Cardiovascular Risk Factors 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.

Cardiovascular risk factors among train drivers, Mansoura, Egypt

Cardiovascular risk factors and diseases are the most prevalent health conditions in train drivers. A comparative cross-sectional study was carried out to estimate the prevalence of some cardiovascular risk factors among train drivers. A pre-designed questionnaire was used to collect socio-demographic and occupational data. Physical activity and dietary habits were assessed, psychological distress was measured. Out of 100 recruited train drivers, 62% had obesity, 46% were hypertensive, 72.8% had dyslipidemia, and 71% had mild and/or moderate level of psychological distress. Being a train driver is independently associated with the likelihood of having obesity (AOR = 14.2) and psychological distress (AOR = 6.6). The prevalence of various cardiovascular risk factors was significantly higher among train drivers than the comparison group. Being a train driver is independently associated with obesity and psychological distress.

Acute-on-Chronic Pattern of Isolated Upper Back Pain in a Patient With Acute Coronary Syndrome

The aim of this case report is to describe the diagnostic pitfalls of acute coronary syndrome in patients with relatively atypical presentation and how we can prevent diagnostic errors in such a patient, particularly focusing on occupational information. A 66-year-old male, a professional taxi driver, presented with severely deteriorated chronic upper back pain on the left side. Furthermore, the upper back pain was exacerbated by changes in position. An orthopedist examined the patient and arrived at a provisional diagnosis of musculoskeletal pain. However, as the patient was concerned about his cardiopulmonary diseases, he visited another physician. Although musculoskeletal pain was still considered as the most possible diagnosis, the physician advised him additional tests for cardiovascular diseases because he had some risk factors such as smoking, hypertension, and dyslipidemia, and the physician thought that "taxi driving" was a high-risk occupation for cardiovascular diseases. Finally, the patient was diagnosed with acute coronary syndrome, and the pain abated soon after percutaneous coronary intervention. Musculoskeletal pain is very common in professional drivers, and isolated upper back pain worsened by changes in position is a characteristic of musculoskeletal disease. However, since professional drivers also have a higher risk of cardiovascular diseases, physicians should consider the coexistence of two types of conditions. This case underscores that if physicians could utilize occupational information to assess patients' risks, diagnostic accuracy would improve, particularly in patients presenting with atypical symptoms and signs, which are at risk of diagnostic errors.

Co-Design of an eHealth Intervention to Reduce Cardiovascular Disease Risk in Male Taxi Drivers: ManGuard

Taxi driving, a male-dominated occupation, is associated with an increased risk of cardiovascular disease (CVD). The increased risk is linked to a high prevalence of modifiable CVD risk factors including overweight/obesity, poor nutrition, smoking, excessive alcohol consumption and physical inactivity. Behaviour change interventions may prove advantageous, yet little research has been conducted to reduce CVD risk in this population. The purpose of this study was to co-design an eHealth intervention, 'ManGuard', to reduce CVD risk in male taxi drivers. The IDEAS framework was utilised to guide the development of the eHealth intervention, with the Behaviour Change Wheel (BCW) incorporated throughout to ensure the intervention was underpinned by behaviour change theory. Development and refinement of ManGuard was guided by current literature, input from a multidisciplinary team, an online survey, a systematic review and meta-analysis, and focus groups (n = 3) with male taxi drivers. Physical inactivity was identified as the prime behavior to change in order to reduce CVD risk in male taxi drivers. Male taxi drivers indicated a preference for an eHealth intervention to be delivered using smartphone technology, with a simple design, providing concise, straightforward, and relatable content, and with the ability to track and monitor progress.

An eHealth intervention (ManGuard) to reduce cardiovascular disease risk in male taxi drivers: protocol for a feasibility randomised controlled trial

Background

Men are at higher risk then women of developing cardiovascular disease (CVD), and male taxi drivers are a particularly high-risk group because of their typically unhealthy behaviours, such as poor eating habits, smoking and sedentary lifestyle. However, only two studies of behavioural interventions targeting taxi drivers have been identified, one of which reported a high attrition rate. Therefore, an eHealth intervention co-designed by taxi drivers may prove more acceptable and effective. The aim of this study is to assess the feasibility an eHealth intervention (ManGuard) to reduce CVD risk in male taxi drivers.

