How do taxi drivers expose to fine particulate matter (PM2.5) in a Chinese megacity: a rapid assessment incorporating with satellite-derived information and urban mobility data

BACKGROUND

Taxi drivers in a Chinese megacity are frequently exposed to traffic-related particulate matter (PM2.5) due to their job nature, busy road traffic, and urban density. A robust method to quantify dynamic population exposure to PM2.5 among taxi drivers is important for occupational risk prevention, however, it is limited by data availability.

METHODS

This study proposed a rapid assessment of dynamic exposure to PM2.5 among drivers based on satellite-derived information, air quality data from monitoring stations, and GPS-based taxi trajectory data. An empirical study was conducted in Wuhan, China, to examine spatial and temporal variability of dynamic exposure and compare whether drivers' exposure exceeded the World Health Organization (WHO) and China air quality guideline thresholds. Kernel density estimation was conducted to further explore the relationship between dynamic exposure and taxi drivers' activities.

RESULTS

The taxi drivers' weekday and weekend 24-h PM2.5 exposure was 83.60 μg/m3 and 55.62 μg/m3 respectively, 3.4 and 2.2 times than the WHO's recommended level of 25 µg/m3. Specifically, drivers with high PM2.5 exposure had a higher average trip distance and smaller activity areas. Although major transportation interchanges/terminals were the common activity hotspots for both taxi drivers with high and low exposure, activity hotspots of drivers with high exposure were mainly located in busy riverside commercial areas within historic and central districts bounded by the "Inner Ring Road", while hotspots of drivers with low exposure were new commercial areas in the extended urbanized area bounded by the "Third Ring Road".

CONCLUSION

These findings emphasized the need for air quality management and community planning to mitigate the potential health risks of taxi drivers.

The Association of Untreated Mental Health Problems with Alcohol and Tobacco use Among New York City Taxi Drivers

OBJECTIVES

Mental disorders and substance use disorders are highly comorbid. The "self-medication hypothesis" posits that individuals may use substances such as tobacco and alcohol to cope with symptoms associated with untreated mental health problems. The present study examined the association between having a currently untreated mental health condition and tobacco and alcohol use among male taxi drivers in NYC, a population at risk for poor mental and physical health outcomes.

METHODS

The sample included 1105 male, ethnoracially diverse, primarily foreign-born NYC taxi drivers participating in a health fair program. This secondary cross-sectional analysis utilized logistic regression modeling to examine whether endorsement of a currently untreated mental health problem (i.e., depression, anxiety, or posttraumatic stress disorder) was associated with alcohol and/or tobacco use, controlling for potential confounders.

RESULTS

8.5% of drivers reported having mental health problems; among these, only 0.5% reported receiving treatment. Untreated mental health problems were associated with an increased risk of current tobacco/alcohol use after controlling for age, educational attainment, nativity, and pain history: drivers with untreated mental health problems had 1.9x the odds of reporting current tobacco use [95% CI: 1.10-3.19] and 1.6x the odds of reporting current alcohol use [95% CI: 1.01-2.46] than those without untreated mental health problems.

CONCLUSIONS

Few drivers with mental health problems receive treatment. In line with the self-medication hypothesis, drivers with untreated mental health problems demonstrated significantly increased risk of tobacco and alcohol use. Efforts to encourage timely screening and treatment of mental health problems among taxi drivers are warranted.

Assessment of semen quality of taxi drivers exposed to whole body vibration

Whole body vibration (WBV) is a recognized occupational hazard for many workers such as drivers and operators of heavy and light machinery and exposure to it is accompanied by physical and mental repercussions. Only the limited studies have been done on the effects of vibration exposure on reproductive indices, however vibration exposure has been indicated as being a hazardous agents with the potential of being able to directly affect the reproductive system. Considering the importance of infertility, the present study was conducted with the aim of investigating semen quality among taxi drivers in Tehran and determine the effect of exposure to WBV on sperm parameters. The study population consisted of 70 taxi drivers and 70 office employee who attended infertility clinics for diagnostic purposes in the past year. The participants had to meet the entry criteria of the study while also being willing to recruit. Data was collected in the form of demographic questionnaires and general health questionnaires as well as sperm analysis conducted in an infertility clinic according to standard laboratory guidelines. The 8-hour time-weighted average (TWA) exposure to of WBV in automobile was measured as per ISO 2631-1. The TWA exposure to WBV among the taxi drivers and office employees were 0.697 ± 0.13 m/s² and 0.068 ± 0.09 m/s² respectively (P < 0.05). A statistically significant difference in total sperm count, progressive motility, non-progressive motility and total motility was observed between the taxi drivers and the office employees (P < 0.05). According to the univariate analysis of variance, exposure to WBV had negative effect on sperm concentration, progressive motility and normal morphology (P > 0.05); moreover exposure to WBV resulted in the larger effect size (B) on sperm parameters than the demographic variables (P > 0.05). Being taxi drivers increase the chance of the decreased semen quality (P > 0.05). It is difficult to draw definitive conclusions regarding the effects of WBV while intervening factors exist, such as psychological stressors, quality of sleep, background issues as well as environmental factors such as chemical pollutants (heavy metals) or ergonomic factors (body posture and working while sitting down).

