Health Risks of American Long-Distance Truckers: Results From a Multisite Assessment

Health of Family Members of Road Transport Workers: Evaluation of Perceived Stress and Family Effectiveness

The health of road transport workers is affected by working conditions and life. However, there is a lack of studies on the level of stress and health of the families of these workers. This study aimed to evaluate the perceived stress level and family effectiveness of family members of road transport workers. A quantitative study was carried out with the family members of road transport workers in the southern region of Brazil. For data collection, a sociodemographic form, the Perceived Stress Scale (PSS), and the Evaluation of Family Effectiveness Strategies were used. The data were analyzed by simple frequency, Spearman correlation coefficient (ρ) (p < 0.05), and descriptive analysis from the perspective of Systemic Organization. The sample was composed of 49 family members of road transport workers. Perceived stress was higher in family members who had more than nine years of education (p = 0.0403). Family members who scored higher in Family Effectiveness scored high on the targets of Control (p = 0.0353) (Control aims to reduce anxiety and prevent and eliminate events that threaten family stability) and Growth (p = 0.0360) (represented by attitudes that promote new roles in response to critical situations experienced by families, which require re-adaptation processes and adjustments). The Control target was significant (p = 0.0353) in families that had more than three people. The Coherence dimension (concerning self-esteem, body image, personal identity, self-confidence, and sexual identity) presented positive significance (p = 0.0244) in families with health problems and whose income was less than USD 792.00 per month (p = 0.0072). The Individuation dimension (including functions and responsibilities, where talents are reinforced, as well as initiatives that allow for the incorporation of knowledge to assume behaviors against personal/family and environmental pressures), was significant (p = 0.0138) in families with incomes over USD 792.00. The Maintenance System (strategies for decision-making, problem negotiation, ritual and traditional roles, communication patterns, standards, financial management, and approaches to maintaining family harmony) presented positive significance (p = 0.0151) in families where drivers worked as intercity drivers, as did the Stability target (p = 0.0196) (concerning the continuity of routines, structure, organization, traditions, and values assumed by the family and transmitted from generation to generation, which promote unity and the development of values, attitudes, and beliefs). In conclusion, social factors, such as education, income, diseases, type of worker activity in road transport, and number of people in the family, influenced perceived stress and family effectiveness, which demonstrates the need to increase the promotion of health care for the families of road transport workers.

Driving into Diabetes: Risk Assessment among Interstate Truck Drivers in West Bengal

Diabetes mellitus has led to a huge increase in its number over recent decades. Due to their occupation, truck drivers are predisposed to higher risk of lifestyle disorders. Hence, this study intended to assess their risk of developing diabetes mellitus with respect to IDRS (Indian Diabetes Risk Score). A cross-sectional study was conducted in a selected logistic company for 3 months, where 160 interstate truck drivers were selected by simple random sampling. The collected data were analyzed using descriptive and inferential statistics using SPSS 16 version. The mean age of study participants was 38.4 ± 10.7 years. Of the total, 49.5% of the participants had a high IDRS. A significant increase in IDRS was associated with the occupational variables. Strict monitoring of government guidelines on fair working hours for truck drivers is required. They, being a high-risk group due to their occupation, require periodic health checkups, and appropriate measures should be taken to minimize the detrimental effects on their health.

Global burden of HIV among long-distance truck drivers: a systematic review and meta-analysis

OBJECTIVES

The purpose of this study was to systematically summarise the empirical evidence on the prevalence of HIV among long-distance truck drivers (LDTDs) from all parts of the world.

DESIGN

A systematic review and meta-analysis were conducted.

DATA SOURCES

We searched PubMed, ProQuest Central, PubMed Central, Cumulated Index to Nursing and Allied Health Literature and Global Index Medicus to identify relevant information published from 1989 to 16 May 2023.

ELIGIBILITY CRITERIA

Peer-reviewed publications of English language reporting on the prevalence of HIV among LDTDs were included. Non-empirical studies like literature reviews were excluded.

