Long haul truck drivers’ views on the barriers and facilitators to healthy eating and physical activity

Exploration of Barriers and Facilitators to Healthy Eating in UK Truck Drivers

Background

The working environment of truck drivers promotes unhealthy lifestyle behaviours including physical inactivity and poor dietary choices. This leads to high levels of chronic diseases and a reduced life expectancy compared to other occupational groups. However, little is known about how drivers in the UK perceive their working environment and how this affects their food choices. This study aimed to gain a better understanding of long-haul (8-10-hour shifts) truck drivers' needs regarding healthy food choices whilst on the road to better inform future health promotion programmes and policy needs.

Methods

Individual semi-structured interviews were conducted, allowing an in-depth exploration of truck drivers' experiences. The interview guide was grounded within the COM-B model and theoretical domains framework. Audio recordings were anonymised and transcribed verbatim and data analysed using thematic analysis.

Results

Ten drivers (8 male) were interviewed with a mean age of 49 years (SD 9.7). Frequently mentioned barriers to healthy eating were limited availability of affordable healthy food options at truck stops, food storage limitations, and limited time for food preparation. Commonly reported facilitators to improve drivers' diet were flexible break times, shorter shifts, secure parking places and/or better-equipped vehicles.

Conclusions

Limited availability of healthy food options, high costs, poor facilities within rest areas, long working hours/shifts, and lack of food storage and preparation time, negatively impacts UK truck drivers' eating behaviours. This study highlights that multi-component interventions targeting the individual, environment and policy, are ultimately needed to improve truck drivers' working conditions and health.

Risk of crashes among self-employed truck drivers: Prevalence evaluation using fatigue data and machine learning prediction models

INTRODUCTION

Transportation companies have increasingly shifted their workforce from permanent to outsourced roles, a trend that has consequences for self-employed truck drivers. This transition leads to extended working hours, resulting in fatigue and an increased risk of crashes. The present study investigates the factors contributing to fatigue and impairment in truck driving performance while developing a machine learning-based model for predicting the risk of traffic crashes.

METHOD

To achieve this, a comprehensive questionnaire was designed, covering various aspects of the participants' sociodemographic characteristics, health, sleep, and working conditions. The questionnaire was administered to 363 self-employed truck drivers operating in the State of São Paulo, Brazil. Approximately 63% of the participants were smokers, while 17.56% reported drinking alcohol more than four times a week, and also admitted to being involved in at least one crash in the last three years. Fifty percent of the respondents reported consuming drugs (such as amphetamines, marijuana, or cocaine).

RESULTS

The surveyed individuals declared driving for approximately 14.62 h (SD = 1.97) before they felt fatigued, with an average of approximately 5.92 h of sleep in the last 24 h (SD = 0.96). Truck drivers unanimously agreed that waiting times for truck loading/unloading significantly impact the duration of their working day and rest time. The study employed eight machine learning algorithms to estimate the likelihood of truck drivers being involved in crashes, achieving accuracy rates ranging between 78% and 85%.

CONCLUSIONS

These results validated the construction of accurate machine learning-derived models.

PRACTICAL APPLICATIONS

These findings can inform policies and practices aimed at enhancing the safety and well-being of self-employed truck drivers and the broader public.

Qualitative Study of Multilevel Barriers and Facilitators Associated With Physical Activity and Diet Among Long-haul Truck Drivers

Background

Long-haul truck drivers (LHTD) experience disproportionately greater chronic disease risk, which may be influenced by both occupational and lifestyle factors. This study aimed to explore the multilevel factors associated with LHTD's diet and physical activity (PA).

Methods

Thirty in-depth interviews were conducted with LHTD in the Southern California border region. Interview questions captured occupational and lifestyle factors relating to PA and diet at multiple levels and were analyzed using thematic analysis.

Results

Emergent themes relating to both diet and PA included time constraints, attitudes and perceived beliefs, and accessibility of environments to engage in PA and healthy eating. Themes specific to PA were weather conditions and flatbed job duties. Themes specific to diet included access to refrigerators/microwaves and social interactions.

Conclusion

Findings from this study can inform the development of tailored, multi-level interventions to encourage PA and healthy dietary behaviors among LHTD.

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.

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.