Examining demographic, work, and sleep characteristics among older South Asian American yellow taxi drivers in New York City: A brief report

OBJECTIVES

This exploratory study examines workplace factors, sleep, sleep disorders, and safety among older (age 50 years and above) yellow taxi drivers in New York City (NYC) of South Asian descent.

METHODS

Using street intercept methods, quantitative data was collected among yellow taxi drivers in NYC (n = 27) from January-March 2020.

RESULTS

Among drivers, higher than normal sleepiness was identified in 33%, sleeping fewer than 7 hours on worknights work nights was reported by 52%, and 37% were at high risk for obstructive sleep apnea (OSA). Among drivers, 11% (n = 3) reported a motor vehicle accident in the past year and all drivers who reported an accident were at high risk for OSA.

CONCLUSIONS

Findings from this hard-to-reach and understudied population revealed that most drivers did not report sufficient sleep on work nights. Results found over one-third of drivers had high OSA risk and drivers at high risk for OSA contributed to all reports of motor vehicle crashes.

Early diagnosis of T2DM using high sensitive tests in the mandatory medical examinations for fishers, seafarers and other transport workers

Transport workers like seafarers, truck-, bus-, train- and taxi drivers and fishers have a known great inequity in health at work including high risk of developing type 2 diabetes. Their routine mandatory medical examinations use urine glucose for diabetes check with more than 50% false negatives, which should be replaced by high sensitive tests for diabetes-2, like A1C, Fasting Glucose (FPG) or Oral Glucose Tolerance Test (OGTT).

COVID-19 related risk perception among taxi operators in Kingston and St. Andrew, Jamaica

BACKGROUND

In the Caribbean, all countries have confirmed COVID-19 cases. Considering the high infectivity of the virus, no preexisting immunity to the virus and an associated modest reproductive rate (R₀), the high density of persons utilizing public transport is of immense public health concern. Public transport systems may facilitate and accelerate the transmission of the disease.

AIM

The aim of this study was to assess the COVID-19 related risk perceptions among taxi drivers by virtue of their occupation and the implications for health promotion interventions.

METHODS

A cross-sectional study was conducted in May 2020 among 282 taxi drivers in the Kingston and St. Andrew (KSA) metropolitan region in Jamaica. A 28-item anonymized self-administered questionnaire was used to collect data which was subsequently analyzed using SPSS version 20. A risk score was generated and the Mann-Whitney U and Kruskal Wallis tests were used to determine differences in the mean ranks for risk perception score as applicable. A 5% alpha level was utilized in determining statistical significance.

RESULTS

Risk perception scores ranged from 10 to 21 with a median of 17 (IQR 3.25) and there was no statistically significant difference in the median risk perception score by socio-demographic variables. There was however, a statistically significant positive correlation (Spearman's rho = 0.238, p=<0.001) between risk perception and knowledge. Approximately, 86% of respondents reported that they obtained COVID-19-related information from news reports (traditional media).

CONCLUSION

Taxi drivers perceive themselves to be at occupationally related risk of COVID-19. Therefore, greater understanding of this issue is paramount as it can aid in the crafting of initiatives that may enhance personal safety of both taxi drivers and commuters.

Taxi drivers' exposure to black carbon and nitrogen dioxide in electric and diesel vehicles: A case study in London

Nitrogen dioxide (NO₂) and black carbon (BC) concentrations were measured inside London taxicabs across 40 work shifts in a real-world occupational study. The shifts were measured across five plug-in hybrid range-extender electric taxicabs (TXe City) and five diesel taxicabs (TX4 Diesel). The aim of this study was to characterise the impact of fuel and cabin design on professional drivers' air pollution exposures. Personal exposure was monitored using portable BC, NO₂ and GPS devices. A controlled study replicating a typical taxi drivers' route in central London was conducted. Simultaneous inside and outside BC concentrations were measured to assess infiltration rates. The drivers were instructed to keep the BC devices with them at all times, providing a comparison of exposures at work and outside of work. The driver's average BC and NO₂ exposure while working was nearly twice as high for diesel taxicab drivers (6.8 ± 7.0 μg/m³, 101.9 ± 87.8 μg/m³) compared with electric drivers (3.6 ± 4.9 μg/m³, 55.3 ± 53.0 μg/m³, respectively). The exposure to BC while not working was 1.6 μg/m³ for diesel drivers and 1.1 μg/m³ for electric drivers, highlighting the very high exposures experienced by this occupational sector. The analysis of vehicle type on BC concentrations showed that the airtight cabin design and presence of an in-built filter in the electric TXe City reduced the exposure to BC substantially; indoor to outdoor ratios being 0.63 on the electric taxi compared to 0.99 on the diesel taxi with recirculate ventilation mode off and 0.07 to 0.44 with recirculate on. These findings provide important evidence for occupational health of professional drivers through exposure reduction measures in vehicle design.