Methods

A randomised wait-list controlled trial will be conducted with a sample of 30 male taxi drivers to establish feasibility, including recruitment, engagement, and retention rates. Program usability and participant satisfaction will be assessed by a survey completed by all participants at 3 months after allocation. Additionally, an in-depth qualitative process evaluation to explore acceptability of the intervention will be conducted with a subset of participants by semi-structured telephone interviews. Preliminary efficacy of ManGuard for improving key CVD-related outcomes will be assessed, including biomarkers (total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, and total/HDL cholesterol ratio), blood pressure, anthropometry (body mass index, body fat percentage, and waist circumference), physical activity (accelerometery, and self-report) and psychosocial status (health-related quality of life, self-efficacy, and social support). Outcomes will be assessed at baseline, 7 weeks, and 3 months after group allocation. The wait-list control group will be offered access to the intervention at the completion of data collection.

Discussion

eHealth interventions show potential for promoting behaviour change and reducing CVD risk in men, yet there remains a paucity of robust evidence pertaining to male taxi drivers, classified as a high-risk group. This study uses a randomised controlled trial to assess the feasibility of ManGuard for reducing CVD risk in male taxi drivers. It is envisaged that this study will inform a fully powered trial that will determine the effectiveness of eHealth interventions for this high risk and underserved population.

Trial registration

This trial has been registered prospectively on the ISRCTN registry on 5 January 2022, registration number ISRCTN29693943

Supplementary Information

The online version contains supplementary material available at 10.1186/s40814-022-01163-4.

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.

Low back pain and risk factors among Taxi drivers in Turkey: a cross-sectional study

BACKGROUND

Taxi drivers have an increased risk of low back pain due to both physical and occupational conditions. This study aims to determine the prevalence of low back pain and occupational risk factors among taxi drivers working in İzmir, Turkey.

METHODS

This study was conducted with 447 taxi drivers at randomly selected taxi stands between April and September 2021. The questionnaire included demographic, individual, and work-related questions; the Nordic Musculoskeletal Questionnaire; and the Back Pain Functional Scale (BPFS).

RESULTS

The prevalence of low back pain in the last year was 49.7%. In multivariate logistic regression analyses, the risk factors for low back pain included having a body mass index of 25-29.9 kg/m2 (OR= 1.67, 95% CI 1.01-2.76) or ≥30 kg/m2 (OR= 2.15, %95 CI 1.19-3.87), no physical activity (OR= 1.66, 95% CI 1.06-2.62), years of work >10 (OR= 3.23, 95% CI 1.89-5.53), no weekly rest period (OR= 3.11, 95% CI 1.42-6.81), having no lumbar support on the driver's seat (OR:1.67, 95% CI:1.05-2.66), or undecisive job satisfaction (OR= 2.07, 95% CI 1.17-3.66). Being undecided about job satisfaction (OR= 2.34, 95% CI 1.15-4.92) and not having physical activity (OR= 2.10 CI 1.08-4.08) were found to be risk factors for reduced BPFS scores.

CONCLUSION

A strong correlation was found between the frequency of low back pain and the BPFS score and occupational factors. Early detection and management of low back pain are critical to avoid increased low back pain and related injuries among taxi drivers.

Factors Affecting the Deterioration of the Physical Health Status of Taxi Drivers by Age Group

With the rapidly aging population, taxi drivers are aging at a fast pace, and competition in the taxi industry is intensifying due to the emergence of various transportation platforms. A descriptive secondary data study was conducted (on a total of 936 subjects) to determine the factors affecting the deterioration of taxi drivers’ physical health status (PHS) according to their age group. The increased incidence of chronic diseases and cognitive decline among taxi drivers aged 55−64 years had the greatest influence on the deterioration of their PHS. Driver obesity was more likely to be related to deterioration of the PHS in the drivers aged 55−64 years (OR: 2.459, <0.001) and 35−54 years (OR: 2.133, <0.001). Among the financial factors, a driver’s income and their number of dependent family members were correlated with the deterioration of the PHS for drivers aged 55 years or over. Therefore, chronic diseases, obesity and cognitive decline were related with deterioration of the physical health status. This suggests that attention should be paid to healthcare policies not only for the elderly aged over 65 years but also those aged 50 to 64 years, i.e., middle-aged people at the beginning of the transition to old age.