DATA EXTRACTION AND SYNTHESIS

Using a standardised data abstraction form, we extracted information on study characteristics and HIV prevalence levels. Crude prevalence estimates per 100 participants were computed and later transformed using logit transformation to have them follow a normal distribution. A meta-analysis of prevalences using the random effects model was performed. The I2 statistic was used to quantify the degree of heterogeneity across studies. A subgroup analysis using meta-regression was performed to investigate factors that could explain variability across studies. The Joanna Briggs Institute tools and Newcastle-Ottawa Scale were used to assess the quality of the included studies. To assess the certainty of evidence, the Grading of Recommendations Assessment, Development, and Evaluation approach was used.

RESULTS

Of the 1787 articles identified, 42 were included. Most of the included studies were conducted in sub-Saharan Africa (45.23%, n=19) and Asia and the Pacific (35.71%, n=15). The pooled prevalence of HIV was 3.86%, 95% CI (2.22% to 6.64%). The burden of HIV was highest in sub-Saharan Africa at 14.34%, 95% CI (9.94% to 20.26%), followed by Asia and the Pacific at 2.12%, 95 CI (0.94% to 4.7%) and lastly Western, Central Europe and North America at 0.17%, 95% CI (0.03% to 0.82%). The overall heterogeneity score was (I2=98.2%, p<0.001).

CONCLUSION

The global burden of HIV among LDTDs is 3.86%, six times higher than that of the general population globally. Compared with other regions, the burden of HIV is highest in sub-Saharan Africa at 14.34%, where it is estimated to be 3% in the general population. Thus, LDTDs endure a disproportionately high burden of HIV compared with other populations. Consequently, more LDTD-centred HIV research and surveillance is needed at national and regional levels to institute tailored preventive policies and interventions.

PROSPERO REGISTRATION NUMBER

CRD42023429390.

Risk Factors for Chronic Non-Communicable Diseases of Long-Haul Truck Drivers during the COVID-19 Pandemic: An Integrative Review

Long-haul truck drivers are responsible for transporting goods valued at millions of dollars of the world economy, and may have their health affected by living and working conditions. This study analyzed and synthesized scientific findings about risk factors for the development of chronic non-communicable diseases in long-haul truck drivers. An integrative literature review was conducted. We identified 23 studies that met the inclusion criteria and evaluated the health of 7363 drivers. The biological risk factors identified were age, gender, race/ethnicity, genetics, and comorbidities, and were considered to be non-modifiable for chronic diseases. The behavioral risks considered to be modifiable were sedentary lifestyle, smoking, alcohol consumption, overweight, diet, stress, anxiety, and unfavorable socioeconomic conditions. Environmental risks involved working conditions such as the following: number of working hours per day, week, and month; time away from home; risk of musculoskeletal injury; and opportunities for rest, hours of sleep, and access to health services. The results were presented in two categories: (1) biological, behavioral, and environmental risks, and (2) general recommendations to promote physical, cognitive, and emotional health. Macro-structural changes are needed to reorganize work and rest, improve access to health services to control modifiable risk factors, and to support behavioral and environmental changes to reduce chronic non-communicable diseases and deaths.

A blueprint for a new commercial driving epidemiology: An emerging paradigm grounded in integrative exposome and network epistemologies