Attenuated Cardiovascular Reactivity to Acute Psychological Stress Predicts Future Fatigue Symptoms in Truck Drivers

OBJECTIVES

This study aimed to investigate the impact of a 6-month health intervention on truck drivers' cardiovascular reactivity to stress and whether cardiovascular reactivity was predictive of depression, anxiety, or fatigue symptoms at 6-month follow-up.

METHODS

Two hundred thirty-eight truck drivers completed a 6-month cluster randomized controlled trial to increase physical activity and completed a stress protocol (Stroop and mirror-tracing tasks) with measurements of heart rate, systolic blood pressure, and diastolic blood pressure taken, alongside fatigue, anxiety, and depressive symptoms assessment. Measures were taken at 0 and 6 months.

RESULTS

Analyses showed a negative relationship between 0-month diastolic blood pressure reactivity and 6-month persistent fatigue. Trends toward negative relationships between systolic blood pressure reactivity and future anxiety and fatigue symptoms at 6 months were evident.

CONCLUSIONS

Our findings may have serious implications, as fatigue can be a major cause of road traffic collisions in truck drivers.

"Mars Bar and a Tin of Red Bull Kept Me and My Patients Alive": Exploring Barriers to Healthy Eating through Facebook Comments of Shiftworkers

The negative impact of an unhealthy diet on the shiftworker population has been well-documented. However, little evidence exists on the underlying reasons for unhealthy eating behaviours and the existing barriers to healthy eating withinshiftwork environments. This qualitative study investigated the dietary behaviours reported by shiftworkers through Facebook comments. Comments were collected if they were on public shiftworker-relevant posts pertaining to dietary news or dietary information on Facebook and were posted by self-identified shiftworkers, relatives of shiftworkers, or partners of shiftworkers. A thematic analysis of the 144 comments collected generated four categories that can be used to understand the motivations for eating behaviour on-shift: what shiftworkers eat, where food is sourced from, when food is eaten, and why certain foods are chosen. Results reveal motivations, attitudes, and both internal and external barriers to healthy eating behaviours, as well as similarities and differences across shiftwork industries. Recommendations for future research include further explorations on the link between scheduled eating (e.g., time-restricted eating) and shiftwork, the impact of a rotating shift arrangements on dietary health behaviours, and the impact of interpersonal relationships on shiftworker dietary choices. Understanding these motivations will inform strategies to promote healthy eating and help understand barriers for shiftworkers.

Physical activity in the workplace: a cost or a benefit for organizations? A systematic review

Purpose

Most adults do not follow the minimum requirements for physical activity despite the benefits such activity can provide toward improving quality of life. On average, an adult spends 60% of daily hours in the workplace, making it essential to create working environments that are favorable to avoiding harmful effects on the health of workers. Toward this end, the application of physical activity programs in a work context is one of the possible interventions. This study aims to carry out a systematic review of the literature to identify the impact of physical activity programs applied in the workplace, on employee wellness and organizational productivity.

Design/methodology/approach

The search for reports was carried out in two databases, namely, Thomson Reuters Web of Science and Scopus, according to several inclusion and exclusion criteria. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) was applied to ensure the quality of the study. Microsoft Excel 2016 was used to organize the database to support the data analysis.

Findings

The sample comprised 64 reports published in international journals between 1986 and 2019. From these studies, six thematic clusters were formed: Workplace Physical Activity Interventions, Workplace Wellness, Physical Activity and Organizational Performance, Barriers to Developing Physical Activity Programs in the Workplace, Physical Activity and Sedentary Occupations and Workplace Physical Activity Incentives. The analysis of these clusters confirmed that the implementation of physical activity programs in this context could represent beneficial effects for workers and the organizational system by contributing to a reduction in the rates of absenteeism and presenteeism. However, there are still many organizations that do not implement such programs.

Originality/value

The results of this study are essential for managers of organizations to be able to implement physical activity programs in a work context, similarly to the application of a strategy of corporate social responsibility in an intra-organizational environment. This research may also be useful for professionals in the areas of sports and physical exercise, who want to build their business around physical exercise programs applied to a work context.

