Work Strain, Social Isolation and Mental Health of Long-Haul Truckers

Mental health and sociodemographic influences during COVID-19: Longitudinal findings from Iceland

The COVID-19 pandemic introduced numerous stressors and challenges that have had profound implications for mental health. This study examined the effects of the pandemic on mental health among Icelandic adults (n = 1766), using longitudinal survey data spanning three waves of data collection from 2019 to 2022. Symptoms of depression, anxiety, and stress increased from the beginning of the pandemic to the second time point, approximately one year into the pandemic, coinciding with reductions in happiness and social support. By the third time point, mental health remained slightly poorer than pre-pandemic levels, even after all COVID-19-related restrictions had been lifted. Unlike some other countries, COVID-19 infections in Iceland did not rise significantly until after the summer of 2021. Overall, participants perceived that the pandemic most adversely affected their social relationships and mental health. Prolonged periods in quarantine were predictive of these perceptions, albeit effect sizes were small. During the pandemic, women and younger participants reported slightly poorer mental health, while social support predicted better mental health outcomes. These results show that large societal stressors can significantly impact the mental health of populations. While social support is a prominent predictor of better mental health, additional variables may be needed to explain these effects fully.

What is needed to address psychosocial hazards in road transport? Using implementation science to understand the gaps

Work-related psychosocial hazards have a significant influence on the development of musculoskeletal and mental health disorders (MSDs and MHDs). This study used behavioural change theory to guide understanding of barriers and enablers for leaders working in the Heavy Vehicle Road Transport industry, to address workplace psychosocial hazards. The findings will be used to inform design of a future intervention to support leaders to more effectively address these hazards. Principal results and major conclusions: A higher number of barriers than enablers were identified. The most prevalent barriers were inadequate knowledge and interpersonal skills, and environmental context and inadequate resources, and the most prevalent enabler was risk management. The findings extend previous evidence by providing more specific detail regarding requirements for addressing psychosocial hazards. Further, the findings identified there is a need to improve the capability, opportunity and motivation of leaders to enable them to more effectively address psychosocial hazards.

Gossip and coping with social isolation: the case of migrant truck drivers in Western Europe

This article examines how employees use gossip as a resource to cope with social isolation. Building on a qualitative study with 32 truck drivers in a Western European company, our research identified gossip in close relationships and gossip in distant relationships as distinct patterns playing a different role in coping with social isolation, and a third pattern in which gossip was not beneficial. First, gossiping with close friends at work helped drivers engage in emotion-focused coping by reducing stress and loneliness. Second, gossiping with distant colleagues helped drivers engage in problem-focused coping by exchanging knowledge involving people in the organization. Third, gossip avoidance occurred in distant relationships, where drivers limited gossip exchanges going beyond instrumentally useful information. Overall, these findings show that drivers relied on different layers of their social network to cope with social isolation. Enriching previous research, this study shows that gossip represents an essential resource for emotion-focused and problem-focused coping.

Stress, Mental Health, and Coping Among Workers in the Northern California Cannabis Industry: A Qualitative Descriptive Analysis

California is home to a multibillion-dollar cannabis (marijuana) industry, but little is known about the occupational health and safety hazards faced by cannabis workers and even less of the stress, mental health, and coping mechanisms among these workers. Previous research has been based on long-term workers at legal businesses, but most California cannabis is produced and sold unlawfully. There are many seasonal workers whose experiences have not been studied. A qualitative study based on focus group discussions and key informant interviews was performed to understand cannabis workers' experiences, knowledge, and perceptions of occupational hazards. Participants reported sources of stress including production pressure and isolation, and mental health outcomes such as depression and mental fatigue. They described primarily maladaptive coping mechanisms. Unique characteristics of the cannabis industry, including criminalization and isolated, remote farms, make interventions challenging. However, policy approaches that involve community organizations could promote worker health.

An Agenda for Advancing Research and Prevention at the Nexus of Work Organization, Occupational Stress, and Mental Health and Well-Being

Work characteristics and worker well-being are inextricably connected. In particular, the characteristics of work organization shape and perpetuate occupational stress, which contributes to worker mental health and well-being outcomes. Consequently, the importance of understanding and addressing connections between work organization, occupational stress, and mental health and well-being-the focus of this Special Issue-increasingly demand attention from those affected by these issues. Thus, focusing on these issues in the long-haul truck driver (LHTD) sector as an illustrative example, the purpose of this commentary is as follows: (1) to outline current research approaches and the extant knowledge base regarding the connections between work organization, occupational stress, and mental health; (2) to provide an overview of current intervention strategies and public policy solutions associated with the current knowledge base to protect and promote worker mental health and well-being; and (3) to propose a two-pronged agenda for advancing research and prevention for workers during the 21st century. It is anticipated that this commentary, and this Special Issue more broadly, will both echo numerous other calls for building knowledge and engaging in this area and motivate further research within complementary current and novel research frameworks.

Factors Associated with Fatigued Driving among Australian Truck Drivers: A Cross-Sectional Study

BACKGROUND

Fatigued driving is one of the leading factors contributing to road crashes in the trucking industry. The nature of trucking, prolonged working time, and irregular sleep patterns can negatively impact drivers' health and wellbeing. However, there is limited research in Australia investigating the impact of demographic, occupational, or lifestyle factors on fatigue among truck drivers.

OBJECTIVE

This cross-sectional study examines the role of demographic, occupational, lifestyle, and other health risk factors associated with fatigue among Australian truck drivers.

METHOD

This study was part of a larger study that used a short online survey with a follow-up telephone survey to capture in-depth information on a wide range of determinants related to truck drivers' physical and mental health outcomes. Fatigue was measured by three questions, including the frequency of fatigue, fatigue management training, and strategies used to combat fatigue. Multivariate regression analysis was used to determine the specific impact of demographics, occupational factors, lifestyle factors, and other health risk factors on fatigue.