Excess health and safety risks of commercial drivers are largely determined by, embedded in, or operate as complex, dynamic, and randomly determined systems with interacting parts. Yet, prevailing epidemiology is entrenched in narrow, deterministic, and static exposure-response frameworks along with ensuing inadequate data and limiting methods, thereby perpetuating an incomplete understanding of commercial drivers' health and safety risks. This paper is grounded in our ongoing research that conceptualizes health and safety challenges of working people as multilayered "wholes" of interacting work and nonwork factors, exemplified by complex-systems epistemologies. Building upon and expanding these assumptions, herein we: (a) discuss how insights from integrative exposome and network-science-based frameworks can enhance our understanding of commercial drivers' chronic disease and injury burden; (b) introduce the "working life exposome of commercial driving" (WLE-CD)-an array of multifactorial and interdependent work and nonwork exposures and associated biological responses that concurrently or sequentially impact commercial drivers' health and safety during and beyond their work tenure; (c) conceptualize commercial drivers' health and safety risks as multilayered networks centered on the WLE-CD and network relational patterns and topological properties-that is, arrangement, connections, and relationships among network components-that largely govern risk dynamics; and (d) elucidate how integrative exposome and network-science-based innovations can contribute to a more comprehensive understanding of commercial drivers' chronic disease and injury risk dynamics. Development, validation, and proliferation of this emerging discourse can move commercial driving epidemiology to the frontier of science with implications for policy, action, other working populations, and population health at large.

What moves truck drivers? A person-centered perspective on workplace physical activity promotion

Objectives. In developing physical activity (PA) promotion measures in the workplace, individual needs of the target groups must be considered. For this reason, this study aimed to qualitatively identify the individual needs for an increase of PA in truck drivers, representing a neglected working group in terms of PA promotion. Methods. Semi-structured interviews were conducted (N = 19; mean age 50.5 years, SD 11.4 years; 10.5% female). The interview guide was based on the COM-B model to identify needs related to PA behavior in terms of capabilities, opportunities and motivation. The interviews were transcribed and coded by two independent investigators. Results. Altogether, the codes encompassed 395 statements, and the code system contained 14 codes. Three additional codes described further individual needs related to other health behaviors (nutrition, recreation) or external incentives for health interventions. Conclusion. The results reveal a variety of needs that are fundamental to the development of PA-promoting interventions for truck drivers. These needs appear to be closely linked, so a combination of capabilities, opportunities and/or motivation should be considered when developing holistic interventions. An example would be linking automatic motivation and psychological capabilities that encompass motivational techniques combined with information for psychoeducation of truck drivers.

Exploring the challenges faced by Dutch truck drivers in the era of technological advancement

Introduction

Despite their important role in the economy, truck drivers face several challenges, including adapting to advancing technology. The current study investigated the occupational experiences of Dutch truck drivers to detect common patterns.

Methods

A questionnaire was distributed to professional drivers in order to collect data on public image, traffic safety, work pressure, transport crime, driver shortage, and sector improvements.

Results

The findings based on 3,708 respondents revealed a general dissatisfaction with the image of the industry and reluctance to recommend the profession. A factor analysis of the questionnaire items identified two primary factors: 'Work Pressure', more common among national drivers, and 'Safety & Security Concerns', more common among international drivers. A ChatGPT-assisted analysis of textbox comments indicated that vehicle technology received mixed feedback, with praise for safety and fuel-efficiency improvements, but concerns about reliability and intrusiveness.

Discussion

In conclusion, Dutch professional truck drivers indicate a need for industry improvements. While the work pressure for truck drivers in general may not be high relative to certain other occupational groups, truck drivers appear to face a deficit of support and respect.

Program Evaluation of Fit to Pass®, a Remotely Accessible Health Promotion Program for Commercial Motor Vehicle Truck Drivers

BACKGROUND

Chronic health conditions are highly prevalent among truck drivers due to many unique occupational and environmental stressors. Health promotion programs are shown to be effective in improving truck driver health outcomes; however, there is no research on whether such programs can increase the length of a driver's Department of Transportation (DOT) medical certificate. The purpose of this quality improvement project was to evaluate Fit to Pass (FTP), a remotely accessible health promotion program available for truck drivers on improved health outcomes and increased DOT medical certificate length.

METHOD

Program evaluation included an evaluation of the FTP coaching guide against evidence-based practice guidelines. An analysis of a limited dataset of 22 truck driver records examined the effectiveness of the program in achieving improved health outcomes and increased medical certification length.