Short-term association of in-vehicle ultrafine particles and black carbon concentrations with respiratory health in Parisian taxi drivers

INTRODUCTION

Professional drivers are exposed inside their vehicles to high levels of air pollutants due to the considerable time they spend close to motor vehicle emissions. Little is known about ultrafine particles (UFP) or black carbon (BC) adverse respiratory health effects compared to the regulated pollutants.

OBJECTIVES

We aimed to study the short-term associations between UFP and BC concentrations inside vehicles and (1) the onset of mucosal irritation and (2) the acute changes in lung function of Parisian taxi drivers during a working day.

METHODS

An epidemiological study was carried out on 50 taxi drivers in Paris. UFP and BC were measured inside their vehicles with DiSCmini® and microAeth®, respectively. On the same day, the frequency and the severity of nose, eye, and throat irritations were self-reported by each participant and a spirometry test was performed before and after the work shift. Multivariate analysis was used to evaluate the associations between in-taxis UFP and BC concentrations and mucosal irritation and lung function, after adjustment for potential confounders.

RESULTS

In-taxis UFP concentrations ranged from 17.9 to 37.9 × 10³ particles/cm³ and BC concentrations from 2.2 to 3.9 μg/m3, during a mean of 9 ± 2 working hours. Significant dose-response relationships were observed between in-taxis UFP concentrations and both nasal irritation and lung function. The increase of in-taxis UFP (for an interquartile range of 20 × 10³ particles/cm³) was associated to an increase in nasal irritation (adjusted OR = 6.27 [95% CI: 1.02 to 38.62]) and to a reduction in forced expiratory flow at 25-75% by -7.44% [95% CI: -12.63 to -2.24], forced expiratory volume in one second by -4.46% [95% CI: -6.99 to -1.93] and forced vital capacity by -3.31% [95% CI: -5.82 to -0.80]. Such associations were not found with BC. Incident throat and eye irritations were not related to in-vehicle particles exposure; however, they were associated with outdoor air quality (estimated by the Atmo index) and in-vehicle humidity, respectively.

CONCLUSION

To our knowledge, our study is the first to show a significant association, within a short-period of time, between in and vehicle UFP exposure and acute respiratory effects in professional drivers.

Predictors of Health Insurance, Life Insurance, and Retirement Savings Among NYC's Immigrant Taxi and For-Hire Vehicle Drivers

Taxi and for-hire vehicle (FHV) drivers are a predominantly immigrant population facing a range of occupational stressors, including lack of workplace benefits and increasing financial strain from tumultuous industry changes and now COVID-19's devastating impact. Bilingual research staff surveyed 422 New York City taxi/FHV drivers using a stratified sampling approach in driver-frequented locations to examine drivers' health and financial planning behaviors for the first time. Drivers lacked health insurance at double the NYC rate (20% vs. 10%). Life insurance and retirement savings rates were lower than U.S. averages (20% vs. 60%, 25% vs. 58%, respectively). Vehicle ownership was a significant predictor of health insurance, life insurance, and retirement savings. Compared to South Asian drivers, Sub-Saharan African drivers were significantly less likely to have health insurance and North African, and Middle Eastern drivers were significantly less likely to have retirement savings. Although most drivers indicated the importance of insurance and benefits, < 50% understood how to use them. Drivers felt primary care coverage to be most important followed by other health-related coverage, retirement benefits, and life insurance. Results reveal compelling addressable gaps in insurance and benefits coverage and the need to implement accessible financial literacy with navigation and advising services and programs.

Safe driving behaviors among taxi drivers: a predictive cross-sectional study based on the health belief model

Background

The purpose of this study was to predict safe driving behaviors among taxi drivers of Tehran based on the constructs of health belief model.

Methods

This descriptive-analytical study was performed on 450 taxi drivers in Tehran using multi-stage sampling. Data were analyzed through SPSS software version 18 using Pearson correlation coefficient and multivariate regression analysis. The P < 0.05 was considered statistically significant.