Health Insurance and Primary Care Access for Taxi/FHV Drivers in New York City: Trends from 2015-2018

There are hundreds of thousands of metropolitan United States taxi and for-hire vehicle (FHV) drivers who lack health insurance and have limited access to primary care. The Affordable Care Act provided increased opportunities for insurance coverage. The current study used a 1,864 person 2015-2018 NYC taxi/FHV driver dataset, which included health insurance coverage and primary care access information. The data revealed an increase in insurance coverage and primary care uptake across the four years, from 40% to 63% and 52% to 60%, respectively. Drivers' age, region of birth, and hours driving per week predicted insurance coverage, and drivers' age, region of birth, hours driving per week, and insurance status predicted primary care coverage. Recommendations for addressing the pervasive low rates of insurance and primary care coverage among this understudied marginalized population are presented.

Predictors of Limited Access to Dental Health Care Among NYC Taxi/FHV Drivers

Taxi and for-hire vehicle (FHV) drivers are a largely immigrant, low-income occupational group at increased cardiovascular disease (CVD) risk. Poor dental health is a CVD risk factor, and dental care access is an unexamined taxi/FHV driver CVD risk factor. A cross-sectional survey was administered to 422 taxi/FHV drivers (2016-2017) to identify predictors of access to dental health care among drivers. One-third (n = 128, 30.3%) reported needing dental care/tests/treatment within the past six months, and nearly one-half (n = 61, 48%) were delayed/unable to obtain care. Only 57.6% (n = 241) had past-year dental cleanings. Not having enough money to cover household expenses was a significant predictor of being delayed/unable to obtain needed dental care/tests/treatment in the prior six months (0.5 OR; 95% CI, 0.28-0.89; p < .05). Lack of dental insurance coverage (2.72 OR; 95% CI, 1.60-4.63; p < .001) or lack of primary care provider (2.72 OR; 95% CI, 1.60-4.63; p < .001) were associated with lack of past-year dental cleaning. Seventeen percent of drivers with Medicaid were unaware of their dental coverage, which was associated with both inability to access needed dental care/tests/treatment in the past 6 months (p = .026) and no past-year dental cleaning (p < .001). Limited understanding of dental coverage was associated with both an inability to access needed dental care/tests/treatment in the past 6 months (p = .028) and lack of past-year dental cleaning (p = .014). Our findings can inform targeted intervention development to increase taxi/FHV driver dental care access/uptake, potentially improving their CVD risk.

Comparison of Physical, Occupational, and Sociocognitive Characteristics of Corporate and Private Taxi Drivers in Korea

Taxis are a form of public transport which is very closely related to the safety of the public. Although private and corporate taxis have quite different characteristics, there have only been a few studies comparing the characteristics of corporate and private taxis. Moreover, among various characteristics, research was conducted mainly focusing on occupational characteristics. This study was undertaken to compare various physical, occupational, and sociocognitive characteristics of corporate and private taxi drivers. A descriptive cross-sectional study was conducted from 22 August to 11 September 2018. The subjects of this study were 960 corporate and private taxi drivers over 30 years old in Seoul to compare the means and association between private and corporate taxi drivers’ characteristics. In terms of the physical characteristics, corporate taxi drivers’ general physical health status was worse. In terms of the occupational characteristics, corporate taxi drivers had a high working intensity, and the incidence rate of traffic accidents and near misses was also high. This comparison of the characteristics of corporate and private taxis is expected to serve as evidence for developing tailored policies and programs to improve the health of corporate and private taxi drivers.

Cardiovascular health status of taxi/for-hire vehicle drivers in the United States: A systematic review

BACKGROUND

Taxi/for-hire vehicle (FHV) drivers are a predominantly immigrant, male, and growing population in large, metropolitan cities in the U.S. at risk for cardiovascular conditions.

OBJECTIVE

This review sought to systematically investigate the literature given mounting evidence of poor taxi/FHV driver health.

METHODS

A systematic search of peer-reviewed journal articles that included a range of cardiovascular risks and conditions among taxi/FHV drivers in the U.S. was conducted.

