High Risk Occupations
Balancing Safety, Rights, and Opportunity
Some occupations involve safety risks — to the worker or others — where sudden hypoglycaemia, hyperglycaemia, or medical impairment could have serious consequences.
For people living with diabetes, this doesn’t automatically mean exclusion. Instead, it requires a case-by-case assessment of risk, treatment stability, and available technology or monitoring supports.
This page explains how New Zealand approaches safety-sensitive work, where restrictions may apply, and how to navigate medical assessments and fair treatment under employment and human-rights law.
Under Te Tiriti o Waitangi, the Crown and employers have obligations to ensure that Māori workers are not unfairly excluded from employment opportunities due to inequitable or outdated health policies.
- Partnership: Māori voices should shape how occupational health standards are designed and applied.
- Protection: Employers must protect both safety and mana — avoiding bias or assumptions about capability.
- Participation: All workers should have equitable access to assessment, technology (like CGM), and pathways to retain or regain fitness for work.
Equity in employment means valuing health, skill, and cultural identity together — not using health conditions as grounds for exclusion.
Understanding Safety-Sensitive Work
Jobs may be considered safety-sensitive if an unexpected medical event could endanger the worker, co-workers, passengers, or the public. Examples include:
- Aviation – commercial or private pilots, air-traffic control.
- Commercial driving – trucks, buses, trains, heavy machinery.
- Maritime roles – seafarers, ferry crew, port pilots, divers.
- Emergency services – police, firefighters, paramedics.
- Military and defence.
- Mining, construction, electrical, or high-voltage work.
Each sector has its own fitness-for-duty or medical certification standards, often set by legislation or an authority such as CAA, NZTA, or Maritime NZ.
How Fitness for Work Is Determined
Most sectors require assessment by a designated medical examiner who considers:
- Type of diabetes (T1 or T2).
- Treatment method (insulin, oral meds, or diet-controlled).
- History of hypoglycaemia or loss of awareness.
- Recent glucose control (HbA1c, sensor data).
- Use of diabetes technology (CGM, alarms, pump).
- Individual risk mitigation strategies (testing frequency, backup plans).
With the introduction of CGM and hybrid closed-loop systems, many people previously excluded from certain roles can now demonstrate real-time safety control — hopefully prompting some regulators to review historic policies.
Sector-Specific Guidance
Aviation (Civil Aviation Authority – CAA)
- Pilots or air-traffic controllers using insulin require a CAA medical certification under specific criteria.
- Currently, CAA allows Class 1 or 2 certification for insulin-treated diabetes in some cases with strict monitoring and CGM use.
- Non-insulin-treated diabetes (diet or oral meds) is usually accepted if well-controlled and stable.
Commercial and Heavy Vehicle Drivers (NZTA)
- Drivers of classes 2–5, passenger endorsements, or heavy machinery must meet the Medical Aspects of Fitness to Drive standard.
- Insulin use does not automatically disqualify a person, but stability, hypoglycaemia awareness, and medical certification from a GP or occupational physician are required.
- Regular review intervals may be shorter (often yearly).
Maritime and Diving (Maritime NZ)
- Commercial seafarers or divers must meet Maritime Medical Fitness standards.
- Insulin-treated diabetes may restrict offshore or deep-sea diving but can be compatible with coastal or shore-based roles.
- Recreational diving (under PADI or SSI) is permitted for many people with stable diabetes, following medical clearance and appropriate precautions.
Emergency Services and Defence
- Each service has its own occupational-health policies.
- Stable diabetes with CGM or pump use is increasingly accepted, though specific duties (e.g., armed response or aviation-related tasks) may have limits.
- Applicants should be assessed individually, not excluded on diagnosis alone.
Legal Protections and Fair Process
- Under the Human Rights Act 1993 and Employment Relations Act 2000, it is unlawful to discriminate based on disability or medical condition unless the condition genuinely prevents safe performance of essential duties.
- Employers must consider reasonable accommodations, such as schedule flexibility, glucose breaks, or technology use.
- Workers have the right to medical confidentiality — information should be shared only with consent and on a need-to-know basis.
- If employment is declined or changed due to diabetes, the employer must explain the safety rationale and offer a review process.
Practical Steps for Workers
- Be proactive: disclose your condition early in the application or medical review stage.
- Bring documentation: CGM reports, doctor’s letters, and treatment summaries help demonstrate stability.
- Ask for clarification: request written copies of the medical standards used for your assessment.
- Seek support: your diabetes specialist, Diabetes NZ, or union can help prepare your case.
- Appeal or review: if declined certification, you can usually appeal through the relevant authority (e.g., CAA, NZTA, Maritime NZ).
When Things Go Wrong
If you believe you’ve been unfairly excluded or discriminated against because of diabetes:
- Contact the Human Rights Commission (Te Kāhui Tika Tangata) for free, confidential advice.
- Discuss with your union, professional body, or legal adviser.
- In some cases, issues can be resolved through Occupational Health review rather than legal complaint.
Equity in Access to Employment
The availability of CGM, insulin pumps, and closed-loop systems now enables far greater safety and self-management at work.
Policies that exclude people based solely on diagnosis rather than demonstrated capability risk breaching equity principles and Te Tiriti o Waitangi obligations.
A fair system means assessing people, not conditions — recognising individual competence, lived experience, and technological support.
High-risk or safety-sensitive work is possible for many people living with diabetes in Aotearoa NZ.
With accurate assessment, modern technology, and fair, evidence-based policies, people can pursue their chosen careers while protecting safety and wellbeing for all.
Diabetes should not define what work you can do — capability, safety, and mana motuhake should.
Page updated: October 2025
| LEGAL DISCLAIMER: The information on this website is provided for general educational purposes only and is intended for a New Zealand audience. It is not a substitute for professional medical advice, diagnosis, or treatment. While I strive to ensure accuracy and relevance, please always seek guidance from your healthcare provider for personal medical decisions. Use of the content is at your own risk. Links to other sites are for convenience and do not imply endorsement. |
