Surveying the Impact of Work Hours and Schedules on Commercial Motor Vehicle Driver Sleep

Effects of insomnia on risky driving behavior among bus drivers: The mediating effect of mental health

Crashes caused by problems with bus drivers' physical and mental health have increased in frequency in recent years. Insomnia, a common type of sleep problem, has significant positive relationships with both crash risk and mental health problems, especially anxiety and depression, which are themselves associated with driving behavior. However, few studies have conducted analysis on sleep-related problems and mental health exclusively on bus drivers, nor on how these problems influence driving performance. Thus, this study explored the effect of insomnia and mental health on bus drivers' risky driving behavior and evaluated the interaction of four variables: insomnia, anxiety, depression, and risky driving behavior. The survey-based investigation was conducted in a bus company in Suzhou, China, with 1,295 bus drivers participating. Insomnia, anxiety, and depression were self-reported based on professional mental health scales and risky driving behaviors were measured by the Driver Behavior Questionnaire. Two mediation models and a chain mediation model were developed to examine relationships among the bus drivers' insomnia, anxiety, depression, and risky driving behavior. Results revealed that (a) bus drivers less than 31 years old, drivers with more than 11 years' experience driving buses, and those with crash and violation involvement within three years demonstrated more severe degrees of insomnia, anxiety, depression, and risky driving behavior; (b) there were significant positive correlations and interactions among the four variables. Results specifically related to the interaction among variables include findings that (a) anxiety mediated between insomnia and risky driving behavior; (b) depression mediated between insomnia and risky driving behavior; and (c) anxiety affected bus drivers' risky driving behavior primarily though depression. The findings in this study indicate the importance of regular physical and mental health examination of bus drivers and suggest that interventions focused on insomnia and mental health problems may be helpful to reduce risky driving behaviors of bus drivers both directly and indirectly.

Optimal Duration of In-Vehicle Data Recorder Monitoring to Assess Bus Driver Behavior

This study examined the optimal sampling durations for in-vehicle data recorder (IVDR) data analysis, focusing on professional bus drivers. Vision-based technology (VBT) from Mobileye Inc. is an emerging technology for monitoring driver behavior and enhancing safety in advanced driver assistance systems (ADASs) and autonomous driving. VBT detects hazardous driving events by assessing distances to vehicles. This naturalistic study of 77 male bus drivers aimed to determine the optimal duration for monitoring professional bus driving patterns and the stabilization point in risky driving events over time using VBT and G-sensor-equipped buses. Of the initial cohort, 61 drivers' VBT data and 66 drivers' G-sensor data were suitable for analysis. Findings indicated that achieving a stable driving pattern required approximately 130 h of VBT data and 170 h of G-sensor data with an expected 10% error rate. Deviating downward from these durations led to higher error rates or unreliable data. The study found that VBT and G-sensor data are both valuable tools for driving assessment. Moreover, it underscored the effective application of VBT technology in driving behavior analysis as a way of assessing interventions and refining autonomous vehicle algorithms. These results provide practical recommendations for IVDR researchers, stressing the importance of adequate monitoring durations for reliable and accurate outcomes.

The impact of break duration, time of break onset, and prior shift duration on the amount of sleep between shifts in heavy vehicle drivers

This study aimed to examine the impact of break duration between consecutive shifts, time of break onset, and prior shift duration on total sleep time (TST) between shifts in heavy vehicle drivers (HVDs), and to assess the interaction between break duration and time of break onset. The sleep (actigraphy and sleep diaries) and work shifts (work diaries) of 27 HVDs were monitored during their usual work schedule for up to 9 weeks. Differences in TST between consecutive shifts and days off were assessed. Linear mixed models (followed by pairwise comparisons) assessed whether break duration, prior shift duration, time of break onset, and the interaction between break duration and break onset were related to TST between shifts. Investigators found TST between consecutive shifts (mean [SD] 6.38 [1.38] h) was significantly less than on days off (mean [SD] 7.63 [1.93] h; p < 0.001). Breaks starting between 12:01 and 8:00 a.m. led to shorter sleep (p < 0.05) compared to breaks starting between 4:01 and 8:00 p.m. Break durations up to 7, 9, and 11 h (Australian and European minimum break durations) resulted in a mean (SD) of 4.76 (1.06), 5.66 (0.77), and 6.41 (1.06) h of sleep, respectively. The impact of shift duration prior to the break and the interaction between break duration and time of break were not significant. HVDs' sleep between workdays is influenced independently by break duration and time of break onset. This naturalistic study provides evidence that current break regulations prevent sufficient sleep duration in this industry. Work regulations should evaluate appropriate break durations and break onset times to allow longer sleep opportunities for HVDs.

