation":[{"name":"Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada"},{"name":"Department of Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, Canada"},{"name":"Department of Cell Biology and Anatomy, Cumming School of Medicine, University of Calgary, Calgary, Canada"},{"name":"Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael D","family":"Hill","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada"},{"name":"Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada"},{"name":"Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada"},{"name":"Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2016,7,20]]},"reference":[{"key":"bibr1-1747493016660101","unstructured":"Gertler J, Hartenbaum N, Viale A, Wittels E and Ellis SH.\n Medical standards for railroad workers\n . Washington, DC, USA: U.S. Department of Transportation, 2005, pp.1\u2013211."},{"key":"bibr2-1747493016660101","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31822dc795"},{"key":"bibr3-1747493016660101","doi-asserted-by":"publisher","DOI":"10.1007\/s10926-012-9401-1"},{"key":"bibr4-1747493016660101","doi-asserted-by":"publisher","DOI":"10.1111\/ene.12157"},{"key":"bibr5-1747493016660101","unstructured":"Railway Safety Act\n . 1\u201384. Minister of Justice, 2015, http:\/\/laws-lois.justice.gc.ca."},{"key":"bibr6-1747493016660101","unstructured":"Dalp\u00e9, D.\n Canadian railway medical guidelines handbook\n . Ottawa, Ontario, Canada: Railway Association of Canada, 2013, pp.1\u2013212."},{"key":"bibr7-1747493016660101","doi-asserted-by":"crossref","unstructured":"Rail Safety Improvement Act of 2008\n . 122 STAT. 4848, 2008, pp.1\u2013124.","DOI":"10.5325\/ecumenica.1.2.0122"},{"key":"bibr8-1747493016660101","unstructured":"Guidance on Medical Fitness for Railway Safety Critical Workers\n . RSSB, 2011, pp.1\u201346, www.rgsonline.co.uk."},{"key":"bibr9-1747493016660101","unstructured":"National Transport Commission.\n National Standard for Health Assessment of Rail Safety Workers\n . Australia: NTC Australia, 2012, pp.1\u2013224, www.ntc.gov.au."},{"key":"bibr10-1747493016660101","unstructured":"Handbook for civil aviation medical examiners\n . Transport Canada, 2004, pp.1\u2013138, http:\/\/www.tc.gc.ca\/CivilAviation\/Cam\/menu.htm."},{"key":"bibr11-1747493016660101","unstructured":"Aeronautics Act\n . 2015, pp.1\u201399, http:\/\/laws-lois.justice.gc.ca."},{"key":"bibr12-1747493016660101","unstructured":"Enterprise A.\n Guide for aviation medical examiners\n . Federal Aviation Administration, 2015, pp.1\u2013387, http:\/\/www.faa.gov\/about\/office_org\/headquarters_offices\/avs\/offices\/aam\/ame\/guide\/."},{"key":"bibr13-1747493016660101","unstructured":"Certification after cerebrovascular events stroke & transient ischaemic attack\n , Civil Aviation Authority, 2014, pp.1\u20132, https:\/\/www.caa.co.uk\/WorkArea\/DownloadAsset.aspx?id=4294973900."},{"key":"bibr14-1747493016660101","unstructured":"Authority CAS. Documents relating to CASA\u2019s Medical Handbook and application forms for class 1 and 2 medical certificates. Canberra Australia: Civil Aviation Safety Authority, 2013, pp.1\u20132054."},{"key":"bibr15-1747493016660101","unstructured":"Pawluk IJ.\n Determining driver fitness in Canada\n . Ottawa, Canada: CCMTA, 2013, pp.1\u2013302."},{"key":"bibr16-1747493016660101","unstructured":"CMA driver\u2019s guide: determining medical fitness to operate motor vehicles\n . Ottawa, Canada: Canadian Medical Association, 2012, pp.1\u2013148."},{"key":"bibr17-1747493016660101","unstructured":"FMCSA.\n Federal Motor Carrier Safety Administration (FMCSA) medical examiner handbook\n , Washington, DC, USA, 2014, pp.1\u2013260."},{"key":"bibr18-1747493016660101","unstructured":"DVLA.\n For medical practitioners at a glance guide to the current medical standards of fitness to drive\n . Driver & Vehicle Licensing Agency, 2014, pp. 1\u201374, gov.uk\/government\/publications\/at-a-glance."},{"key":"bibr19-1747493016660101","unstructured":"Austrouds.\n Assessing fitness to drive for commercial and private vehicle drivers\n . Sydney, Australia: Austrouds Ltd, 2012, pp.1\u2013176."}],"container-title":["International Journal of Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1747493016660101","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1747493016660101","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1747493016660101","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T07:14:04Z","timestamp":1777706044000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1747493016660101"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,7,20]]},"references-count":19,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2016,10]]}},"alternative-id":["10.1177\/1747493016660101"],"URL":"https:\/\/doi.org\/10.1177\/1747493016660101","relation":{},"ISSN":["1747-4930","1747-4949"],"issn-type":[{"value":"1747-4930","type":"print"},{"value":"1747-4949","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,7,20]]}}}