FINDINGS

A review of the literature revealed three major themes: (a) motivational interviewing to increase driver intention and self-efficacy; (b) mobile health care technology to connect hard-to-reach truck drivers; and (c) effectiveness of structured multicomponent health promotion programs. After participation in FTP, truck drivers experienced a mean decrease in weight and body mass index (BMI) of 4.6 lbs and 1.3 kg/m2, respectively. The lengths of initial DOT medical certificates were compared with DOT medical certificates received at the time of recertification (post-FTP). Only eight participants had the potential for improvement in certificate length. Of those, three truck drivers achieved an increased DOT medical certificate length at the time of recertification.

CONCLUSION/APPLICATIONS TO PRACTICE

FTP offers tailored and comprehensive health coaching for truck drivers using current evidence-based practice guidelines to educate and reinforce healthy lifestyle habits. Analysis of a limited dataset revealed a mean decrease in BMI and a trend of increased DOT medical certification lengths after participation in FTP; however, further research with larger sample sizes is recommended.

Rethinking Efforts to Improve Dietary Patterns Among Long-Haul Truck Drivers: Transforming Truck Stop Retail Food Environments Through Upstream Change

A multitude of upstream occupational exposures influence poor dietary patterns that contribute to cardiometabolic health disparities among long-haul truck drivers in the United States. Herein, we delineate the unique characteristics of the truck driving profession that shape dietary patterns. Next, we discuss current health promotion efforts and why they are unlikely to be sufficient for improving population-level dietary patterns. We then advocate for prioritizing health promotion efforts that target upstream factors that influence population dietary patterns and have the potential to holistically and sustainably support drivers' nutrition. Finally, we propose novel research directions to catalyze upstream-oriented health promotion efforts.

A look through Latin America truck drivers' health, a systematic review and meta-analysis

Heavy truck drivers represent a social group of great importance to any country's economy. Their professional activity requires a high level of dedication. Due to the irregular hours in their work routine and adopted habits, they mostly predispose them to a diversity of health problems. The purpose of this study is to perform a systematic review and meta-analysis aiming to identify the prevalence of diabetes, hypertension, and obesity in Latin American Truck Drivers. We searched the PubMed, Web of Science, Scopus and LILACS databases, for scientific publications articles, as reported by The PRISMA Statement. From 1,382, 7 studies were included according to the established criteria. The hypertension prevalence found was 34.2%, diabetes was of 9.2% and the highest prevalence found was for overweight and obesity (56%). Meta-analysis presented that drivers have a higher prevalence of overweight or obesity when compared to eutrophic individuals and that drivers with diabetes and hyperglycemia have a lower prevalence. Due to their work activity, their access to the health system is compromised limiting any type of monitoring of their health. This study showed that there is, in Latin America, an investment and assistance gap, both in the health sector and in the research section, for this professional category, which is so important to the economy of these countries. These data should help to identify the difficulties faced by this professional in health assistance, road safety, public safety, leisure and social life. This research also highlighted that they are young and already have the first sign of non-transmissible chronic diseases, which is overweight and obesity.

Metabolic syndrome among commercial truck drivers: The relationship between condition prevalence and crashes

BACKGROUND

Metabolic syndrome (MetS) is especially prevalent among US truck drivers. However, there has been limited research exploring associations between MetS conditions with roadway crashes among truck drivers. The objective of this paper is to assess relationships between specific combinations of individual MetS components and crashes and near-misses.

METHODS

Survey, biometric, and anthropometric data were collected from 817 truck drivers across 6 diverse US states. Survey data focused on demographics and roadway safety outcomes, and anthropometric/biometric data corresponded to five MetS conditions (waist circumference blood pressure, hemoglobin A1c, triglycerides, and high-density lipoprotein [HDL] cholesterol). Logistic regression was used to calculate odds ratios of lifetime crashes and near-miss 1-month period prevalence associated with: 1) specific MetS conditions regardless of presence or absence of other MetS conditions, and 2) specific MetS conditions and counts of other accompanying MetS conditions.