RESULTS

8800 journal articles were initially found. 14 eligible articles were included: 3 mixed methods articles, 1 qualitative article, and 10 quantitative articles. Articles spanned 13 cardiovascular risks and conditions, including tobacco, nutrition, physical activity, stress, depression, body mass index/waist circumference, cholesterol, blood glucose/diabetes, air pollution, sleep, blood pressure/hypertension, heart disease, and stroke. The majority of studies were cross-sectional and utilized convenience samples.

CONCLUSIONS

Rigorous and high quality research is needed to further investigate rates of cardiovascular health in this population. The complexity of data collection in this group presents challenges to this endeavor. The high prevalence of poor nutrition, limited physical activity, diabetes, and blood pressure across studies indicates an urgent need to address low rates of health care access at a policy level and to design targeted workplace interventions.

Taxi drivers and modifiable health behaviors: Is stress associated?

BACKGROUND

Taxi drivers, an immigrant male population, may exhibit poor health behaviors and increased health risks.

OBJECTIVE

The current study examined stress and demographics as predictors of physical activity (PA), nutrition, sleep, and smoking, and the co-occurrence of these behaviors among taxi drivers.

METHODS

A cross-sectional needs assessment was conducted in New York City. The sample (n = 252) was comprised of male taxi drivers, 98%of whom were born outside of the U.S., with the majority from South Asian countries (62%), and 45 years old on average (SD = 11).

RESULTS

We found low rates of fruit/vegetable consumption and PA. Rates of stress, PA, and smoking varied by demographic factors. Stress was positively associated with sleep disturbances and negatively associated with smoking. Aside from a relationship between sugar consumption and smoking, other health behaviors were not associated.

CONCLUSIONS

While stress appears to impact some indicators of modifiable health behaviors, its lack of relationship with others points to more persistent health issues. Demographic differences found for PA and smoking also point to groups that may especially benefit from interventions. These findings suggest the need for targeted health interventions for taxi drivers in large metropolitan cities.

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.

The impact of working conditions on the health of taxi drivers in an urban metropolis

Purpose

This descriptive qualitative study explores how working conditions impact the health of taxi drivers in Toronto, Canada.

Design/methodology/approach

Drivers were recruited between September 2016 and March 2017. A total of 14 semi-structured qualitative interviews and one focus group (n = 11) were conducted. Transcripts were analyzed inductively through a socioecological lens.

Findings

The findings of this study are as follows: drivers acknowledged that job precariousness (represented by unstable employment, long hours and low wages) and challenging workplace conditions (sitting all day and limited breaks) contribute to poor physical/mental health. Also, these conditions undermine opportunities to engage in health-protective behaviors (healthy eating, regularly exercising and taking breaks). Drivers do not receive health-enabling reinforcements from religious/cultural networks, colleagues or their taxi brokerage. Drivers do seek support from their primary care providers and family for their physical health but remain discreet about their mental health.

Research limitations/implications

As this study relied on a convenience sample, the sample did not represent all Toronto taxi drivers. All interviews were completed in English and all drivers were male, thus limiting commentary on other experiences and any gender differences in health management approaches among drivers.

Practical implications

Given the global ubiquity of taxi driving and an evolving workplace environment characterized by growing competition, findings are generalizable across settings and may resonate with other precarious professions, including long-haul truck operators and Uber/Lyft drivers. Findings also expose areas for targeted intervention outside the workplace setting.

Originality/value

Health management among taxi drivers is understudied. A fulsome, socioecological understanding of how working conditions (both within and outside the workplace) impact their health is essential in developing targeted interventions to improve health outcomes.

Discrimination as a social determinant of stress and health among New York City taxi drivers

Discrimination is associated with poorer mental and physical health outcomes. Taxi drivers have a higher risk of exposure to discrimination and higher rates of chronic conditions. A cross-sectional needs assessment was conducted with a multilingual group of 535 male taxi drivers in New York City. Drivers reporting higher discrimination were more likely to have higher perceived stress and were more likely to have anxiety/depression and chronic pain, adjusting for confounders. Workplace-based interventions designed to help drivers cope with discrimination, stress, and chronic health conditions, interventions to educate the taxi-riding public, and greater attention to these issues from administrative agencies are warranted.