Results

Among the constructs of health belief model, perceived severity, perceived benefits and self-efficacy, had significant and direct relationship and perceived barriers had a significant and reverse relationship with safe driving behaviors. According to the results, the constructs of health belief model predicted 17.3% of safe driving behaviors. Self-efficacy was the strongest determinant of safety behaviors (0.362 CI 0.098–0.625).

Conclusions

Increasing self-efficacy, reducing perceived barriers and highlighting benefits for the purpose of accepting safe behaviors can be considered as a principle in driving education and training. Also, increasing the perceived severity of adverse outcomes of RTAs and the susceptibility to these outcomes will lead to higher levels of safe driving behaviors.

Qualitative study of knowledge, perception, behavior and barriers associated with cardiovascular disease risk among overweight and obese Hispanic taxi drivers of South Bronx, NYC

BACKGROUND

Taxi drivers are prone to developing cardiovascular disease (CVD) risk factors by adopting poor health behaviors due to their work environment. The population of Hispanic taxi drivers in inner city South Bronx, NYC, have not been studied. The goal of our qualitative study is to understand the perception, knowledge, behavior and barriers that influence CVD risk in overweight and obese inner-city Hispanic drivers.

METHODS

A cross-sectional qualitative study was conducted among community-based taxi drivers in South Bronx, NYC. Hispanic taxi drivers with body mass index of greater than 25 kg/m2 were screened and recruited for the study. Focus groups were organized to evaluate CVD and obesity risk factors through open-ended questions. The discussions were recorded, transcribed and analyzed using standard qualitative techniques. The Health Belief Model framework was applied to understand and evaluate likelihood of promoting health behaviors in this population based on the findings from the focus groups.

RESULTS

We conducted 3 focus groups (N = 25) and themes that emerged were evaluated. Through the Health Belief Model framework, Hispanic taxi driver participants reported demanding and stressful work shifts, barriers to better nutrition and good health, poor support systems, and low self-efficacy in overcoming barriers to improve their risk for CVD, due to lower perceived benefits and greater perceived barriers.

CONCLUSIONS

Inner-city Hispanic NYC taxi drivers have several contributing factors and barriers leading to a poor CVD risk and high body weight profile. Understanding their knowledge, perception and barriers the drivers face in improving their CVD risk, underscores the importance of community outreach programs to develop a framework in empowering and improving the health of this population.

How does financial burden influence the crash rate among taxi drivers? A self-reported questionnaire study in China

Objective: Taxis play an important role in the transportation system of China, but they have a relatively high accident rate. The current study discusses the driver's financial burden in the Chinese context and explores its correlation with working conditions, risky driving behavior, and other characteristics of taxi drivers who are involved in accidents.Method: A total of 2,391 taxi drivers from 29 companies in four Chinese cities were interviewed and then asked to complete a questionnaire concerning their socio-demographic characteristics, working conditions, risky driving behavior, and accident frequency during the previous two years. Given the increase in the management fee (measured in CNY) charged by taxi companies, the drivers were divided into three groups: the "less than 150" group, the" 150 to 180" group and the "over 180" group, where were named Group 1, Group 2 and Group 3, respectively. Finally, the zero-inflated Poisson model was used to investigate the factors that contributed to the accident rate for each group.Result: The significant factors that lead to accidents differed significantly for drivers with different levels of financial burden. First, most of the factors were weakly correlated with the crash rate among Group 1 drivers. Second, many factors related to working conditions and risky driving behavior were significant for drivers in Groups 2 and 3, while working hours and off-duty days were significant only for drivers in Group 3. Third, working hours were negatively correlated with accident rates for drivers in Group 3, and the drivers who suffered from the heaviest financial burden were most affected by fatigue and sleep problems.Conclusion: Financial burden is the root cause behind the propensity of taxi drivers to be involved in accidents. Taxi companies should find ways to reduce drivers' expenses, and new technologies, such as taxi-calling or location and navigation based on mobile applications, should be introduced into the traditional taxi industry.

Phenomenology of being a safe taxi driver

BACKGROUND

In developing countries, a great number of people typically utilize public transportation such as Taxis. Therefore, taxi drivers have an important role in residents' well-being and safety. The aim of this study was to describe the subjective experiences and insights on safe driving among taxi drivers in Zanjan, Iran.

METHOD

In this qualitative study, 17 taxi drivers (23-54 years) were purposefully selected to participate in 11 semi-structured interviews, as well as one focus group (n = 6). The data was then analyzed based on a combination of Braun's and Colaizzi's methods.

RESULT

By analysis of the qualitative data, four main themes emerged from expressed experiences by taxi drivers, including 1) traffic chaos, 2) social prestige, 3) economic pressure, and 3) job satisfaction.