RESULTS

Hypertension was the MetS characteristic most strongly associated with lifetime crash and 1-month near-miss outcomes, while high triglycerides, low HDL cholesterol, and large waist circumference were most commonly present among groups of conditions associated with crashes and near-misses. Overall, an increasing number of specific co-occurring MetS conditions were associated with higher reporting of roadway crashes.

CONCLUSIONS

Specific combinations and higher prevalence of MetS conditions were associated with increased frequency of reported crashes. Moreover, when the co-occurrence of MetS conditions is aggregated, a dose-response relationship with crashes appears. These results suggest that policy changes and interventions addressing MetS may increase driver health and reduce crash risk.

Hypertension and Its Associated Factors Among Long-Distance Truck Drivers in Ethiopia

Introduction

Hypertension is rising globally and is one of the leading causes of cardiovascular disease. It affects people of different groups; however, owing to a rise in a sedentary lifestyle it is more prevalent among long-distance truck drivers. However, the prevalence of hypertension and its associated factors among truck drivers in Ethiopia is not known. Therefore, this study aimed to determine the prevalence of hypertension and its associated factors among long-distance truck drivers in Ethiopia.

Methods

A cross-sectional study was conducted among 415 long-distance truck drivers selected by systematic random sampling technique at Modjo dry port from May 15 to 30, 2021. The data were collected and entered into Epi-data 4.6 then it was exported to SPSS version 25 for analysis. Descriptive statistics, bivariable, and multivariable logistic regression analyses were executed. The odds ratio with a 95% confidence interval was computed. In the final model, a variable with a p ≤ 0.05 was declared as a predictor of hypertension.

Results

The prevalence of hypertension among long-distance truck drivers in Ethiopia was 34.7%. The odds of hypertension was higher among drivers who were ≥45 years old [Adjusted odds ratio (AOR) = 4.32; 95% Confidence interval (CI): 2.16, 8.62], obese [AOR= 5.12; 95% CI: 1.33, 19.8], alcohol drinkers [AOR=3.05; 95% CI: 1.27, 7.31], and cigarette smokers [AOR= 3.74; 95% CI: 1.64, 8.51]. Drivers who had regular physical exercise were less likely [AOR=0.33; 95% CI: 0.17, 0.63] to have hypertension than drivers with no physical activity.

Conclusion

More than a third of the participants in Ethiopia had hypertension. Higher age, obesity, absence of rest between driving, short sleep duration, smoking, alcohol drinking, and physical inactivity were significantly associated with hypertension. Therefore, health education on lifestyle modifications, sleep habits, and the importance of rest breaks between driving should be considered to prevent hypertension and further complications.

A systematic review of trucking food, physical activity, and tobacco environments and tractor-trailer drivers’ related patterns and practices in the United States and Canada, 1993–2021

•

The built environment is recognized to influence health patterns and practices.

•

No review has explored trucking food, physical activity, and tobacco environments.

•

Trucking built environment science is underdeveloped and requires validated tools.

•

Future research should explore truckers’ views on built environment interventions.

•

More emphasis on the trucking built environment and health equity is warranted.

Truckers in the United States (U.S.) and Canada are at high risk for noncommunicable disease. Although trucking built environments have been highlighted for intervention, no systematic review has assessed aspects of trucking environments that may influence food, physical activity (PA), and smoking patterns/practices. The purpose of this systematic review was to characterize the state of the science on trucking food, PA, and tobacco environments and to examine truckers’ food, PA, and tobacco patterns/practices. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used. Five databases were selected for searching in April 2020 and 2021 using key terms constructed by a librarian. Peer-reviewed research with data about U.S. and Canadian truckers’ (i.e., drivers operating 18-wheelers or tractor trailers) food, PA, and/or tobacco environments and related patterns/practices were included. Quality was assessed using the Mixed Method Appraisal Tool. Thirty-eight studies were identified. Results included data from at least 16,600 truckers and 282 trucking settings in the U.S. (n = 32) and Canada (n = 6). Most studies were classified as quantitative descriptive and of poor quality (average score 3 of 7). The few studies (n = 4) that measured trucking food and PA environments characterized trucking sites as poor. Fifteen (47%) presented data about truckers’ perceptions of food or PA environments and highlighted prominent environmental barriers. Truckers’ food, PA, and smoking patterns and practices suggested poor diet quality, sedentary practices, and a high prevalence of smoking. The science of trucking food, PA, and tobacco environments is underdeveloped and requires much more focus using validated measures.