Lurking in plain sight: Hypertension awareness and treatment among New York City taxi/for-hire vehicle drivers

Hypertension is a risk factor for cardiovascular disease, which is the leading cause of death in the United States. Taxi and for-hire vehicle (FHV) drivers, a largely male, immigrant and medically underserved population, are at increased risk of cardiovascular disease, in part due to the nature of their work. This study examined demographic and lifestyle predictors of hypertension diagnosis awareness, objectively measured blood pressure (hypertensive-range vs non-hypertensive-range readings), medication use, and hypertension control. A cross-sectional assessment was conducted with 983 male taxi/FHV drivers who attended health fairs in New York City from 2010 to 2017. Twenty-three percent self-reported a hypertension history and 46% had hypertensive-range BP readings. Approximately, half the drivers lacked health insurance (47%) and a usual care source (46%). Thirty percent did not self-report hypertension and had hypertensive-range BP readings. Medication use was reported by 69% of hypertension-aware drivers, and being older and having health care access (insurance, a usual care source, and seeing a doctor in the past year) was significantly associated with medication use. Hypertension-unaware drivers with hypertensive-range BP readings were less likely to have a usual care source. Over 60% of drivers who were hypertension-aware and on medication had hypertensive-range readings. There is a need for community-based and workplace driver and provider interventions to address BP awareness and management and to provide health care navigation for vulnerable populations such as taxi/FHV vehicle drivers.

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.

[Development and Effects of Smartphone App-Based Walking Exercise Program for Taxi Drivers: Based on Bandura's Self Efficacy Theory]

PURPOSE

The purpose of this study was to examine the effects of smart-phone app-based walking exercise programs for taxi drivers on self-efficacy and outcome expectations for exercise, health-related quality of life, walking as an exercise, and physiological indexes.

METHODS

A nonequivalent control group with a pre-post-test design was used. The subjects were recruited in G metropolitan city. Subjects were assigned to the experimental (n=31) or control groups (n=30). The smart phone app-based walking exercise program consisted of educations via the app, twelve short message services, and one individual telephone counseling session, which was spread over 12 weeks.

RESULTS

Self-efficacy, outcome expectations, and health-related quality of life had significantly higher pre-post test differences in scores in the experimental group. Additionally, blood pressure, body mass index, and waist circumference had significantly decreased pre-post-test difference levels in the experimental group. Walking as an exercise (which consisted of days walked, number of steps walked, and amount of time walked) had significantly increased in the experimental group after 7~12 weeks in the period following the intervention program rather than 1~6 weeks after the program.

CONCLUSION

The smart phone app-based walking exercise program based on the self-efficacy theory demonstrates a significant effect on improving self-efficacy, outcome expectations physical activities, and health-related quality of life for taxi drivers. Therefore, it is recommended to actively use the program as a tool to promote self-efficacy, physical activities, and health behaviors in taxi drivers.

Relationships between Body Mass Index and Self-Reported Motorcycle Crashes in Vietnam

The relationship between overweight, obesity, or body mass index (BMI) and crashes among drivers of passenger cars, vans, and trucks has been the focus of much research. However, little is understood about this relationship among motorcyclists, particularly motorcycle taxi drivers who tend to work long hours. Motorcycle taxis are an increasingly popular and important mode of travel in many cities, especially in South-East Asia, due partly to the rise of ride-hailing services. This paper assesses the body mass index (BMI) of motorcycle taxi drivers in Vietnam and its impacts on crashes among three types of drivers (traditional, ride-hailing, and hybrid). Data from a structured questionnaire survey of motorcycle taxi drivers conducted in Hanoi, Vietnam were used. Results show that 18.8% of motorcycle taxi drivers were overweight or obese whereas only 1.4% were underweight. Fulltime motorcycle taxi drivers were more likely to be overweight or obese. Results of random effect binary logistic regression show that overweight and obese motorcycle taxi drivers had significantly higher overall and injury crash risks, when compared to normal-weight motorcycle taxi drivers. Results also indicate that hybrid motorcycle taxi drivers had lower overall and injury crash risks when compared to traditional motorcycle taxi drivers.

"Always on the go": A qualitative study of the perceptions of cardiovascular disease risk among Latino cab drivers

BACKGROUND

The taxicab industry is a burgeoning occupation that predominantly employs immigrant males from low socioeconomic backgrounds. Factors such as sedentary nature, environmental factors, high stress coupled with socioeconomic factors may increase cardiovascular disease risk among taxicab drivers. Latinos, a growing immigrant population make up approximately 20% of this industry. However, few studies focus on their experiences as cab drivers or on the factors that may increase their cardiovascular risks.