CONCLUSION

The emerging concepts of the present study imply a threefold structure of existence, which introduced by Heidegger, as taxi drivers' (the self) feelings and experiences of being under pressure of traffic chaos (the world), accompanied by low social prestige, economic pressure and job dissatisfaction (being in). Thus, strategic planning for traffic safety should consider taxi drivers' needs to feel a friendly world, as well as, to find themselves in a respectful and supportive environment.

Exposure to traffic air pollutants in taxicabs and acute adverse respiratory effects: A systematic review

INTRODUCTION

Taxi drivers could be at risk regarding their respiratory health due to their constant exposure to traffic related air pollutants (TRAP) inside their vehicles. Therefore, we aimed to review pollutants exposure inside taxi vehicles and its determinants as well as its acute adverse respiratory effects.

METHODS

The literature search was done in Pubmed and in Embase. For additional resources we searched manually articles from the reference lists of the selected papers and from Google Scholar. We included only studies in French or in English language meeting the following eligibility criteria: design: observational and quasi-experimental; study population: taxi drivers or taxi commuters, outcome: pollutants levels in taxicabs and/or acute adverse respiratory effects. Data was extracted using tabulation according to the type of the study (exposure or epidemiological).

RESULTS

Out of 1753 articles, 21 studies were included. Exposure studies underlined that TRAP concentrations inside taxicabs were higher than their urban background levels and even exceeded those recorded in buses, in trains and when commuting by active transport modes. Overall, their concentrations varied widely between studies depending on the characteristics of the urban environment and the vehicle fleet of each location. Meteorological parameters and ventilation settings appeared to influence pollutants concentrations inside each vehicle. Otherwise, deficiency in epidemiological studies and inconsistencies in their findings restrain our ability to determine the association between acute respiratory effects and exposure to TRAP inside taxicabs.

CONCLUSION

Although studies are heterogeneous, results have shown a high but variable occupational exposure of taxi drivers to TRAP inside their vehicles. However, future researches are required to study short respiratory impact of taxi drivers' exposure to TRAP inside their vehicles.

Self-reports of workloads and aberrant driving behaviors as predictors of crash rate among taxi drivers: A cross-sectional study in China

Objective: Taxis provide an important mode of public transport in China, but there has been very little in-depth research on the crash involvement propensity of taxi drivers. Thus, this study was conducted to develop a quantitative model for predicting the crash rate of taxi drivers. Methods: A total of 2,391 taxi drivers from 29 companies in 4 Chinese cities completed a structured and anonymous face-to-face questionnaire reporting their demographic information, workload conditions, aberrant driving behaviors, and crash history within the 2 years prior to the survey. Using the self-reported variables, a negative binomial model was implemented to predict taxi drivers' property damage only (PDO) and personal injury (PI) crash rates and identify the factors contributing to this risk. Results: Descriptive analysis of the survey data revealed that the workload of taxi drivers in China is relatively heavy. Seven significant predictors of PDO and PI crash rates were identified, including crossing red lights, dangerous overtaking, honking at a slow driver, failure to use an indicator lamp, driving while fatigued, stopping in forbidden areas to pick up or drop off a passenger, and driving with one hand. Taxi drivers' average off-duty days per week, aggressive driving behaviors, and preventing another driver from merging had significant effects only on PDO crash rate, and sleep problems were found to be significantly correlated with PI crash rate. Conclusions: To improve the safety of taxi drivers, considerable measures should be strictly implemented, ranging from periodic driver training and safety education to workload reduction, with the cooperation of government agencies and taxi companies. The findings of this study contribute to the design of potentially useful policy initiatives as well as targeted safety promotion programs.

Influence of workplace environment, working conditions and health status of taxi drivers on vehicle collisions or near-miss events

Sudden illness while driving has been identified as a major cause of vehicle collisions, particularly among taxi drivers. However, no previous studies have examined the factors contributing to the occurrence of health-related vehicle collisions. The current study aimed to identify the risk factors causing health-related vehicle collisions among taxi drivers, and to inform preventative interventions. A cross-sectional survey involving a written anonymous questionnaire was conducted for company-employed taxi drivers in Chiba Prefecture, Japan. A total of 1,739 drivers returned questionnaires. Drivers were classified into those who had experienced collisions or near-miss incidents caused by health problems (Event group), and those who had not (Non-event group). According to a multivariable logistic regression analysis, being unable to take vacation time (odds ratio [OR] 4.59, 95% confidence interval [CI] 2.2-9.58), having chronic diseases (OR 1.52, 95% CI 1.02-2.27), taking insufficient vacation time (OR 1.81, 95% CI 1.19-2.79), and difficulty reporting poor health conditions (OR 2.29, 95% CI 1.36-3.87) were significant factors for the likelihood of an event. Support for drivers to maintain well-balanced control of illnesses and improvement of working environments could prevent health-related events while driving.