A Retrospective Medical Record Review to Describe Health Status and Cardiovascular Disease Risk Factors of Bus Drivers in South Africa

Cardiovascular disease (CVD) is the leading cause of death globally. The occupational challenges of bus drivers may increase their risk of CVD, including developing obesity, hypertension, and diabetes. We evaluated the medical records of 266 bus drivers visiting an occupational medical practice between 2007 and 2017 in Johannesburg, South Africa, to determine the health status of bus drivers and investigate risk factors for CVD, and their impact on the ability to work. The participants were in majority male (99.3%) with a median age of 41.2 years (IQR 35.2); 23.7% were smokers, and 27.1% consumed alcohol. The median body mass index (BMI) was 26.8 m/kg² (IQR 7.1), with 63.1% of participants having above normal BMI. Smoking, BMI, and hypertension findings were in line with national South African data, but diabetes prevalence was far lower. Undiagnosed hypertension was found in 9.4% of participants, uncontrolled hypertension in 5.6%, and diabetes in 3.0%. Analysis by BMI category found that obesity was significantly associated with increased odds of hypertension. Uncontrolled hypertension was the main reason for being deemed 'unfit to work' (35.3%). Our research highlights the need for more regular screening for hypertension and interventions to address high BMI.

Unravelling the Complexity of Irregular Shiftwork, Fatigue and Sleep Health for Commercial Drivers and the Associated Implications for Roadway Safety

Fatigue can be a significant problem for commercial motor vehicle (CMV) drivers. The lifestyle of a long-haul CMV driver may include long and irregular work hours, inconsistent sleep schedules, poor eating and exercise habits, and mental and physical stress, all contributors to fatigue. Shiftwork is associated with lacking, restricted, and poor-quality sleep and variations in circadian rhythms, all shown to negatively affect driving performance through impaired in judgment and coordination, longer reaction times, and cognitive impairment. Overweight and obesity may be as high as 90% in CMV drivers, and are associated with prevalent comorbidities, including obstructive sleep apnea, hypertension, and cardiovascular and metabolic disorders. As cognitive and motor processing declines with fatigue, driver performance decreases, and the risk of errors, near crashes, and crashes increases. Tools and assessments to determine and quantify the nature, severity, and impact of fatigue and sleep disorders across a variety of environments and populations have been developed and should be critically examined before being employed with CMV drivers. Strategies to mitigate fatigue in CMV operations include addressing the numerous personal, health, and work factors contributing to fatigue and sleepiness. Further research is needed across these areas to better understand implications for roadway safety.

Research gaps and needs for preventing worker fatigue in the transportation and utilities industries

BACKGROUND

The transportation and utilities industries include establishments engaged in the movement of passengers and freight, or the provision of public power, water, and other services. Along with the warehousing industry, they make up the US National Occupational Research Agenda's Transportation, Warehousing and Utilities (TWU) industry sector. In 2018 the sector composed 5% of the US workforce, with approximately 8 million workers. TWU workers experienced 19% of all fatalities among U.S. workers in 2018 and 7% of total occupational injuries and illnesses.

METHODS

Around-the-clock operations, heavy workloads, long and irregular shifts, complicated schedules, and time pressures characterize work across the US TWU sector. However, there are considerable differences in worker priorities and concerns between TWU industries. Major areas of concern within the sector include disparities in work schedules; required training for employee fatigue awareness and prevention; physical and mental job demands; and safety culture.

RESULTS

Strategies for fatigue mitigation are critical to reduce the prevalence of injuries, safety-critical events, and crashes in TWU workers. Further research on the incidence and characterization of fatigue among TWU workers will guide the development of effective mitigation strategies. The influence of work scheduling on missed sleep opportunities and disrupted circadian rhythms should be determined. Evaluation of fatigue mitigation strategies can lead to the adoption of the most effective ones for each TWU industry.

CONCLUSION

Implementation of effective strategies is critical for the health, safety, wellbeing, and productivity of workers in the TWU sector.

The effect of listening to Iranian pop and classical music, on mental and physiological drowsiness

Driver's drowsiness is one of the high-risk road behaviors that quadruples the risk of road accidents. Measures to deal with drowsiness during driving include listening to music. The present study investigates the effect of two types of music, namely Iranian high-tempo pop and classical music, on mental and physiological drowsiness during driving. Twelve male students at Tehran University of Medical Sciences within the normal range of the Epworth Drowsiness Scale (ESS) participated in this study. Two types of music (classical and pop) were assessed on two separate days with an interval of one week. The mental aspect of drowsiness was evaluated using the Karolinska Sleepiness Scale (KSS), the physiological aspect by monitoring the EEG and heart rate, and the functional aspect through the mean and standard deviation of speed and the Standard Deviation of Lateral Position (SDLP) in a driving simulator. The results showed that the brain waves (four algorithms (1) (θ + α)/β, (2) α/β, (3) (θ + α)/(α + β) and (4) θ/β), the KSS score, SDLP and standard deviation of speed all decrease while the mean heart rate increases when listening to music during driving compared to driving without music. No significant difference was observed in the mean speed when exposed to music. Moreover, no difference was observed between the effect of the two music styles, i.e. Iranian classical and pop music. Listening to Iranian classical and pop music while driving improves the driver's performance and reduces drowsiness. The present study showed that higher tempo music during driving can reduce drowsiness and change physiological responses and driving performance.