METHODS

This was an ethnographic qualitative study. Data was collected via individual interviews combined with Go-Alongs. The Go-Along is an observational qualitative method whereby researchers accompany participants during routine activities and make observations. Interviews and observations were transcribed and coded to identify emerging themes.

RESULTS

Thirty-two Latino male cab drivers participated; their mean age was 45 + 12 years; 47% did not finish high school; and 63% earned $30 000 or less. Time and stress emerged as dominant themes. Time constraints posed a barrier to healthy eating and physical activity. Drivers reported stress from constantly worrying about their finances and personal safety. Drivers also described stress from the physical toll of driving on the body. Go-Alongs supported these themes and identified social interactions and environmental factors that could be leveraged for health promotion.

CONCLUSIONS

This study provided an opportunity for cab drivers to describe their perspectives on reasons why their occupation was associated with a high risk for cardiovascular disease. The Go-Alongs contributed to the understanding of the social and environmental context that characterized cardiovascular risks in this occupation.

Associations between daily-on-the job hassles with perceived mental exertion and depression symptoms in taxi drivers

INTRODUCTION

Taxi drivers experience frequent hassles that may contribute to mental exertion and depression symptoms.

AIM

Mental exertion and depression symptoms in taxi drivers are explored in association with hassles, effort-reward imbalance, job strain, and iso-strain.

METHODS

Personal interviews were conducted with 130 drivers in San Francisco.

RESULTS

Mental exertion averaged 4.5 (±2.68) and physical exertion averaged 3.71 (±2.1) on 0 to 10 Borg scales. Based on the Center for Epidemiological Studies-Depression scale, 38% had depression symptoms. Mental exertion and depression symptoms correlated with job strain, iso-strain and effort-reward imbalance in anticipated directions, lending construct validity to the Borg mental exertion scale. Physical exertion, night shift, stressful personal events, and being uninsured for healthcare predicted mental exertion. Lack of respect by dispatchers and stressful personal events predicted depression symptoms.

CONCLUSION

Selected hassles may be remedied by communication trainings, emphasizing mutual respect. Recognition and treatment of depression in taxi drivers are important.

Medical conditions and driving fitness of older Singaporean taxi drivers

BACKGROUND

Taxi driving has been associated with the risk of various diseases (e.g. cardiovascular disease, hypertension, diabetes, hyperlipaemia, back pain). Little is known about the relationship between health conditions and driving fitness of older taxi drivers who continue to work.

AIMS

To investigate the (i) prevalence of medical conditions and (ii) relationship between age and medical conditions, with on-road driving tests in the relicensing process of older taxi drivers aged ≥70 years, prior to the mandatory retirement age of 75 years.

METHODS

We analysed retrospectively all relicensing records (N = 855) of taxi drivers aged 70, 73 and 74 years that were submitted from April 2014 to April 2015.

RESULTS

All passed their medical fitness screening. Ninety-eight per cent passed their driving tests. Thirty-one per cent, 36% and 24% reported none, one and two medical conditions, respectively. These included hypertension (56%), eye disease (25%; cataracts 19%), diabetes (24%), corrected hearing impairment (14%), hyperlipaemia (12%) and heart disease (9%). Deafness (P < 0.001) was associated with older age. No past medical condition affected driving outcome.

CONCLUSION

Older Singaporean taxi drivers were healthy and generally competent drivers. Early effective preventive health screening and modifiable lifestyle intervention are recommended in older taxi drivers.

A Cross-Sectional Study of Prevalence of Depression, Anxiety and Stress among Professional Cab Drivers in New Delhi

Background

The profession of drivers is one of the occupational groups exposed to very poor working conditions. This study aimed to establish the prevalence of depression, anxiety and stress among cab drivers.

Materials and Methods

This cross-sectional study included 134 cab drivers. Their mental health status was assessed with the help of a screening tool - Depression Anxiety Stress Scale (DASS-21). Their demographic details, working conditions, lifestyle factors and use of habit-forming substances were also assessed with the help of a semi-structured questionnaire.

