Safety Critical Work depends on intact neurological functions to maintain situational awareness and respond in an emergency: alertness, attention and concentration, memory, insight and judgement, sensation, muscle power, coordination, balance and vision, and some neurological conditions also produce seizures. This chapter frames the neurological assessment generally, directing seizures and epilepsy, vestibular disorders, aneurysms and vascular malformations, transient ischaemic attacks, subarachnoid haemorrhage, space-occupying lesions and neuromuscular conditions to their own sections, and addresses dementia in particular, with neurodevelopmental disorders covered separately. Its focus is long-term or progressive disorders affecting safe working, with guidance on short-term fitness after head injury; musculoskeletal, visual and psychological symptoms are assessed under their own criteria. Where cognitive decline or dementia is suspected, assessment uses cognitive screening, neuropsychological testing by an experienced psychologist and specialist opinion, and because dementia is progressive and impairs attention, memory and judgement unpredictably, a diagnosis of dementia generally renders a worker not fit for Safety Critical Work, with the fitness criteria in Table 15 setting the position for Category 1 and Category 2 workers and any limited scope for Fit for Duty Subject to Review on specialist advice.
The graph holds this control, the 0 it maps to, and the evidence behind each claim, over MCP and REST.