The Impact of COVID-19 on the Work Environment in Long-Haul Truck Drivers

OBJECTIVE

To describe and compare the working conditions of long-haul truck drivers (LHTD) before and during the Coronavirus (COVID-19) pandemic and to assess the perceptions of LHTDs on accessing food, restrooms, and parking.

METHODS

An online survey was disseminated between August 2020 and March 2021 to various trucking organizations across Canada to collect data on health and wellness during COVID-19. Data were analyzed using descriptive and inferential statistics, and thematic analysis for open-ended responses.

RESULTS

The sample included 146 LHTD (mean age 48.1 ± 11.8; 82.2% were men). Participants reported issues with finding parking, washrooms, and food. Compared with before COVID-19, LHTD worked significantly more hours and consumed more caffeine; and more than 50% reported being fatigued.

CONCLUSIONS

Improving the working conditions of LHTD is critical to support their health and wellbeing, both during and after the pandemic.

Sleep duration and sleep efficiency in UK long-distance heavy goods vehicle drivers

OBJECTIVES

To profile sleep duration and sleep efficiency in UK long-distance heavy goods vehicle (HGV) drivers and explore demographic, occupational and lifestyle predictors of sleep.

METHODS

Cross-sectional analyses were carried out on 329 HGV drivers (98.5% men) recruited across an international logistics company within the midland's region, UK. Sleep duration and efficiency were assessed via wrist-worn accelerometry (GENEActiv) over 8 days. Proportions of drivers with short sleep duration (<6 hour/24 hours and <7 hour/24 hours) and inadequate sleep efficiency (<85%) were calculated. Demographic, occupational and lifestyle data were collected via questionnaires and device-based measures. Logistic regression assessed predictors of short sleep duration and inadequate sleep efficiency.

RESULTS

58% of drivers had a mean sleep duration of <6 hour/24 hours, 91% demonstrated <7-hour sleep/24 hours and 72% achieved <85% sleep efficiency. Sleeping <6 hour/24 hours was less likely in morning (OR 0.45, 95% CI 0.21 to 0.94) and afternoon (OR 0.24, CI 0.10 to 0.60) shift workers (vs night) and if never smoked (vs current smokers) (OR 0.45, CI -0.22 to 0.92). The likelihood of sleeping <7 hour/24 hours reduced with age (OR 0.92, CI 0.87 to 0.98). The likelihood of presenting inadequate sleep efficiency reduced with age (OR 0.96, CI 0.93 to 0.99) and overweight body mass index category (vs obese) (OR 0.47, CI 0.27 to 0.82).

CONCLUSIONS

The high prevalence of short sleep duration and insufficient sleep quality (efficiency) rate suggest that many HGV drivers have increased risk of excessive daytime sleepiness, road traffic accidents and chronic disease. Future sleep research in UK HGV cohorts is warranted given the road safety and public health implications.

Characteristics and Causes of Particularly Major Road Traffic Accidents Involving Commercial Vehicles in China

Major accidents occurred frequently in the road transportation industry, and the resulting harm to drivers, property loss, and traffic interruption are very serious. This study investigated 11 particularly major accidents involving commercial vehicles in China, and performed analysis on accident characteristics regarding the time, location, types of vehicles, and accident causation at different levels based on the 24Model. Large buses and dangerous goods vehicles were involved in 10 accidents and they all occurred on a freeway. The months from May to August, especially during the time periods of 2:00–4:00 and 14:00–16:00 every day, were the most prone to accidents. The driver’s speeding and fatigued driving, and vehicle failure were the direct causes of most of the accidents. The defects in organizational safety management involved 12 system elements, such as safety accountability, education and training, etc. Procedures are of no use if they were not followed, and there was often no effective process to assess the implementation of procedures in many organizations. The weaknesses in organizational safety culture were the source of accidents, which was mainly manifested in members’ inadequate cognition of key elements in the aspects of safety importance, safety commitment, safety management system, etc. Understanding the characteristics and root causes of accidents can help to prevent the recurrence of similar mistakes and strengthen preventative measures in road transportation enterprises.

Qualitative Study of Long-Haul Truck Drivers' Health and Healthcare Experiences

OBJECTIVE

Long-haul truck drivers suffer increased health risk, but how they use healthcare is unknown. The objectives of this study were to explore the health experiences of these drivers, their healthcare experiences, and their relationship with their main medical provider.

METHODS

In-depth semi-structured interviews were conducted with 13 Canadian long-haul truck drivers. The majority (85%) were men and recruited at a truck stop on a major transport corridor between Canada and the United States.

RESULTS

Through phenomenological analysis of the transcribed interviews, themes of perseverance, isolation, dehumanization, and working in a hidden world emerged as major influences on the health experiences of these drivers. Barriers to their medical provider were also revealed.

CONCLUSIONS

Continuous exposure to a stressful work environment and inadequate access to primary care likely negatively affect the health of long-haul truck drivers. Given the experiences of this small group of drivers, improved healthcare and health resource availability might mitigate the risk of this occupational group.