Physical Activity, Sedentary Time, and Cardiometabolic Health in Heavy Goods Vehicle Drivers

OBJECTIVE

Physical inactivity, prolonged sitting, and unhealthy dietary habits are common in Heavy Goods Vehicle (HGV) drivers. These factors increase risk of long-term health conditions.

METHODS

329 HGV drivers across 25 UK depots completed a health assessment, including questionnaire completion, and objectively measured anthropometrics, blood biomarkers, physical activity (PA), and sedentary behavior.

RESULTS

The sample demonstrated a high-risk cardiometabolic health profile. 88.1% were overweight or had obesity, and 11.9% had pre-diabetes or diabetes. 28.3% had hypertension, 83.6% had clinically elevated circulating low-density lipoprotein-cholesterol concentrations (>2mmol/l), and 66.6% had high total cholesterol levels (>4mmol/l). On workdays drivers accumulated 12 hours/day of sitting, 1.7 hours/day of light PA, and 9.8 mins/day of moderate-to-vigorous PA. Associations between light PA and cardiometabolic markers were observed.

CONCLUSION

This sample presents high levels of inactivity, overweight, and obesity, and unhealthy cardiometabolic health profiles.

Not Quite Out of the Woods: Overall Health and Chronic Disease Risk Factors among Maine Logging Workers

OBJECTIVE

This research reports on the health status, including chronic disease risk factors, among Maine loggers.

METHODS

Loggers completed a survey and health screenings were held across Maine, collecting data on a variety of health endpoints.

RESULTS

Seventy-five loggers participated. The majority were men (97.1%) with a median age of 46, and a mean BMI of 30.6 kg/m2 (SD 4.9). Nearly half of those screened (45.9%) had blood pressure at the level of stage II hypertension. Loggers with at least a single joint abnormality were 38.4%. The health screening cohort was similar to the non-health screening cohort for many attributes.

CONCLUSIONS

Future research should focus on tailored interventions to improve cardiovascular and musculoskeletal risk factors among loggers.

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.

Commercial truck drivers should be a priority population for COVID-19 vaccinations

As COVID-19 vaccines become available, supply is expected to initially fall short of demand. In response, the Advisory Committee on Immunization Practices (ACIP) has issued guidance on which groups should be prioritized to receive vaccines. For the first phase of vaccine allocation, the ACIP recommended healthcare personnel and long-term care facility residents as recipients. This recommendation was based on risks endemic to these populations, as well as ethical principles related to benefits and harms, mitigating health inequalities, and promoting justice. Commercial truck drivers have played a vital and underappreciated role during the COVID-19 pandemic. Despite the indispensable role that commercial drivers play in distributing vaccines, they have not been recommended for vaccine allocation in the next phase (1b) by the ACIP. However, the rationale and ethical principles cited for the first vaccine phase suggest that these workers should be recommended for inclusion. By doing so, the acquisition and transmission of COVID-19 may be mitigated, which would benefit both these workers and the US public. Further, persistent vulnerabilities render commercial truck drivers susceptible to severe COVID-19 infection; therefore, vaccination during the next phase is imperative to curb the exacerbation of extant health inequities. Finally, because present-day COVID-19 vulnerabilities in these workers have been shaped by unjust policies over the past several decades, and because COVID-19 public health policies have excluded and potentially exacerbated the impacts of the pandemic for these workers, allocating vaccines to commercial truck drivers is a necessary step toward promoting justice.