The relation between working conditions, aberrant driving behaviour and crash propensity among taxi drivers in China

Although the taxi industry is playing an important role in Chinese everyday life, little attention has been posed towards occupational health issues concerning the taxi drivers' working conditions, driving behaviour and road safety. A cross-sectional survey was administered to 1021 taxi drivers from 21 companies in four Chinese cities and collected information about (i) sociodemographic characteristics, (ii) working conditions, (iii) frequency of daily aberrant driving behaviour, and (iv) involvement in property-damage-only (PDO) and personal injury (PI) crashes over the past two years. A hybrid bivariate model of crash involvement was specified: (i) the hybrid part concerned a latent variable model capturing unobserved traits of the taxi drivers; (ii) the bivariate part modelled jointly both types of crashes while capturing unobserved correlation between error terms. The survey answers paint a gloomy picture in terms of workload, as taxi drivers reported averages of 9.4 working hours per day and 6.7 working days per week that amount on average to about 63.0 working hours per week. Moreover, the estimates of the hybrid bivariate model reveal that increasing levels of fatigue, reckless behaviour and aggressive behaviour are positively related to a higher propensity of crash involvement. Lastly, the heavy workload is also positively correlated with the higher propensity of crashing, not only directly as a predictor of crash involvement, but also indirectly as a covariate of fatigue and aberrant driving behaviour. The findings from this study provide insights into potential strategies for preventive education and taxi industry management to improve the working conditions and hence reduce fatigue and road risk for the taxi drivers.

Risky behaviors of taxi drivers in Bandar Abbas, Iran

BACKGROUND AND AIM

It has been revealed that taxi drivers break more traffic rules than ordinary drivers. Such risky behaviors include stopping at prohibited areas and sudden change of direction. The present study aimed to determine the Risky Behaviors of Taxi Drivers in Bandar Abbas, Iran.

METHODS

In this cross-sectional study, 184 taxi drivers were randomly selected from eight taxi stations located at different parts of Bandar Abbas city in 2016. Taxi drivers' risky behaviors were evaluated via a 20-item questionnaire. Data were analyzed by SPSS version 19, using descriptive statistics and independent-samples t-test. The p-values less than 0.05 were considered as statistically significant.

RESULTS

The mean age of the drivers was 45.1 (±11.1) years. The mean of their occupational experience was 18.7 (±10.8) years. The risky behaviors which showed the highest frequency were respectively, failure to use signal-lights, driving too close to the cars in front, refusing to drive within the lanes and erratic lane changing.The lowest frequency belonged to running a red light, ignoring 'no entry' signs and taking illegal U-turns. Risky driving behaviors were shown to be significantly more prevalent among drivers with previous experience of crashes or tickets than drivers with no such experiences (p<0.01).

CONCLUSION

Increasing the role of police supervision for the strict implementation of driving laws, and modification of the drivers' behavior and implementation of periodic training programs on drivers' safety issues can be considered for reducing taxi drivers' unsafe behaviors.

Discrimination and Health Among Taxi Drivers in New York and Toronto

Immigrant taxi drivers in metropolitan cities are exposed to experiences of discrimination and occupation-based health risks. Given the structural differences in health care systems in the United States and Canada, we investigated the differences in reports of discrimination, health conditions and concern about health conditions between taxi drivers in New York City and Toronto, Ontario. Participants were recruited for a taxi driver Needs Assessment Survey as part of a Taxi Network needs assessment project using a street side convenience sampling technique in New York City and Toronto. The matched sample contained 33 drivers from Toronto and 33 drivers from NYC. All Toronto drivers in our sample reported having health insurance while over a quarter of NYC drivers did not have health insurance. Toronto drivers reported greater everyday and workplace discrimination. Drivers in both cities experienced higher rates than average, and reported concern about, major health conditions. We also found preliminary evidence suggesting a relationship between experiencing discrimination and reporting chronic pain. Our findings suggest the need for future research to more closely examine the associations between discrimination and health among the taxi driver population.