Factors Associated with Insomnia Among Truck Drivers in Japan

PURPOSE

Truck drivers with insomnia are at a high risk of traffic accidents. We aimed to investigate the prevalence of insomnia and identify its associated factors among truck drivers in Japan.

METHODS

Participants were 2927 male truck drivers younger than 65 years old. Self-administered questionnaires were used to assess insomnia symptoms, State-Trait Anxiety Inventory, drinking, smoking habits, body mass index, caffeine intake, as well as daily driving hours, consecutive days away from home, and driving distance. Insomnia symptoms included difficulty initiating sleep, maintaining sleep and early morning awakening. Insomnia was defined when any of these symptoms were observed with daily tiredness.

RESULTS

The prevalence of insomnia among the subjects was 13.3% (n=356), of which 13.5% had difficulty initiating sleep, 78% had difficulty maintaining sleep, and 26.4% had early morning awakening. After adjusting for covariates, drinking habits, daily driving hours, and STAI score were significantly and linearly associated with insomnia; the adjusted odds ratio (OR) of drinking habits for insomnia was 1.74 [95% confidence interval (CI), 1.23-2.47] for heavy drinkers compared to non-drinkers (trend p<0.001); the adjusted OR of daily driving hours was 1.87 (95% CI, 1.00-3.49) for 12 hours or longer in a day compared to <8 hours in a day (trend p<0.001); the adjusted OR of STAI quartiles was 5.30 (95% CI, 3.66-7.67) for the highest quartile compared to the lowest quartile (trend p<0.001).

CONCLUSION

The present study demonstrated that insomnia is prevalent among truck drivers in Japan, and its risk factors include drinking habits, daily driving hours, and anxiety.

Assessment of physical work demands of long-distance industrial gas delivery truck drivers

AIM

The aim of this study was to assess the work-related physical demands of long-distance truck drivers employed by a large gas delivery company in Canada.

METHODS

A total of 15 truck drivers participated in a data collection that included self-reporting assessments, field observations, and direct measurements to describe daily tasks organization, postural demands, physical workload, and force exertions.

RESULTS

Truck drivers' work was characterized by long working days ranging from 9.9 to 15.1 h (mean = 11.4 h), with half (49%) of the total working time spent behind the wheel. The overall workload as measured by relative cardiac strain (18.7% RHR) was found excessive for the long term given the shift duration. Peaks of heart rate in excess of 30 beats per minute above the daily average occurred mainly while operating valves and handling heavy hoses during gas deliveries. The task of delivering gas at a client's site required a moderate work rate on average (8.3 mlO₂/kg/min) requiring 24.4% or maximum work capacity on average.

CONCLUSION

Based on multiple data sources, this study highlights the risks of over-exertion and of excessive physical fatigue in the truck drivers' work that are coherent with the high prevalence of self-reported musculoskeletal pain in this group of workers.

Relationship between Negative Work Situation, Work-Family Conflict, Sleep-Related Problems, and Job Dissatisfaction in the Truck Drivers

Understanding the relationship between psychological factors of truck drivers is very important for accident prevention plans. This study investigates whether the negative work situation or work-family conflict positively affects sleep-related problems and whether sleep-related problems positively affect job dissatisfaction. The relationship was verified by structural equation modeling. The analysis was conducted with 184 truck drivers who drive daily from the 5th Korea Working Conditions Survey (KWCS) data. The structural equation modeling results found that work-family conflict (standardized path coefficient = 0.274) and negative work situation (standardized path coefficient = 0.203) had significantly affected sleep-related problems. Also, the sleep-related problems were more affected by the work-family conflict level than the negative work situation level. Sleep-related problems were found to correlate with job dissatisfaction (standardized path coefficient = 0.336). The relationship between negative work situation and work-family conflict on sleep-related problems and job dissatisfaction will help establish preventive policies for truck drivers’ safety and health.

Mindfulness, sleep, and post-traumatic stress in long-haul truck drivers

BACKGROUND

The high stress culture and demands associated with long-haul truck driving place truckers at risk for mental health and sleep disorders, and thereby, increased risk for accidents, injuries, and fatality. Hours-of-service regulations have proven insufficient as a stand-alone intervention to protect the welfare of long-haul truckers, impacting those working in the industry and those sharing our nation's roads. Interventions to increase mindfulness have been used across occupational and personal domains to improve sleep quality, mental health, awareness of the environment, and reaction time.

OBJECTIVE

The purpose of this study was to examine the relationships between sleep, mental health, health care utilization, and mindfulness in long-haul truck drivers in the United States.

METHODS

Participants (N = 140) were recruited to complete a web-based survey. Descriptive statistics, bivariate analysis, and regression analysis were used to examine variables of interest.

RESULTS

Post-traumatic Stress Disorder (PTSD) symptomology and daytime sleepiness predicted mental health care utilization in the past year. Mindfulness was inversely correlated with PTSD symptomology, however in the full regression model, mindfulness failed to predict mental health care utilization.