[Examining the association between work-life factors and health disorders/excessive fatigue among Japanese truck drivers]

OBJECTIVES

Karoshi problems (overwork-related deaths and disorders caused by cerebrovascular and cardiovascular diseases) still occur in Japan. Truck drivers, who are in one of the riskiest occupations, are reported to show an increased prevalence of hypertension, obesity, hyperlipidemia, and diabetes, which are characteristic of Karoshi. Their health problems also include excessive fatigue. This cross-sectional study aimed to examine the association between work-life factors and health disorders/excessive fatigue among Japanese truck drivers.

METHODS

We distributed a questionnaire regarding work hours, health status, lifestyle, burden of driving, and excessive fatigue to 5,410 truck drivers and collected a total of 1,947 responses, all from males. The association between work-life factors and health outcomes was evaluated by multivariable logistic regression analysis adjusted for age, drinking, and smoking status.

RESULTS

The prevalence rates of obesity, hypertension, hyperlipidemia, diabetes, cardiovascular disease, cerebrovascular disease, and excessive fatigue were 22.2%, 19.3%, 8.5%, 5.6%, 2.5%, 0.7%, and 6.0%, respectively. Significant associations were observed for long-haul trips (two days or more) with obesity (adjusted odds ratio 1.5 [95% Confidence Interval 1.1-2.1]), local and night trips with hypertension (1.5 [1.0-2.2]), early morning awakening on workdays with obesity (1.5 [1.1-2.1]), being indoor-oriented on weekends with hypertension (1.5 [1.1-2.0]); and heavy burden of driving at night with hyperlipidemia (2.0 [1.3-3.0]). The adjusted odds ratios were significant for waking after sleep onset (2.6 [1.2-5.3]) and lack of sleep satisfaction (2.7 [1.4-5.1]) on workdays, less than six hours of sleep (2.8 [1.0-7.8]) and lack of sleep satisfaction (2.8 [1.5-5.2]) on weekends, 0-3 days off per month (3.6 [1.3-10.2]), and heavy burden of driving at night (2.2 [1.0-4.8]) with excessive fatigue.

CONCLUSIONS

The present findings highlight that night and early morning work, heavy burden of night driving, and the resultant decreases in the quality and quantity of sleep may represent shared risk factors for health disorders and excessive fatigue among truck drivers. Adequate measures should be taken to limit the amount of night and early morning work, reduce the burden of night driving, and ensure days off for sleep opportunities and leisure activities, with the goal of preventing Karoshi.

Cardiometabolic risk factors and mental health status among truck drivers: a systematic review

OBJECTIVE

This study aimed to systematically review and summarise the literature on cardiometabolic risk factors, lifestyle health behaviours and mental health status of truck drivers globally to ascertain the scale of these health concerns.

DESIGN

Systematic review reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

DATA SOURCES

PubMed, Scopus, PsycINFO and Web of Science were searched in January 2019 and updated in January 2020, from the date of inception to 16 January 2020.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Papers were included if they (1) reported independent data on truck drivers, (2) included quantitative data on outcomes related to cardiometabolic markers of health, mental health and/or health behaviours, (3) were written in English and (4) were published in a peer-reviewed journal. Grey literature was ineligible for this review.

DATA EXTRACTION AND SYNTHESIS

One reviewer independently extracted data and assessed methodological quality using a checklist based on the National Heart, Lung and Blood Institute Quality Assessment tool. 20% were independently assessed for eligibility and quality by a second reviewer. Due to heterogeneity of the outcomes, results were narratively presented.

RESULTS

3601 titles and abstracts were screened. Seventy-three studies met the inclusion criteria. Truck driving is associated with enforced sedentarism, long and irregular working hours, lack of healthy foods, social isolation and chronic time pressures. Strong evidence was observed for truck drivers to generally exhibit poor cardiometabolic risk profiles including overweight and obesity, hypertension, hypercholesterolaemia, high blood glucose, poor mental health and cigarette smoking.