Results

It was revealed that all cab drivers were male and between 20 to 64 years of age. Eighty two (62%) drivers said they are sometimes irritated at work, 29 (21.5%) said they feel irritated daily and rest 23 (17.2%) said that they were never irritated at work. When screened for depression, anxiety and stress, it was found out that 81 (60.5%) were suffering from depression, 63 (47%) from anxiety and 49 (36.5%) had variable degree of stress.

Conclusion

Cab drivers are at high risk of acquiring mental health diseases, yet the mental health of this large workforce is ignored.

Psychological distress and unmet mental health needs among urban taxi drivers: A cross-sectional survey

OBJECTIVES

The taxi industry relies on a male-dominated, predominately immigrant workforce who face multiple risk factors for poor mental health including shift work, low pay and threats of violence. Despite these risk factors, no previous study has documented the prevalence of psychological distress in the taxi industry. We investigated psychological distress among urban taxi drivers and explored the factors associated with high levels of distress.

METHOD

A total of 380 taxi drivers were surveyed at the Melbourne Airport holding yard between September 2016 and March 2017. Psychological distress was measured using the K10. Logistic regression models were used to estimate the association between high levels of psychological distress and migration, work patterns, potentially traumatic events, health care use and social connectedness.

RESULTS

A third (33%) of drivers had very high (K10 ⩾ 30) levels of distress and 28% had high (K10 = 22-29) levels of distress. Trauma was significantly associated with high levels of psychological distress, and rates of trauma were much higher among drivers than among the Australian population. Despite high levels of distress, drivers were no more likely than other Australian men to visit a health professional.

CONCLUSION

Urban taxi drivers are at very high risk for mental health problems, yet the mental health needs of this largely immigrant workforce has gone largely unnoticed. Interventions tailored to the unique characteristics of the job and the demographic composition of the workforce are urgently needed.

Can Periodical Examinations of Employees Be Useful in Detection of Glycaemia Impairment and Improving Patients' Adherence to Medical Recommendations?

Worldwide epidemiological data indicates insufficient diagnosis of diabetes as an increasing public health problem. In the search for solutions to this disadvantageous situation, occupational medicine health services seem to open up a unique opportunity to recognize some abnormalities in the early stages, especially among the asymptomatic working-age population. 316 workers underwent obligatory prophylactic examinations. In patients with twice assayed FGL ≥ 126 mg/dL (7.0 mmol/L) an additional intervention was implemented, including further diagnostic processes and therapy in General Practice (GP), followed by examination by an occupational health specialist within 3 months. The diagnosis of previously unknown diabetes was established among 2.5% of examined workers. All patients referred to the GP due to detected glycaemia impairment visited their doctor and finished the diagnostic process, took up therapy constrained by the occupational health physician to show the effects of intervention within 3 months. Prophylactic medical check-ups allow improved compliance and medical surveillance over glycaemia impairment in patients with prediabetes states, unknown diabetes or uncontrolled clinical course of diabetes. Considering fasting glucose level during mandatory prophylactic examination helps effective prevention of diabetes and its complications and thus provides public health system benefits.

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.

Heart Disease and Occupational Risk Factors in the Canadian Population: An Exploratory Study Using the Canadian Community Health Survey

Background

The objective of this study is to find temporal trends in the associations between cardiovascular disease and occupational risk factors in the context of the Canadian population.

Methods

Population data were analyzed from the Canadian Community Health Survey (CCHS) collected between 2001 and 2014 for trends over time between heart disease and various occupational risk factors: hours worked, physical exertion at work, and occupation type (management/arts/education, business/finance, sales/services, trades/transportations, and primary industry/processing).

Results

We found no significant difference in the average number of hours worked/wk between individuals who report having heart disease in all years of data except in 2011 (F_1,96 = 7.02, p = 0.009) and 2012 (F_1,96 = 8.86, p = 0.004). We also found a significant difference in the degree of physical exertion at work in 2001 (F_1,79 = 7.45, p = 0.008). There were statistically significant results of occupation type on self-reported heart disease from 2003 to 2014.

Conclusion

Canadian data from the CCHS do not exhibit a trend toward an association between heart disease and the number of hours worked/wk. There is an association between heart disease and physical exertion at work, but the trend is inconsistent. The data indicate a trend toward an association between heart disease and occupation type, but further analysis is required to determine which occupation type may be associated with heart disease.