Examining Coroners' Recommendations for Health and Safety Management of Ageing Heavy Vehicle Drivers: A STAMP Analysis

Recommendations were analysed from coronial cases involving ageing heavy vehicle drivers (≥55 years) and mapped onto a Systems Theoretic Accident Model and Processes (STAMP) control structure to identify the controllers and control actions influential in the heavy vehicle industry with regard to health and safety. A National Coronial Information System (NCIS) database search revealed 38 coroners' recommendations arising from 14 unique cases of ageing driver involvement. There were no ageing themes identified in the analysis of coroners' findings and recommendations. An examination of the STAMP control structure identified that the highest concentration of recommendations was in the level of regulation, the second most senior level of control, although safety constraints were advised for all five levels of the system. In regard to identifying themes of control flaws in the recommendations, the study found that "unidentified hazards" were the most common type of safety failure in the analysis of cases of ageing drivers, concentrated at the regulatory level, which indicates that additional risk identification methods by upper levels of control are needed. Therefore, a recommendation arising from the current study is that additional controls in safety intervention are necessitated in the upper and middle levels of the road freight transportation system; in particular, formalising health and safety education for organisational managers, with a focus on identifying ageing issues, would fill a gap in the system for managing ageing heavy vehicle drivers. In conclusion, this study has found that improving the health and safety of ageing heavy vehicle drivers necessitates additional safety constraints with a focus on formalised safety education for organisational managers, in addition to a means to detect emerging and unforeseen hazards in the road freight transportation industry.

Pre-injury health status of truck drivers with a workers' compensation claim

Truck drivers are a vulnerable population due to the high number of workplace injuries and fatalities predominant in their occupation. In Australia, the road freight transportation industry has been identified as a national priority area in terms of creating preventative measures to improve the health and safety of its workers. With an environment conducive to poor nutritional food choices and unhealthy lifestyle behaviours, many barriers exist to creating a safe and healthy workforce. Thus, the current study aimed to describe the pre-injury hospital-recorded health conditions and health service use of truck drivers with a worker’s injury compensation claim/s when compared to workers in other industries. Data was obtained from a compensation claims database and linked with hospital admissions data recorded five years prior to the injury claim. Health and lifestyle behaviour data for the occupational code of truck drivers was compared to other occupational drivers, as well as to all other occupations. Analysis was conducted via logistic regression. The results found that when compared to other occupational drivers, truck drivers were significantly more likely to have a hospital-recorded diagnosis of diabetes and/or hypertension, as well as being significantly more likely to have a hospital record of tobacco use and/or alcohol misuse/abuse. The findings show that there is a need to review and revise existing health strategies to promote the health and wellbeing of truck drivers, especially given their challenging work environment.

The structured health intervention for truckers (SHIFT) cluster randomised controlled trial: a mixed methods process evaluation

Background

This paper presents the mixed methods process evaluation of the randomised controlled trial (RCT) of the Structured Health Intervention For Truckers (SHIFT), a multi-component intervention targeting physical activity and positive lifestyle behaviours in a cohort of 382 truck drivers in the UK. The SHIFT RCT found a significant difference in daily steps between intervention and control groups at 6-months in favour of the intervention participants.

Methods

SHIFT was evaluated within a cluster-RCT and involved 25 transport sites (12 intervention and 13 control sites). Intervention components included an education session, Fitbit, text messages, and cab workout equipment. Participants completed questionnaires at baseline and 6-months follow-up. Semi-structured focus groups/interviews were conducted with drivers (n = 19) and managers (n = 18) from each site, after completion of the final follow-up health assessment (16-18 months post-randomisation). Questionnaires and interviews collected information on fidelity, dose, context, implementation, barriers, sustainability, and contamination.

Results

Questionnaire and interview data from intervention participants indicated favourable attitudes towards SHIFT, specifically towards the Fitbit with a high proportion of drivers reporting regularly using it (89.1%). 79.2% of intervention participants attended the education session, which was deemed useful for facilitating improvements in knowledge and behaviour change, dietary changes were predominantly recalled. Despite not being part of the intervention, participants reported that feedback from the health assessments motivated them to change aspects of their lifestyle (intervention = 91.1%, control = 67.5%). The cab workout equipment was used less and spoken unfavourably of in the interviews. The main barriers to a healthy lifestyle at work were reported as long hours and irregular shift patterns. The most suggested improvement for the intervention was more frequent contact with drivers. Managers were positive about the objectives of SHIFT, however almost all mentioned the challenges related to implementation, specifically in smaller sites.