CONCLUSIONS

Occupational health professionals should utilize mindfulness screenings as an adjunctive component to traditional mental health screenings and refer drivers for advanced care as appropriate.

Impact of limited rest areas on truck driver crashes in Saskatchewan: a mixed-methods approach

Background

Long-haul truck drivers (LHTDs) suffer from long work hours often resulting in fatigue. Although several studies have reported that fatigue can contribute to crashes, no study has identified the location and patterns of fatigue-related crashes and solicited truck driver feedback on potential mitigation strategies. The purpose of this study is 1) to map the location of fatigue-related crashes and 2) examine the perceptions of truck drivers concerning fatigue-related crashes.

Methods

Using databases from the Saskatchewan Government Insurance, information on LHTD demographics, crashes and their causes, as well as crash location was analyzed. All fatigue-related crashes were then documented and mapped. Additionally, we interviewed 67 LHTDs (mean age = 53.0 ± 12.9; range 23–89; 95% were men) asking questions about fatigue, access to truck stops/rest areas, and provided recommendations for improvement. All interviews were subsequently analyzed using thematic analyses.

Results

On average, there were 20 fatigue-related crashes per year over the 10-year period. Fatigue-related crashes were common across Saskatchewan, however, there was a concentration of crashes along major roadways between major cities. There was a significant association between crashes with age and experience. Despite many LHTDs being fatigued, there was a lack of truck stops/rest areas along highway routes. LHTDs suggested having access to truck stops/rest areas 250–400 km apart with running water and washrooms available.

Conclusions

Additional truck stops and rest areas are needed in Saskatchewan to ensure LHTDs have more opportunities for rest to reduce fatigue in general, as well as to reduce the risk of fatigue-related crashes.

Multidimensional prediction of work traffic crashes among Spanish professional drivers in cargo and passenger transportation

The aim of this study was to examine the effect of different environmental, mechanical and individual factors associated with fatalities and serious injuries caused by work traffic accidents among cargo and passenger transport drivers (CPTD) in Spain. For this cross-sectional study, national data on work traffic accidents collected in Spain during the last 3 years were analyzed through a regression modeling approach, in order to predict the severity of traffic crashes involving CPTD. Using binary logistic regression analyses, it was found that the type of road and accident, the meteorological, light and vehicle conditions, individual characteristics and risky driving behaviors significantly predict the risk of fatal work traffic accidents and serious injuries. These findings highlight the importance of combining organizational efforts with national road safety policies in order to generate a traffic safety culture among CPTD.

Using a Single Daytime Performance Test to Identify Most Individuals at High-Risk for Performance Impairment during Extended Wake

We explored the predictive value of a neurobehavioral performance assessment under rested baseline conditions (evaluated at 8 hours awake following 8 hours of sleep) on neurobehavioral response to moderate sleep loss (evaluated at 20 hours awake two days later) in 151 healthy young participants (18-30 years). We defined each participant's response-to-sleep-loss phenotype based on the number of attentional failures on a 10-min visual psychomotor vigilance task taken at 20 hours awake (resilient: less than 6 attentional failures, n = 26 participants; non-resilient: 6 or more attentional failures, n = 125 participants). We observed that 97% of rested participants with 2 or more attentional failures (n = 73 of 151) and 100% of rested participants with 3 or more attentional failures (n = 57 of 151) were non-resilient after moderate sleep loss. Our approach can accurately identify a significant proportion of individuals who are at high risk for neurobehavioral performance impairment from staying up late with a single neurobehavioral performance assessment conducted during rested conditions. Additional methods are needed to predict the future performance of individuals who are not identified as high risk during baseline.

Drowsiness measures for commercial motor vehicle operations

Timely detection of drowsiness in Commercial Motor Vehicle (C MV) operations is necessary to reduce drowsiness-related CMV crashes. This is relevant for manual driving and, paradoxically, even more so with increasing levels of driving automation. Measures available for drowsiness detection vary in reliability, validity, usability, and effectiveness. Passively recorded physiologic measures such as electroencephalography (EEG) and a variety of ocular parameters tend to accurately identify states of considerable drowsiness, but are limited in their potential to detect lower levels of drowsiness. They also do not correlate well with measures of driver performance. Objective measures of vigilant attention performance capture drowsiness reliably, but they require active driver involvement in a performance task and are prone to confounds from distraction and (lack of) motivation. Embedded performance measures of actual driving, such as lane deviation, have been found to correlate with physiologic and vigilance performance measures, yet to what extent drowsiness levels can be derived from them reliably remains a topic of investigation. Transient effects from external circumstances and behaviors - such as task load, light exposure, physical activity, and caffeine intake - may mask a driver's underlying state of drowsiness. Also, drivers differ in the degree to which drowsiness affects their driving performance, based on trait vulnerability as well as age. This paper provides a broad overview of the current science pertinent to a range of drowsiness measures, with an emphasis on those that may be most relevant for CMV operations. There is a need for smart technologies that in a transparent manner combine different measurement modalities with mathematical representations of the neurobiological processes driving drowsiness, that account for various mediators and confounds, and that are appropriately adapted to the individual driver. The research for and development of such technologies requires a multi-disciplinary approach and significant resources, but is technically within reach.