Step On It! Workplace Cardiovascular Risk Assessment of New York City Yellow Taxi Drivers

Multiple factors associated with taxi driving can increase the risk of cardiovascular disease (CVD) in taxi drivers. This paper describes the results of Step On It!, which assessed CVD risk factors among New York City taxi drivers at John F. Kennedy International Airport. Drivers completed an intake questionnaire and free screenings for blood pressure, glucose and body mass index (BMI). 466 drivers participated. 9 % had random plasma glucose values >200 mg/dl. 77 % had elevated BMIs. Immigrants who lived in the US for >10 years had 2.5 times the odds (CI 1.1-5.9) of having high blood pressure compared to newer immigrants. Abnormalities documented in this study were significant, especially for immigrants with greater duration of residence in the US, and underscore the potential for elevated CVD risk in this vulnerable population, and the need to address this risk through frameworks that utilize multiple levels of intervention.

Association between inflammation processes, DNA damage, and exposure to environmental pollutants

Environmental exposure to pollutants, especially polycyclic aromatic hydrocarbons (PAHs), could lead to carcinogenesis development. However, there is a gap on the mechanisms involved in this effect. Therefore, the aim of this study was to investigate the potential relationship between exposure to environmental air pollution and inflammation process in DNA damage in taxi drivers. This study included 45 taxi drivers and 40 controls; non-smokers composed both groups. Biological monitoring was performed through quantification of urinary 1-hydroxypyrene (1-OHP). ICAM-1 (CD54) expression, NTPDase activity, inflammatory cytokine (IL-1β, IL-6, IL-10, TNF-α and IFN-γ) levels, and comet and micronucleus assays were evaluated. The results demonstrated that 1-OHP levels, ICAM-1 expression, NTPDase activity, and DNA damage biomarkers (% tail DNA and micronucleus frequency) were increased in taxi drivers compared to the control group (p < 0.01). Moreover, significant associations were found between 1-OHP levels and ICAM-1 expression, % tail DNA, and micronucleus frequency (p < 0.05). Besides, pro-inflammatory cytokine levels were positively correlated to % tail DNA and micronucleus frequency (p < 0.001). Our findings suggest an important association between environmental exposure to air pollution with increase of ICAM-1 expression and NTPDase activity in taxi drivers. Additionally, the multiple regression linear-analysis demonstrated association between IL-6 and DNA damage. Thus, the present study has provided important evidence that, in addition to environmental exposure to air pollutants, the inflammation process may contribute to DNA damage.

Lifestyle risk factors for cardiovascular disease and diabetic risk in a sedentary occupational group: the Galway taxi driver study

BACKGROUND

Taxi drivers are at increased risk of cardiovascular disease (CVD), something which persists after correcting for the overrepresentation of traditional risk factors for CVD in this cohort. The contribution of lifestyle risk factors to this residually elevated CVD risk remains under-evaluated.

AIMS

We aimed to determine the prevalence of lifestyle risk factors for CVD, self-reported medical risk factors for CVD, and future risk of type 2 diabetes amongst Irish taxi drivers.

METHODS

Male taxi drivers with no history of CVD and type 2 diabetes and working in Galway city in the west of Ireland were invited to participate. Physical activity levels, dietary patterns, anthropometry, smoking, hypertension, hypercholesterolaemia, and Finnish Diabetes Risk Score (FINDRISC) values were recorded in a cross-sectional manner.

RESULTS

41 taxi drivers (mean age 56.7 ± 9.8 years) participated. 37 % were insufficiently active based on self-report, although only 8 % objectively achieved 10, 000 steps per day. Mean modified Mediterranean diet score (mMDS) was 4.6 ± 2.2, and only 13 % of participants had a normal body mass index (BMI) or waist circumference (WC). Those who worked for taxi companies tended to have a higher BMI (p = .07) and WC (p = .04) by multivariable regression. 22 % were current smokers, although a quit rate of 72 % was observed amongst the 78 % of taxi drivers who had ever smoked. 25 % were at high or very high risk of future type 2 diabetes.

CONCLUSION

Lifestyle risk factors for CVD and dysglycaemia are prevalent amongst Irish taxi drivers.

Designing Fatigue Warning Systems: The perspective of professional drivers

Professional drivers have been characterized as experiencing heavy fatigue resulting from long driving time in their daily work. This study aimed to explore the potential demand of Fatigue Warning Systems (FWSs) among professional drivers as a means of reducing the danger of fatigue driving and to examine their opinions regarding the design of FWSs. Six focus groups with 35 participants and a questionnaire survey with 600 respondents were conducted among Chinese truck and taxi drivers to collect qualitative and quantitative data concerning the current situation of fatigue driving and opinions regarding the design of FWSs. The results revealed that both truck and taxi drivers had a positive attitude toward FWSs, and they hoped this system could not only monitor and warn them regarding their fatigue but also somewhat relieve their fatigue before they could stop and rest. As for warning signals, participants preferred auditory warnings, as opposed to visual, vibrotactile or electric stimuli. Interestingly, it was proposed that verbal warnings involving the information regarding consequences of fatigue driving or the wishes of drivers' family members would be more effective. Additionally, different warning patterns, including graded, single and continuous warnings, were discussed in the focus group. Finally, the participants proposed many other suggestions, as well as their concerns regarding FWSs, which will provide valuable information for companies who wish to develop FWSs for professional drivers.