Conclusions

Overall, SHIFT was predominantly implemented as intended, with minimal discrepancies seen between the delivery and protocol. Having said this, transport sites each have distinct characteristics, which may require adaptations to individual settings to encourage participation. Managers and drivers reported enthusiasm and necessity for SHIFT to be included in future Certificate of Professional Competence training.

Trial registration

ISRCTN10483894 (date registered: 01/03/2017).

Factors Associated with Colorectal Cancer Prevalence Among Long-Haul Truck Drivers in the United States

PURPOSE

To determine the age-adjusted association between colorectal cancer (CRC) risk factors and CRC prevalence among long-haul truck drivers (aged 21-85), after adjustment for age.

DESIGN

Pooled cross-sectional analysis using Commercial Driver Medical Exam (CDME) data. Setting. National survey data from January 1, 2005, to October 31, 2012.

PARTICIPANTS

47,786 commercial motor vehicle drivers in 48 states.

MEASURES

CRC prevalence was the primary outcome; independent variables included demographics, body mass index (BMI), and concomitant medical conditions.

ANALYSIS

Kruskal-Wallis tests to analyze continuous variables; Fischer's exact tests to analyze categorical variables; univariate and multivariable logistic regression for rare events (Firth method) to quantify the association between the independent variables of interest and CRC prevalence. Odds ratios (ORs) and 95% confidence intervals (CIs) were adjusted for age, gender, years with current employer, year of exam, and BMI in a multivariate logistic regression.

RESULTS

Many factors were statistically significant. Obesity (OR = 3.14; 95% CI = 1.03-9.61) and increasing age (OR = 1.10 per year; 95% CI = 1.07-1.13) were significantly associated with CRC prevalence. Truckers with 4 or more concomitant medical conditions were significantly more likely to have CRC (OR = 7.03; 95% CI = 1.83-27.03).

CONCLUSIONS

Our findings highlight mutable risk factors and represent an opportunity for intervention that may decrease CRC morbidity and mortality among truck drivers, a unique population in the United States estimated to live up to 16 years less than the general population.

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.

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

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Trucking built environment science is underdeveloped and requires validated tools.

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

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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.

The physical and mental health of Australian truck drivers: a national cross-sectional study

BACKGROUND

The negative health consequences of truck driving are well documented. However, despite the distinct occupational challenges between long- and short-haul driving, limited research has been conducted on how the health profile of these drivers differ. The aims of this study were to characterise the physical and mental health of Australian truck drivers overall, and to identify any differences in factors influencing the health profile of long-haul compared to short-haul drivers.

DESIGN, SETTING, AND PARTICIPANTS

In this cross-sectional study, 1390 Australian truck drivers completed an online survey between August 2019 and May 2020. Questions included validated measures of psychological distress, general health, work ability and health-related quality-of-life. Participants driving 500 km or more per day were categorised as long-haul and those driving less than 500 km as short-haul.

RESULTS

The majority of survey respondents were classified as either overweight (25.2%) or obese (54.3%). Three in ten reported three or more chronic health conditions (29.5%) and poor general health (29.9%). The most commonly diagnosed conditions were back problems (34.5%), high blood pressure (25.8%) and mental health problems (19.4%). Chronic pain was reported by 44% of drivers. Half of drivers reported low levels of psychological distress (50.0%), whereas 13.3 and 36.7% experienced severe or moderate level of psychological distress respectively. There were a small number of differences between the health of long- and short-haul drivers. A higher proportion of short-haul drivers reported severe psychological distress compared to long-haul drivers (15.2% vs 10.4%, χ² = 8.8, 0.012). Long-haul drivers were more likely to be obese (63.0% vs 50.9%, χ2 = 19.8, < 0.001) and report pain lasting over a year (40.0% vs 31.5%, χ² = 12.3, 0.006). Having more than one diagnosed chronic condition was associated with poor mental and physical health outcomes in both long- and short-haul drivers.

CONCLUSION

Australian truck drivers report a high prevalence of multiple physical and mental health problems. Strategies focused on improving diet, exercise and preventing chronic conditions and psychological distress, that can also be implemented within the unique occupational environment of trucking are needed to help improve driver health. Further research is needed to explore risk and protective factors that specifically affect health in both short-haul and long-haul drivers.