Work-Life Conflict among U.S. Long-Haul Truck Drivers: Influences of Work Organization, Perceived Job Stress, Sleep, and Organizational Support

Work-life balance and job stress are critical to health and well-being. Long-haul truck driving (LHTD) is among the unhealthiest and most unsafe occupations in the U.S. Despite these disparities, there are no extant published studies examining the influence of work, stress and sleep outcomes on drivers’ work-life balance. The current study investigated whether adverse work organization, stress, and poor sleep health among LHTDs are significantly associated with work-life conflict. Logistic regression was used to examine how work organization characteristics, job stress, and sleep influenced perceived stress and a composite measure of work-life conflict among a sample of 260 U.S. LHTDs. The pattern of regression results dictated subsequent analyses using structural equation modeling (SEM). Perceived job stress was the only statistically significant predictor for work-life balance. Fast pace of work, sleep duration and sleep quality were predictors of perceived job stress. SEM further elucidated that stress mediates the influences of fast work pace, supervisor/coworker support, and low sleep duration on each of the individual work-life balance indicators. There is an urgent need to address work conditions of LHTDs to better support their health, well-being, and work-life balance. Specifically, the findings from this study illustrate that scheduling practices and sleep outcomes could alleviate job stress and need to be addressed to more effectively support work-life balance. Future research and interventions should focus on policy and systems-level change.

The Impact of Work Organization, Job Stress, and Sleep on the Health Behaviors and Outcomes of U.S. Long-Haul Truck Drivers

Background. Compared with other occupations, long-haul truck drivers (LHTD) engage in excessively unhealthy behaviors and experience disproportionately poor health outcomes. Health promotion efforts targeting LHTDs focus on improving individual-level behaviors; however, this occupation is replete with adverse work organization characteristics, high job stress, and compromised sleep health, which are hypothesized to cause poor health behaviors and outcomes among LHTDs. Therefore, the purpose of this study was to explore the connections between work characteristics, job stress, and sleep outcomes, and health behaviors and physical and mental health outcomes among LHTDs. Method. This was a cross-sectional study, using interviewer-administered surveys with LHTDs (n = 260). Bivariate correlation analysis was used to explore the associations among work organization, job stress, sleep health, and health behaviors and outcomes. Logistic regression analyses were used to determine whether these work organization, job stress, and sleep factors predicted health behaviors and outcomes. Results. Long work hours of more than 11 hours daily (odds ratio [OR] = 2.34) resulted in increased odds of high caffeine consumption. High job stress (OR = 0.48) and poor sleep quality (OR = 0.42) led to decreased odds for spending at least 1 hour daily for cooking/eating. Low sleep duration, less than 7 hours daily (OR = 2.55), led to increased odds of a physical health diagnosis. Both high job stress (OR = 3.58) and poor sleep quality (OR = 2.22) resulted in increased odds of a mental health diagnosis. Conclusion. Health promotion efforts targeting LHTDs need to be coupled with upstream policy, environmental, and systems-level change, especially at the governmental and trucking industry levels.

Occupational health disparities among U.S. long-haul truck drivers: the influence of work organization and sleep on cardiovascular and metabolic disease risk

OBJECTIVE

The organization of work has undergone vast transformations over the past four decades in the United States and has had profound impacts on worker health and wellbeing. The profession of commercial truck driving is one of the best examples. Particularly for long-haul truck drivers, changes in work organization have led to disproportionately poor physiological, psychological, and sleep health outcomes.

METHODS

The present study examined disparities in cardiometabolic disease risk among long-haul truck drivers and the general population, and the influence of work organization and sleep in generating these outcomes. Researchers collected survey data from 260 drivers, and blood assay samples from 115 of those drivers, at a large highway truck stop in North Carolina. Comparisons were made for cardiovascular and metabolic risk against the 2011-2012 National Health and Nutrition Examination Survey (NHANES). In addition, logistic regression was used to explore predictive relationships between work organization and sleep and risk for cardiovascular and metabolic disease.

RESULTS

There were statistically significant mean differences between the long-haul truck driver sample and the NHANES sample for both cardiovascular (3.71 vs. 3.10; p <0.001) and metabolic (4.31 vs. 3.09; p <0.001) disease risk. The truck driver sample was less physically active and had lower HDL cholesterol along with greater levels of smoking, BMI, and metabolic syndrome diagnosis. More years of driving experience and poor sleep quality were statistically significant predictors for both cardiovascular and metabolic disease risk.

CONCLUSIONS

Study findings implicate elements of the occupational milieu experienced by long-haul truck drivers that induce disproportionate cardiometabolic disease risk. Sleep quality, largely compromised by poor work conditions and workplace environments, plays a significant role in increased risks for cardiometabolic disease. There is an urgent need for longitudinal studies of this critical occupational sector as well as intervention research centered on policy and systems level change.

