The health of bus drivers: a study in London transport

Fitness to Drive After Syncope and/or in Cardiovascular Disease - An Overview and Practical Advice

The risk of syncope occurring while driving has implications for personal and public safety. Little is thought about the medical considerations related to the driving of motor vehicles. Physicians treating patients with cardiovascular disease need to acquire basic competences to be able to advise them about their fitness to drive. Current knowledge, governmental regulations, and recommendations concerning fitness to drive in patients with syncope and/or cardiovascular disease are presented. Narrative review with educational and clinical advice. Cardiovascular disease can make a driver lose control of a vehicle without warning and thereby lead to an accident. The main pathophysiological mechanisms of sudden loss of control are disturbances of brain perfusion (eg, syncope with or without cardiac arrhythmia, sudden cardiac death due to ventricular fibrillation or asystole, stroke, etc.) and marked general weakness (eg, after major surgery or in heart failure). Patients with syncope and/or cardiovascular disease should be properly advised by their physicians about their fitness to drive, and restrictions should be documented.

The COVID-19 pandemic and physical activity

The SARS-CoV-2-caused COVID-19 pandemic has resulted in a devastating threat to human society in terms of health, economy, and lifestyle. Although the virus usually first invades and infects the lung and respiratory track tissue, in extreme cases, almost all major organs in the body are now known to be negatively impacted often leading to severe systemic failure in some people. Unfortunately, there is currently no effective treatment for this disease. Pre-existing pathological conditions or comorbidities such as age are a major reason for premature death and increased morbidity and mortality. The immobilization due to hospitalization and bed rest and the physical inactivity due to sustained quarantine and social distancing can downregulate the ability of organs systems to resist to viral infection and increase the risk of damage to the immune, respiratory, cardiovascular, musculoskeletal systems and the brain. The cellular mechanisms and danger of this "second wave" effect of COVID-19 to the human body, along with the effects of aging, proper nutrition, and regular physical activity, are reviewed in this article.

[Risk of minor psychiatric disorders in a metropolitan area of southeast Brazil]

OBJECTIVE

Its aim was to identify and analyse the prevalence and the risks associated with minor psychiatric disorders in bus drivers and conductors in the city of S. Paulo, Brazil, in 1990.

MATERIAL AND METHOD

The prevalence of minor psychiatric disorders was analysed in a random sample of 925. A logistic regression approach was used in the analysis which was implemented by means of a forward stepwise model technique.

RESULTS

A prevalence of 20.3% was observed in the group as a whole, and a significant difference was found between conductors (28%) and drivers (13%) (p < 0.0001). The logistic regression analysis showed that the two major risk factors were heavy traffic (OR = 1.99; confidence interval 95% = 1.39-2.84) and the conductor's activity (OR = 1.84; CI95% = 1.09-3.10). Other risk factors were sleep privation (less than six hours), absenteeism, seats without mechanisms of adjustment, internal migration and work schedule changes.

CONCLUSION

The excess of risk for the occupational category of the conductor suggests the importance of the specific work condition as relevant for psychic suffering, leading to the consideration of the conductor-passenger relationship as possibly an important factor. Further studies for a better understanding of the work specific differences between drivers and conductor are necessary and may provide a basis for changes at the work organization level.

Psychiatric morbidity in bus crews following violent assault: a follow-up study

In a prospective study 22 bus crews who were victims of physical assault were assessed using standardized psychiatric instruments, followed up for 18 months and compared to a non-assaulted control group drawn from the same bus garage. At initial assessment the assaulted group, compared to the controls showed a significant increase in psychiatric impairment and distress (as measured by the GHQ-30 and IES respectively), with 23% of assault victims developing post-traumatic stress disorder as defined by DSM-III-R. At follow-up, while high levels of both psychiatric impairment and distress persisted there was evidence that they may be separate phenomena.

Incidence and prevalence of ischaemic heart disease among urban busdrivers in Copenhagen

A 5-year follow-up study was conducted among all male busdrivers in Copenhagen, Denmark, in addition to the cross-sectional study. In the follow-up study, the SMR for death due to ischaemic heart disease (ICD 410-414) was 144 and SMR for first clinical episode of acute myocardial infarction (ICD 410) was 139, with men in Copenhagen as controls. 80% of the busdrivers (1396 men) participated in the cross-sectional study. The prevalence of questionnaire-positive angina pectoris was 4.9%; in all age groups this was higher than among the controls, locomotive drivers in Denmark. The high health-related selection of busdrivers is assumed to cause an underestimation of the relative occurrence of ischaemic heart disease. Possible explanations for the findings in this study are discussed.

Automobile accidents caused by unsuspected neurological disease

✓ Two patients admitted as cerebral trauma cases following single-car automobile accidents were found to have previously-unsuspected, surgically-treatable neurological diseases that undoubtedly caused the accidents. A left posterior communicating artery aneurysm was clipped in one patient and a right frontal lobe abscess aspirated in the other, with excellent results in both patients.

Changing concepts in occupational health

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Sickness absence in teachers

This paper is based on the records of 738 male teachers and 1,684 female teachers employed by Edinburgh Corporation during the academic year September 1, 1954 to July 31, 1955. The amount and distribution of sickness absence has been assessed by age and sex; and comparisons have been made with similar rates in the academic year 1950/51 to determine trends in absence. An interesting feature is that the amount and duration of sickness absence experienced by single and married women teachers is equivalent. One finding of importance is that in both male and female teachers the highest inception rates for sickness are found at the beginning of a career in teaching. It is suggested that this supplies additional evidence that man's reactions to the situations he encounters in his daily life may affect his internal processes; that man's susceptibility to illness during adult life is, to a large degree, influenced by his relation to the society in which he works. The influence of promotion has been assessed in terms of this hypothesis.