Increasing workplace physical activity through motivational and volitional coaching – a randomized controlled trial with truck drivers

Purpose

Although the health hazards of truck drivers are well known, only few studies address the health status of this occupational group. The purpose of this empirical research paper is to evaluate the effects of motivational and volitional coaching on workplace physical activity (WPA) with the provision of a vehicle-integrated fitness device.

Design/methodology/approach

Intervention group 1 and intervention group 2 received motivational coaching to improve behavioral internalization. Intervention group 2 received additional volitional coaching to increase physical activity (PA)-related self-efficacy. The control group received only the vehicle-integrated fitness device to perform WPA, as did both intervention groups. Internalization and PA-related self-efficacy were collected four times. WPA was assessed weekly.

Findings

All 140 participating truck drivers were consistently physically active for an average of 85 min (SD = 85.2 min) during motivational coaching, 76 min (SD = 65.0 min) during volitional coaching and 71.0 min (SD = 63.5 min) during follow-up, with no differences found between groups. Variance analyses for repeated measures revealed no intervention effects on WPA, internalization and self-efficacy, and internalization and self-efficacy did not prove to be mediators of increased WPA.

Originality/value

The primary goal of increasing WPA of all participants was achieved, but the present form of coaching cannot be confirmed as a successful strategy. Nevertheless, the results are valuable and could be an impetus for further research on WPA promotion in truck drivers as the creation of an opportunity with the vehicle-integrated fitness device alone led to an increased WPA.

Metabolic Syndrome in Commercial Truck Drivers: Prevalence, Associated Factors, and Comparison With the General Population

INTRODUCTION

Commercial motor vehicle drivers, such as truck drivers, experience unique health, lifestyle, and occupational challenges directly associated with their profession.

METHODS

All participants in this multistate cross-sectional study completed questionnaire measurements. Participants were categorized with metabolic syndrome (MetS) if they had at least three of the five modified criteria used in the joint scientific statement on metabolic syndrome.

RESULTS

Overall MetS prevalence was 52.4% (n = 428) of the 817 participants. Prevalence of MetS criteria were waist circumference (n = 634, 77.0%), low HDL cholesterol (n = 580, 71.0%), elevated triglycerides (n = 552, 67.6%), elevated blood pressure (n = 175, 21.2%), and elevated hemoglobin A1c (n = 97, 11.9%). Truck drivers were 2.7 times more likely to have MetS compared to the general working population.

CONCLUSION

Truck drivers in the United States have a high prevalence of MetS compared to the general working population.

Attenuated cardiovascular reactivity is related to higher anxiety and fatigue symptoms in truck drivers

Depression and anxiety have been linked with reduced stress-induced cardiovascular reactivity (CVR), which could be indicative of autonomic dysregulation. Less is known about the association between work-related fatigue and CVR. Truck drivers experience high levels of depression, anxiety, and fatigue, with repeated psychophysiological stressors on the road, yet little is known about the effects of these conditions on their CVR. Three hundred eighty six truck drivers completed the Hospital Anxiety and Depression Scale (HADS) and the Occupational Fatigue Exhaustion/Recovery Scale (OFER-15). Systolic (SBP) and diastolic (DBP) blood pressure and heart rate (HR) were measured at rest and during a stressor protocol to measure CVR. Multivariate regression analyses were used to determine relationships between variables and adjusted for nine key covariates. Higher symptoms of persistent fatigue were related to a reduced SBP reactivity (β = -.236, p = .009) and reduced DBP reactivity (β = -.257, p = .005), whereas there was a positive trend between acute fatigue and DBP reactivity (β = .169, p = .052). Higher symptoms of anxiety were related to a reduced SBP reactivity (β = -.164, p = .016). This study demonstrated in a population of truck drivers that both anxiety and persistent fatigue were related to an attenuated SBP reactivity in a combined model, whereas there was a positive trend between acute fatigue solely and DBP reactivity. These novel findings may have serious implications for cardiovascular disease risk in truck drivers, and future research should attempt to establish the causal effect of these associations and the underlying physiological mechanisms.

Enhancing physical activity knowledge exchange strategies for Canadian long-haul truck drivers

Purpose

Canadian long-haul truck drivers lead sedentary lives, but are receptive to receiving physical activity information to address health risks. This study examined how Canadian long-haul truck drivers would like to receive physical activity information in order to improve their overall health. The purpose of this study was twofold: 1) explore barriers Canadian long-haul truck drivers have to receiving and using physical activity information and 2) understand how physical activity information should be structured and delivered to these drivers to overcome these barriers.