Can subjective sleep problems detect latent sleep disorders among commercial drivers?

INTRODUCTION

Long-haul truck drivers experience poor sleep health and heightened accident rates, and undiagnosed sleep disorders contribute to these negative outcomes. Subjective sleep disorder screening tools may aid in detecting drivers' sleep disorders. This study sought to evaluate the value of subjective screening methods for detecting latent sleep disorders and identifying truck drivers at-risk for poor sleep health and safety-relevant performance.

MATERIALS AND METHODS

Using cross-sectional data from 260 long-haul truck drivers, we: 1) used factor analysis to identify possible latent sleep disorders; 2) explored the construct validity of extracted sleep disorder factors by determining their associations with established sleep disorder risk factors and symptoms; and 3) explored the predictive validity of resulting sleep disorder factors by determining their associations with sleep health and safety-relevant performance.

RESULTS

Five latent sleep disorder factors were extracted: 1) circadian rhythm sleep disorders; 2) sleep-related breathing disorders; 3) parasomnias; 4) insomnias; 5) and sleep-related movement disorders. Patterns of associations between these factors generally corresponded with known risk factors and symptoms. One or more of the extracted latent sleep disorder factors were significantly associated with all the sleep health and safety outcomes.

DISCUSSION

Using subjective sleep problems to detect latent sleep disorders among long-haul truck drivers may be a timely and effective way to screen this highly mobile occupational segment. This approach should constitute one component of comprehensive efforts to diagnose and treat sleep disorders among commercial transport operators.

The Work Organization of Long-Haul Truck Drivers and the Association With Body Mass Index

OBJECTIVE

The aim of this study was to examine relationships between work organization features of work hours, work schedules, and job stress with body mass indexes (BMIs) of long-haul truck drivers.

METHODS

Face-to-face survey data were collected first, followed by collection of anthropometric measures including height and weight (n = 260). Logistic regression (backward stepwise model) was used to identify significant predictors of BMI and to analyze odds ratios.

RESULTS

Mean BMI was 33.40 kg/m(2), with 64.2% obese (BMI > 30 kg/m(2)) and 18.4% extreme/morbidly obese (BMI > 40 kg/m(2)). Working more than 11 daily hours was associated with statistically significant increased odds for being extreme obese.

CONCLUSION

Findings suggest that longer work hours (>11 hours daily) have a major influence on odds for obesity among this population. The results align with recent NIOSH calls for integrated approaches to worker health.

Work Environment, Stress, and Driving Anger: A Structural Equation Model for Predicting Traffic Sanctions of Public Transport Drivers

Public transport is an effective and sustainable alternative to private vehicle usage, also helping to reduce the environmental impact of driving. However, the work environment of public transport operators is full of adverse conditions, which, together with their high mileage, may increase the occurrence of negative safety outcomes such as traffic accidents, often preceded by risky road behaviors enhanced by stress, anger, and difficult operating conditions. The aims of this study were, first, to determine the association between work-related psychosocial factors and individual characteristics of public transport drivers and the rate of traffic sanctions they are subject to; and second, to assess the mediation of driving anger in this relationship. A sample of professional drivers (57.4% city bus, 17.6% taxi, and 25% inter-urban bus male operators) was used for this cross-sectional study, responding to a five-section survey including demographic data and driving-related factors, psychosocial work factors including job stress, driving stress, risk predisposition, and driving anger. The results of this study showed significant associations between work-related factors: measures of stress and self-reported rates of traffic fines. Second, it was found that driving anger mediates the associations between driving stress, risk predisposition, and traffic sanctions; and partially mediates the association between driving experience, hourly intensity, and job stress. This study supports the idea that traffic penalties reported by public transport rates are preceded by work-related, personality, and other individual factors that, when combined with driving anger, enhance the occurrence of road misbehavior that may affect overall road safety.

US long-haul truck driver work organization and the association with cardiometabolic disease risk

Work organization, including long working hours, irregular work schedules, and job stress, has been associated with increased cardiometabolic disease (CMD) risk for numerous working populations. The purpose of this study was to examine the associations between work hours, work schedules, job stress, and CMD risk for a sample of US long-haul truck drivers (LHTDs). A nonexperimental, descriptive, cross-sectional design was employed to collect survey and anthropometric data from 260 US LHTDs at a major truck stop. The mean BMI was 33.40 kg/m² and mean waist circumference was 114.77 cm. Using logistic regression, researchers found longer work hours, especially greater than 11 hours daily, were associated with increased odds for an extremely high risk of CMD. Results support comprehensive and integrated approaches that address work organization, and in particular long working hours, to reduce drivers' CMD risk.

Work-related injury factors and safety climate perception in truck drivers

INTRODUCTION

The trucking industry has a high burden of work-related injuries. This study examined factors, such as safety climate perceptions, that may impact injury risk.

METHOD

A random sample of 9800 commercial driver's license holders (CDL) were sent surveys, only 4360 were eligible truck drivers. Descriptive statistics and logistic regression models were developed to describe the population and identify variables associated with work-related injury.

