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Lack of guidelines on kidney stone attacks could put travel workers and passengers at risk

ediately grounded and referred for investigation if they suffer from renal colic or are found to have kidney stones.

Royal Navy and British Army personnel are also screened before entry and a positive kidney stone result would mean a medical downgrade and restricted duties.

The Rail Safety and Standards Board, which is responsible for the safety of Britains railways, has no specific guidelines for train drivers with kidney stones, but there are general guidelines covering conditions that could cause sudden incapacity.

The UKs Drivers Vehicle Licensing Agency (DVLA), which is responsible for the safety of private and public service drivers, has a "surprisingly large" list of conditions that could be hazardous to road safety, say the authors. But kidney stones are not specifically listed.

However DVLA does provide general guidance that it should be notified of any medical conditions "likely to affect ability to safely control a vehicle."

Travel insurance companies the authors spoke to provided more categorical responses. They said that if they knew that a person had a kidney stone they would not be covered for treatment abroad.

And if the person didnt declare their condition, and then claimed for treatment abroad, their insurance would be invalid.

"It is clear that there are few guidelines for workers in charge of other peoples safety and for patients with stone disease waiting to travel" says Nigel Borley.

The authors have devised their own guidelines for family doctors and urology colleagues, which are published in the journal. But they stress that its essential for governing bodies to develop formal guidelines for the protection of their own staff and the travelling public.


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Contact: Annette Whibley
wizard.media@virgin.net
Blackwell Publishing Ltd.
12-Mar-2007


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