Design/methodology/approach

Semi-structured interviews were conducted with 12 Canadian long-haul truck drivers. Drivers had, on average, 14.3 years of professional long-haul driving experience.

Findings

Few drivers had received any physical activity information. Drivers discussed a culture where they perceived both employers and drivers to be lacking awareness of the importance of physical activity and its impact on health. Drivers explained they were too busy, stressed or tired to be active or to learn about physical activity. Information received by some drivers on this topic was too general to be helpful in changing physical activity behaviours. Drivers mentioned that personalized and accessible physical activity information should be provided to them through multiple methods by their employers, as an aspect of occupational health and safety.

Practical implications

Future physical activity information strategies should use both passive and interactive mediums to promote physical activity to Canadian long-haul truck drivers.

Originality/value

This is the first study to assess how Canadian long-haul truck drivers would like to receive trustworthy information that can lead to healthful improvements in physical activity behaviour.

Worksite health promotion and social inequalities in health

It is well-documented that higher educated employees have better health than the lower educated. The workplace has been put forward as a contributor to this inequality. We extend previous work on workplace characteristics that could influence employee health by asking to what extent workplace health promotion (WHP) can account for the relation between education and health. Two ways in which WHP may relate to health inequalities are addressed: higher educated employees may be more likely to use WHP than lower educated employees and the effect of WHP on health may be stronger for higher educated than for lower educated employees. Using data from the European Sustainable Workforce Survey which contains information on over 11000 employees in 259 organisations, we test whether three types of WHP mediate or moderate the relation between education and health: healthy menus, sports facilities and health checks. We find that higher educated employees are in better health and that use of WHP positively relates to health. Use of healthy menus and sports facilities in the workplace can contribute to increasing health inequalities, as lower educated employees are less likely to make use of these. Health checks could contribute to diminishing health inequalities, as lower educated employees are more likely to use them compared to higher educated employees. The effect of WHP is not contingent on education. We advise stimulating lower educated employees to make more use of WHP, which can contribute to decreasing health inequalities.

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.

Truckies' Nutrition and Physical Activity: A Cross-sectional Survey in Queensland, Australia

Truck drivers are at increased risk of diet- and physical activity-related chronic diseases. Despite this, there is a paucity of data about Australian truck drivers' diet and physical activity behaviors. A multiple choice and short response survey was distributed to truck drivers attending an Australian Truck Show. The survey asked about self-reported health, source of health information, number of serves of fruit, vegetables, unhealthy food, and sugary drink consumed per day, and frequency of moderate- and vigorous-intensity physical activity per week. The survey was completed by 231 truck drivers---almost all were male, with a mean age of 46 (range 20 to 71) years. Over 85% of survey respondents worked more than 9 hrs per day. Nearly 75% acknowledged the need to make changes to improve their health. Half consumed fewer serves of fruit and 88% consumed fewer serves of vegetables than national recommendations. Over 63% consumed at least one serve of unhealthy foods per day, and 65% drank at least one can of sugary drink per day. Most (80%) undertook less than moderate- and vigorous-intensity physical activity levels provided in national recommendations. Of concern, almost 90% of drivers had above the recommended body mass index---approximately 60% were obese. This is almost double the proportion found in the general population. These findings highlight the importance of health promotion to help drivers make better choices about their health behaviors, which are often underpinned by the limitations of their work environment. Health promotion in transport industry workplaces should be an important topic for future research.

A Structured Health Intervention for Truckers (SHIFT): A Process Evaluation of a Pilot Health Intervention in a Transport Company

OBJECTIVES

To undertake a process-evaluation of a structured health intervention for truckers (SHIFT) implemented in a sample of UK lorry drivers.

METHODS

A combination of "debrief interviews," focus groups and one-to-one interviews, in addition to observations and reflections of the two lead researchers were used to collect data on the acceptability of SHIFT from a group of 16 lorry drivers and four transport managers.

RESULTS

The SHIFT program was considered relevant and acceptable to lorry drivers. It provided them with health information tailored to their specific health needs, long-lasting tools and techniques, which helped to raise their awareness of key health issues and helped to stimulate lifestyle changes during their daily routine.