CONCLUSIONS

Improving truck driver health is vital for the longevity of the trucking industry, and for the safety of all road users. The workplace plays a vital role in truck driver health; policies, regulations and procedures are required to address this health crisis.

PROSPERO REGISTRATION NUMBER

CRD42019124499.

A novel COVID-19 based truck driver syndemic? Implications for public health, safety, and vital supply chains

U.S. long-haul truck drivers traverse great distances and interact with numerous individuals, rendering them vulnerable to acquiring and transmitting coronavirus disease 2019 (COVID-19). Together, the unique co-occurrence of pronounced health disparities and known COVID-19 infection, morbidity, and mortality risks suggest the possibility of a novel COVID-19 based truck driver syndemic due to advanced driver age and endemic health issues. In turn, COVID-19 sequelae may perpetuate existing health disparities. The co-occurrence of afflictions may also result in compromised safety performance. To curb the likelihood of a COVID-19 based truck driver syndemic, several action stepsare needed. First, key COVID-19 metrics need to be established for this population. Second, relationships between long-haul trucker network attributes and COVID-19 spread need to bedelineated. Third, mutually reinforcing interactions between endemic health disparities and COVID-19 vulnerability need to be elucidated. Finally, grounded in the aforementioned steps, policies and interventions need to be identified and implemented.

A novel COVID-19 based truck driver syndemic? Implications for public health, safety, and vital supply chains

U.S. long-haul truck drivers traverse great distances and interact with numerous individuals, rendering them vulnerable to acquiring and transmitting coronavirus disease 2019 (COVID-19). Together, the unique co-occurrence of pronounced health disparities and known COVID-19 infection, morbidity, and mortality risks suggest the possibility of a novel COVID-19 based truck driver syndemic due to advanced driver age and endemic health issues. In turn, COVID-19 sequelae may perpetuate existing health disparities. The co-occurrence of afflictions may also result in compromised safety performance. To curb the likelihood of a COVID-19 based truck driver syndemic, several action stepsare needed. First, key COVID-19 metrics need to be established for this population. Second, relationships between long-haul trucker network attributes and COVID-19 spread need to bedelineated. Third, mutually reinforcing interactions between endemic health disparities and COVID-19 vulnerability need to be elucidated. Finally, grounded in the aforementioned steps, policies and interventions need to be identified and implemented.

Food choice patterns of long-haul truck drivers driving through Germany, a cross sectional study

Background

Long-haul truck drivers are exposed to unfavorable working conditions affecting their health but information on truck drivers travelling through Europe is missing. The study aimed to describe the populations' characteristics and food choice patterns while working compared with eating patterns at home, taking weight status into account.

Methods

A cross-sectional survey using questionnaires in 12 languages conducted at two truck stops in Germany.

Results

Among 404 truck drivers of 24 nationalities, only 24% were normal weight while 46% were considered overweight and 30% obese. In regards to their health, more than half reported that they smoked and 32% reported at least one chronic disease. 37% ate their meals often or always at truck stops, while 6% never did so. The most common food items brought from home were fruits (62%) followed by sausages (50.6%), sandwiches (38.7%), self-cooked meals (37%), sweets (35.4%), and raw vegetables (31%). Bivariate analyses revealed differences in food choices during work and at home with more sausages, energy drinks and soft drinks, and canned foods eaten during trips. Fresh vegetables, legumes and fish were more often chosen at home. Available food appliances in trucks appeared to be associated with food choice patterns. Interestingly, food choice patterns and food preparation did not differ significantly across weight categories.

Conclusions

The working conditions of professional truck drivers make a healthy lifestyle difficult to follow and appear to influence food choices while working. Particular effort should be taken to improve food choice patterns, food preparation and purchasing possibilities during trips.