New York City Taxi Drivers' Knowledge and Perceptions of the Affordable Care Act

This study was conducted to assess New York City taxi drivers' knowledge and perceptions of the Affordable Care Act (ACA). A cross-sectional street-intercept study design was used to assess drivers' knowledge about the ACA. A 146-item questionnaire was administered from September 12 to December 6, 2013 to 175 yellow taxi and for-hire vehicle drivers. 91 % of drivers were foreign-born; 50 % were uninsured. Mean knowledge about the ACA was quite low; 78 % of the sample either knew nothing or only a little bit about the ACA. 77 % wanted more information about the ACA. Greater English proficiency, more years driving a taxi, and knowledge of having or not having a pre-existing health condition (vs. not knowing) were related to higher ACA knowledge levels. Knowledge of a pre-existing condition (whether they had one or not) compared to those who lacked such knowledge was also an important predictor of the perception of whether the ACA would have a positive impact. To facilitate enrollment, efforts should focus on occupationally-focused initiatives that educate drivers at their places of work and leisure, to raise the overall knowledge levels and enrollment of the community.

Evaluation of chromosomal aberrations caused by air pollutants in some taxi drivers from two polluted districts of urban Tehran and its comparison with drivers from rural areas of Lahijan: a pilot study

BACKGROUND

Chromosome instability is the most common form of genomic instability. Genomic instability can lead to tumorogenesis. High level of chromosomal aberrations in peripheral blood lymphocytes can be used as a biomarker for cancer. Air pollution is one of the most important factors that cause chromosomal instability (CIN). In this comparative study we used classic Cytogenetic technique to analyze the effects of air pollutants on chromosome stability. We collected peripheral blood from 30 taxi drivers of two polluted districts (districts 6 and 7) in Tehran and 30 taxi drivers from rural areas of Lahijan, north of Iran.

RESULTS

Comparison of the level of chromosome breakage in the two groups showed an increased level of chromosome breakage in the drivers from polluted districts of Tehran, although not significant, using Fisher exact test (p-value = 0.300). However, the overall chromosome aberration rate (including both chromosome and chromatid gaps), the difference was significant using Chi-square test (p-value = 0.012).

CONCLUSION

An increased level of chromosome aberration was present in the drivers from polluted districts of Tehran compared to drivers from non-polluted areas in Lahijan.

Biomarkers of occupational exposure to air pollution, inflammation and oxidative damage in taxi drivers

Exposure to environmental pollutants has been recognised as a risk factor for cardiovascular events. 1-hydroxypyrene (1-OHP) is a biomarker of exposure to polycyclic aromatic hydrocarbons (PAHs) from traffic-related air pollution. Experimental studies indicate that PAH exposure could be associated with inflammation and atherogenesis. Thus, the purpose of this study was to evaluate whether the biomarker of PAH exposure is associated with biomarkers of inflammation and oxidative stress and if these effects modulate the risk of developing cardiovascular diseases in workers exposed to air pollution. This study included 60 subjects, comprising 39 taxi drivers and 21 non-occupationally exposed persons. Environmental PM2.5 and benzo[a]pyrene (BaP) levels, in addition to biomarkers of exposure and oxidative damage, were determined. Inflammatory cytokines (IL-1β, IL-6, IL-10, TNF-α, IFN-γ and hs-CRP) and serum levels of oxidised LDL (ox-LDL), auto-antibodies (ox-LDL-Ab) and homocysteine (Hcy) were also evaluated. PM2.5 and BaP exhibited averages of 12.4±6.9 μg m(-3) and 1.0±0.6 ng m(-3), respectively. Urinary 1-OHP levels were increased in taxi drivers compared to the non-occupationally exposed subjects (p<0.05) and were positively correlated with pro-inflammatory cytokines and negatively correlated with antioxidants. Furthermore, taxi drivers had elevated pro-inflammatory cytokines, biomarkers of oxidative damage, and ox-LDL, ox-LDL-Ab and Hcy levels, although antioxidant enzymes were decreased compared to the non-occupationally exposed subjects (p<0.05). In summary, our findings indicate that taxi drivers showed major exposure to pollutants, such as PAHs, in relation to non-occupationally exposed subjects. This finding was associated with higher inflammatory biomarkers and Hcy, which represent important predictors for cardiovascular events. These data suggest a contribution of PAHs to cardiovascular diseases upon occupational exposure.