CONCLUSION

This process-evaluation suggests that the SHIFT program should now be evaluated on a larger scale and tested through fully randomized controlled trials.

Relationships Between Poor Health and Calories From Fat Among Commercial Truck Drivers

OBJECTIVE

Commercial motor vehicle (CMV) drivers face many challenges to their health, including poor diet, disease, and crash risk. This study quantifies relationships between the percentage of calories from fat (PCF) and markers of poor health, many of which are associated with increased crash risk.

METHODS

Cross-sectional data from 790 CMV drivers were analyzed. PCF were estimated using the National Cancer Institute Percentage Energy from Fat Screener. Adjusted odds ratios (ORs) were calculated.

RESULTS

The highest category of PCF (>38.2%) was statistically significantly more likely to not exercise (OR = 2.08), have sleep apnea (OR = 2.31), snore (OR = 1.90), smoke (OR = 2.28), and use alcohol (OR = 1.87) after adjustments.

CONCLUSION

Meaningful relationships between PCF and poor health indicators exist. These indicators may provide an intervention to improve the health and safety of CMV drivers.

Working conditions, health and retirement intentions: a case study of truck drivers

Purpose

Being a professional truck driver implies prolonged exposure to physical and psychosocial risks, which can affect health and work ability in the short and long term. The purpose of this paper is to examine the role of working conditions in truck drivers’ perceived health and retirement intentions in a Portuguese transportation company.

Design/methodology/approach

Using ergonomic work analysis (EWA), this study incorporates document analysis, observation and 16 interviews. Content analysis is applied to interviews’ transcripts.

Findings

In line with previous research, drivers acknowledged their activity as physically demanding (e.g. static postures, repetitive movements, heavy lifting) and psychologically demanding (e.g. high time pressure, lack of control, lack of work–family balance). Despite that, drivers report themselves to be in good health, with only some complaints related to back and knee pain. However, hard working conditions associated with ageing can contribute to gradual health deterioration, leading them to desire to retire before the legal retirement age.

Practical implications

The company can promote drivers’ health by creating a unit to provide psychosocial support and career orientation, improving the mentoring programme, and investing in training on occupational risk prevention.

Originality/value

This study is the first to use EWA to examine the impact of the complex relationship between truck drivers’ work and health in their retirement intentions, adopting a temporal perspective.

A retrospective analysis of cardiometabolic health in a large cohort of truck drivers compared to the American working population

BACKGROUND

Truck drivers face many health challenges, including lifestyle, diet, inactivity, stressors, and social support.

METHODS

A repeated cross-sectional analysis compared 88,246 truck drivers with data from (n = 11 918) the National Health and Nutrition Examination Survey (NHANES). Trends over time for body mass index (BMI), high blood pressure, diabetes mellitus, heart disease, and sleep disorders were analyzed, adjusting for potential confounders.

RESULTS

Truck drivers had significantly worsening health metrics between 2005 and 2012 compared to NHANES participants. Truck drivers were significantly more likely to be obese and morbidly obese with prevalence odds ratios (POR) and 95% confidence intervals (95%CI) of 1.99 (1.87, 2.13) and 2.34 (2.16, 2.54), respectively. Measured blood pressure, self-reported high blood pressure, diabetes mellitus, and heart disease all significantly increased. Also, sleep disorders increased among truck drivers from 2005 to 2012 (POR = 6.55, 95%CI 5.68, 7.55).

CONCLUSION

These data suggest disproportionate increases in poor health among truck drivers from 2005 to 2012.

Working around it

Purpose

The rail driver workplace is full of challenges for effective health management. The purpose of this paper is to investigate how known barriers in rail driving may be overcome by seeking enablers of positive health status and lifestyle.

Design/methodology/approach

Five focus groups were conducted with 29 rail drivers from four rail organisations across three Australian states. Transcribed data were analysed using directed content analysis and thematic coding to develop health enabler themes and categories.

Findings

Formal initiatives to manage health were piecemeal. Efforts to maintain health involved countering deteriorative, and promoting restorative, health factors. Themes systematically illustrated work environmental, adaptational, and autonomous features of health management. Participants expressed many different approaches to enabling positive health status, and how these connected to known barriers.

