Version: 1
Last updated: May 2024

Click here to download this RLSS UK Guidance Statement

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NOTE: This guidance note sets out the position of RLSS UK about epilepsy and seizure management in aquatic environments. Following industry guidance, such as that set out in this statement, can help you comply with your legal obligations as an employer or employee.

Epilepsy 

Epilepsy is a neurological condition and one of the main causes of seizures. A seizure occurs when sudden uncontrolled bursts of electrical activity disrupt normal impulses that control brain function. Seizures are regarded as partial, with no loss of consciousness, or generalised, where consciousness is lost. Seizures can develop because of congenital factors or may be acquired, for example, following injury. The duration of seizures can vary from a few seconds to several minutes. Over 500,000 people in the UK have epilepsy, around 1 in 100 people.

Can you be a lifeguard if you experience seizures? 

Yes, and in most cases, you will be entitled to reasonable adjustments under section 20 of the Equality Act 2010. Only 34% of people with epilepsy in the UK work full-time. Sector employers, therefore, need to do more to attract and retain this talent pool. Employers should consider putting guidance in place to ensure that those with epilepsy do not experience discrimination in seeking and maintaining work in the sector. 

What do I need to know about someone's epilepsy?

As an employer, you should take steps to ensure an employee with epilepsy feels valued and included so they feel comfortable with disclosing relevant information about their condition. 

Employers should be clear on why they are requesting any information about the employee’s condition and how they might adjust should that information be disclosed. The following information and its potential use are detailed below:

• Types of seizures they have, how often, and what happens – This can help you as an employer plan shift rotas and on-shift activities to minimise any harm if a seizure were to occur.
• Common triggers for seizures – This can help employers eliminate or reduce triggers for seizures. 
• Any history of status epilepticus - Status epilepticus is when one seizure leads immediately to the next without the person recovering in between, which continues for more than five minutes. Whilst infrequent, employers must know to call 999 in this instance.
• Any emergency medication that can be taken – It is an offence under the Medicines Regulations 2012 to administer medication for epilepsy. Exceptions can be found here: The Human Medicines Regulations 2012 (legislation.gov.uk).
• How long it typically takes them to recover from a seizure – This can help an employer determine when to call 999 because a seizure is uncharacteristic for the individual.
• Whether they take any anti-epileptic drugs – This can help an employer discuss the importance of being ‘fit for work’, which means taking your medication as prescribed.
• Whether they have a medical ID card or jewellery – An employer can include this amongst their control measures in their risk assessment. 

Adjustments at the recruitment stage

It is an offence under the Equality Act 2010 for an employer to ask questions about an applicant’s health in any written form or an interview until the applicant has been offered the job. As an employer, you should:

• Ensure job adverts only ask for skills, behaviours, and qualifications that are genuinely required by the job.
• Invite applicants to disclose whether they require any reasonable adjustments to attend the interview. Relevant adjustments may include:
  • Adjusting the date and time of the interview.
  • Allowing late notice to be given to defer an interview.
• Eliminating triggers related to seizures.  If an applicant discloses their epilepsy to you during the recruitment process, you should conduct a risk assessment to assess whether their epilepsy is relevant to the needs of the job. Key factors include:
  • Requirement for work at height, such as in a highchair.
  • Requirement for lone working.
  • Requirement to provide poolside supervision as a sole lifeguard. 

• Once a job has been offered, an employer can ask questions about a disability to put reasonable adjustments in place and conduct/update its risk assessment. 

Adjustments when providing poolside supervision

Employers will need to take additional precautions to protect the safety of those with epilepsy and those who use the water when you provide supervision. Precautions may include:

• The employee should discuss their condition with their employer, including the duration, characteristics, and frequency of their seizures and any triggers they experience to identify what reasonable adjustments are required in their role.
• Any anti-epilepsy medication is taken as prescribed.
• The employee must notify their employer if their condition or medication changes and results in a change in the risk of experiencing seizures whilst at work.
• Conducting a risk assessment for lone working when the employee with epilepsy is providing constant poolside supervision, the employer should demonstrate that they can identify and react promptly to any loss of consciousness (via a fall monitor or otherwise).
• Minimise or eliminate the need to conduct heavy lifting or work at height when your condition presents a substantially increased risk of seizures (e.g., the top of flumes or sitting in highchairs). At times when your condition is under control, it may be safe to carry out these duties.
• Eliminate situations where the employee would constitute a lone swimmer.
• Employees should be equipped with a fall monitor and a communication device to summon assistance from colleagues should you require it.
• Careful consideration should be given to controls to prevent falls from height, such as when using a highchair.
• You are provided with time off to attend medical appointments.
• It may be necessary to:
  • Avoid areas/media with strobe effects and flashing lights.
  • Avoid flickering screens.
  • Adjustments when undertaking lifeguard/lifesaving training or assessment 

See guidance in RLSS UK Code of Practice for Epilepsy during training/assessment

Adjustments when providing supervision over open/coastal waters 

Immersion in hot or cold water is known as one of the most common stimuli for seizures; in addition to the guidance in RLSS UK Code of Practice for Epilepsy during training/assessment, employers should consider the risk of the employee taking part in a rescue on cold water. 

Adjustments when providing remote monitoring via CCTV

It may be necessary for those employees with photosensitive epilepsy for the employer to ensure the monitor does not flicker or display flashing lights. 

Assisted Lifeguard Technology (ALT) 

Do not rely solely on assistive lifeguard technology to detect a person in difficulty or submerged (employees or pool users) with epilepsy. Body movements caused during some seizures may affect the ability of some ALT systems to detect these events. If you have installed an ALT system, you should take reasonable steps to assess the effect body movement during seizures may have on its ability to detect an event. 

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References

Epilepsy Action
Epilepsy Action. Sports and leisure
Epilepsy Action. Work
Swim England. Epilepsy and swimming
Epilepsy Society
Epilepsy Foundation. Seizures in water
CIPD. Managing and supporting staff with long-term health conditions