RESULTS

2189 drivers completed the pertinent interview questions. Driving less-than-truckload, daytime sleepiness, pressure to work faster, and having a poor composite score for safety perceptions were all associated with increased likelihood of work-related injury. Positive safety perception score was protective for odds of work-related injury, and increased claim filing when injured.

CONCLUSIONS

Positive psychological safety climate is associated with decreased likelihood of work-related injury and increased likelihood that a driver injured on the job files a workers' compensation claim.

Work, sleep, and cholesterol levels of U.S. long-haul truck drivers

Long-haul truck drivers in the United States experience elevated cardiovascular health risks, possibly due to hypercholesterolemia. The current study has two objectives: 1) to generate a cholesterol profile for U.S. long-haul truck drivers; and 2) to determine the influence of work organization characteristics and sleep quality and duration on cholesterol levels of long-haul truck drivers. Survey and biometric data were collected from 262 long-haul truck drivers. Descriptive analyses were performed for demographic, work organization, sleep, and cholesterol measures. Linear regression and ordinal logistic regression analyses were conducted to examine for possible predictive relationships between demographic, work organization, and sleep variables, and cholesterol outcomes. The majority (66.4%) of drivers had a low HDL (<40 mg/dL), and nearly 42% of drivers had a high-risk total cholesterol to HDL cholesterol ratio. Sleep quality was associated with HDL, LDL, and total cholesterol, and daily work hours were associated with LDL cholesterol. Workday sleep duration was associated with non-HDL cholesterol, and driving experience and sleep quality were associated with cholesterol ratio. Long-haul truck drivers have a high risk cholesterol profile, and sleep quality and work organization factors may induce these cholesterol outcomes. Targeted worksite health promotion programs are needed to curb these atherosclerotic risks.

Understanding the role of sleep quality and sleep duration in commercial driving safety

INTRODUCTION

Long-haul truck drivers in the United States suffer disproportionately high injury rates. Sleep is a critical factor in these outcomes, contributing to fatigue and degrading multiple aspects of safety-relevant performance. Both sleep duration and sleep quality are often compromised among truck drivers; however, much of the efforts to combat fatigue focus on sleep duration rather than sleep quality. Thus, the current study has two objectives: (1) to determine the degree to which sleep impacts safety-relevant performance among long-haul truck drivers; and (2) to evaluate workday and non-workday sleep quality and duration as predictors of drivers' safety-relevant performance.

MATERIALS AND METHODS

A non-experimental, descriptive, cross-sectional design was employed to collect survey and biometric data from 260 long-haul truck drivers. The Trucker Sleep Disorders Survey was developed to assess sleep duration and quality, the impact of sleep on job performance and accident risk, and other relevant work organization characteristics. Descriptive statistics assessed work organization variables, sleep duration and quality, and frequency of engaging in safety-relevant performance while sleepy. Linear regression analyses were conducted to evaluate relationships between sleep duration, sleep quality, and work organization variables with safety composite variables.

RESULTS

Drivers reported long work hours, with over 70% of drivers working more than 11h daily. Drivers also reported a large number of miles driven per week, with an average of 2,812.61 miles per week, and frequent violations of hours-of-service rules, with 43.8% of drivers "sometimes to always" violating the "14-h rule." Sleep duration was longer, and sleep quality was better, on non-workdays compared on workdays. Drivers frequently operated motor vehicles while sleepy, and sleepiness impacted several aspects of safety-relevant performance. Sleep quality was better associated with driving while sleepy and with job performance and concentration than sleep duration. Sleep duration was better associated with accidents and accident risk than sleep quality.

DISCUSSION

Sleep quality appears to be better associated with safety-relevant performance among long-haul truck drivers than sleep duration. Comprehensive and multilevel efforts are needed to meaningfully address sleep quality among drivers.

Truck Drivers' Use of the Internet: A Mobile Health Lifeline

Because of their social isolation, irregular and unpredictable schedules, limited access to health care, and long periods of travel, long-haul truckers may benefit from the use of mobile health applications on Internet-capable devices. The purpose of this study was to determine Internet access and usage among a sample of long-haul truck drivers. In this cross-sectional study, truck drivers completed a pencil and paper survey with questions on demographics, work and health histories, and Internet access and usage for both personal and job reasons. A total of 106 truck drivers were recruited from trucking industry trade shows, by word of mouth, and directly from trucking companies. Overall, the truck drivers' use of the Internet was limited. Their usage for personal and job-related reasons differed. Social connectivity and access to health and wellness information were important during personal usage time. Job-related Internet use was highly practical, and applied to seeking information for directions and maps, fuel stops and pricing, and communicating with employers or transmitting documents. Age and experience were associated with Internet use. Younger, less-experienced drivers used the Internet more than older, experienced drivers. Targeted mobile health messaging may be a useful tool to inform truck drivers of health conditions and plans, and may provide links to primary care providers needing to monitor or notify drivers of diagnostic results or treatment plans.