Research limitations/implications

Discussion of personal health issues within the rail industry is considered a taboo topic by some, therefore participants who took part in this study data may be more representative of health-conscious drivers.

Practical implications

Occupational health in rail can be enabled in multiple ways, including: improving social support, scheduling certainty, and cross-communication around health behaviours; increasing flexibility and environmental support for health behaviours; and directly promoting dietary control and physical activity engagement. Given the diversity and global representativeness of rail systems found within Australia, the findings have international application.

Originality/value

This study uses a strength-focussed approach to highlight multiple leverage points for organisational rail-driver health interventions across three levels of the system, helping improve health intervention efficacy despite the intractable nature of their environments.

Cross-sectional surveillance study to phenotype lorry drivers' sedentary behaviours, physical activity and cardio-metabolic health

OBJECTIVES

Elevated risk factors for a number of chronic diseases have been identified in lorry drivers. Unhealthy lifestyle behaviours such as a lack of physical activity (PA) and high levels of sedentary behaviour (sitting) likely contribute to this elevated risk. This study behaviourally phenotyped UK lorry drivers' sedentary and non-sedentary behaviours during workdays and non-workdays and examined markers of drivers cardio-metabolic health.

SETTING

A transport company from the East Midlands, UK.

PARTICIPANTS

A sample of 159 male heavy goods vehicle drivers (91% white European; (median (range)) age: 50 (24, 67) years) completed the health assessments. 87 (age: 50.0 (25.0, 65.0); body mass index (BMI): 27.7 (19.6, 43.4) kg/m²) provided objective information on sedentary and non-sedentary time.

OUTCOMES

Participants self-reported their sociodemographic information. Primary outcomes: sedentary behaviour and PA, assessed over 7 days using an activPAL3 inclinometer. Cardio-metabolic markers included: blood pressure (BP), heart rate, waist circumference (WC), hip circumference, body composition and fasted capillary blood glucose, triglycerides, high-density lipopreotein cholesterol, low-density lipoprotein cholesterol (LDL-C) and total cholesterol (TC) levels. These cardio-metabolic markers were treated as secondary outcomes.

RESULTS

Lorry drivers presented an unhealthy cardio-metabolic health profile (median (IQR) systolic BP: 129 (108.5, 164) mm Hg; diastolic BP: 81 (63, 104) mm Hg; BMI: 29 (20, 47) kg/m²; WC: 102 (77.5, 146.5) cm; LDL-C: 3 (1, 6) mmol/L; TC: 4.9 (3, 7.5) mmol/L). 84% were overweight or obese, 43% had type 2 diabetes or prediabetes and 34% had the metabolic syndrome. The subsample of lorry drivers with objective postural data (n=87) accumulated 13 hours/day and 8 hours/day of sedentary behaviour on workdays and non-workdays (p<0.001), respectively. On average, drivers accrued 12 min/day on workdays and 6 min/day on non-workdays of moderate-to-vigorous PA (MVPA).

CONCLUSION

Lorry drivers demonstrate a high-risk cardio-metabolic profile and are highly sedentary and physically inactive. Interventions to reduce sitting and increase MVPA during breaks and leisure time to improve cardio-metabolic health are urgently needed. Educational programmes to raise awareness about diet and exercise are recommended.

Understanding the health of lorry drivers in context: A critical discourse analysis

This article moves beyond previous attempts to understand health problems in the lives of professional lorry drivers by placing the study of drivers' health in a wider social and cultural context. A combination of methods including focus groups, interviews and observations were used to collect data from a group of 24 lorry drivers working at a large transport company in the United Kingdom. Employing a critical discourse analysis, we identified the dominant discourses and subject positions shaping the formation of drivers' health and lifestyle choices. This analysis was systematically combined with an exploration of the gendered ways in which an almost exclusively male workforce talked about health. Findings revealed that drivers were constituted within a neoliberal economic discourse, which is reflective of the broader social structure, and which partly restricted drivers' opportunities for healthy living. Concurrently, drivers adopted the subject position of 'average man' as a way of defending their personal and masculine status in regards to health and to justify jettisoning approaches to healthy living that were deemed too extreme or irrational in the face of the constraints of their working lives. Suggestions for driver health promotion include refocusing on the social and cultural - rather than individual - underpinnings of driver health issues and a move away from moralistic approaches to health promotion.