RESULTS

In total, 332 drivers completed both the online and telephone surveys; 97% were male, representing drivers from broad age groups and professional experience. The odds of being in the high-risk fatigue group were nearly three times higher in drivers who worked 40-60 h compared to those who worked < 40 h. Poor sleep increased the odds of high-risk fatigue by seventimes (95% CI: 2.26-21.67, p = 0.001). Drivers who reported experiencing loneliness also had double the odds of being at high risk of fatigued driving.

CONCLUSIONS

The increased risk of fatigue in truck drivers is associated with prolonged working hours, poor sleep, and social aspects such as loneliness. Further interventions seeking to reduce driver fatigue should consider the impact of work schedules, the availability of quality sleeping spaces, and the level of social connections.

Research gaps and needs for preventing worker fatigue in the transportation and utilities industries

BACKGROUND

The transportation and utilities industries include establishments engaged in the movement of passengers and freight, or the provision of public power, water, and other services. Along with the warehousing industry, they make up the US National Occupational Research Agenda's Transportation, Warehousing and Utilities (TWU) industry sector. In 2018 the sector composed 5% of the US workforce, with approximately 8 million workers. TWU workers experienced 19% of all fatalities among U.S. workers in 2018 and 7% of total occupational injuries and illnesses.

METHODS

Around-the-clock operations, heavy workloads, long and irregular shifts, complicated schedules, and time pressures characterize work across the US TWU sector. However, there are considerable differences in worker priorities and concerns between TWU industries. Major areas of concern within the sector include disparities in work schedules; required training for employee fatigue awareness and prevention; physical and mental job demands; and safety culture.

RESULTS

Strategies for fatigue mitigation are critical to reduce the prevalence of injuries, safety-critical events, and crashes in TWU workers. Further research on the incidence and characterization of fatigue among TWU workers will guide the development of effective mitigation strategies. The influence of work scheduling on missed sleep opportunities and disrupted circadian rhythms should be determined. Evaluation of fatigue mitigation strategies can lead to the adoption of the most effective ones for each TWU industry.

CONCLUSION

Implementation of effective strategies is critical for the health, safety, wellbeing, and productivity of workers in the TWU sector.

Containing the spatial spread of COVID-19 through the trucking network

The trucking industry is the backbone of domestic supply chains. In the context of the COVID-19 pandemic, road transportation has been essential to guarantee the supply of basic goods to confined urban areas. However, the connectivity of the trucking network can also act as an efficient virus spreader. This paper applies network science to uncover the characteristics of the trucking network in one major Latin American country -Colombia- and provides evidence on freight networks' ability to spread contagious diseases spatially. Network metrics, official COVID-19 records at the municipality level, and a zero-inflated negative binomial model are used to test the association between network topology and confirmed COVID-19 cases. Results suggest that: (i) the number of COVID-19 cases in a municipality is linked to its level and type of network centrality; and (ii) being a port-city and a primary economic hub in the trucking network is associated with a higher probability of contracting earlier a pandemic. Based on these results, a risk-based approach is proposed to help policymakers implement containment measures.

A Conceptual Review of Loneliness in Adults: Qualitative Evidence Synthesis

The paper reports an evidence synthesis of how loneliness is conceptualised in qualitative studies in adults. Using PRISMA guidelines, our review evaluated exposure to or experiences of loneliness by adults (aged 16+) in any setting as outcomes, processes, or both. Our initial review included any qualitative or mixed-methods study, published or unpublished, in English, from 1945 to 2018, if it employed an identified theory or concept for understanding loneliness. The review was updated to include publications up to November 2020. We used a PEEST (Participants, Exposure, Evaluation, Study Design, Theory) inclusion criteria. Data extraction and quality assessment (CASP) were completed and cross-checked by a second reviewer. The Evidence of Reviews of Qualitative Research (CERQual) was used to evaluate confidence in the findings. We undertook a thematic synthesis using inductive methods for peer-reviewed papers. The evidence identified three types of distinct but overlapping conceptualisations of loneliness: social, emotional, and existential. We have high confidence in the evidence conceptualising social loneliness and moderate confidence in the evidence on emotional and existential loneliness. Our findings provide a more nuanced understanding of these diverse conceptualisations to inform more effective decision-making and intervention development to address the negative wellbeing impacts of loneliness.

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

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

Syndemic frameworks to understand the effects of COVID-19 on commercial driver stress, health, and safety

INTRODUCTION

U.S. commercial drivers are entrenched in a stressogenic profession, and exposures to endemic chronic stressors shape drivers' behavioral and psychosocial responses and induce profound health and safety disparities. To gain a complete understanding of how the COVID-19 pandemic will affect commercial driver stress, health, and safety over time, and to mitigate these impacts, research and prevention efforts must be grounded in theoretical perspectives that contextualize these impacts within the chronic stressors already endemic to profession, the historical and ongoing forces that have induced them, and the potentially reinforcing nature of the resulting afflictions.

METHODS

Extant literature reveals how an array of macro-level changes has shaped downstream trucking industry policies, resulting in stressogenic work organization and workplace characteristics. Emerging evidence suggests that the COVID-19 pandemic exacerbates existing stressors and introduces novel stressors, with potentially exacerbatory impacts on health and safety disparities.

RESULTS

As COVID-19 exerts an array of multi-level stressors on commercial drivers, syndemic frameworks can provide the appropriate theoretical lens to guide research and prevention. Syndemic frameworks can provide the grounding to allow foregoing commercial driver COVID-19 research to transcend the limitations of prevailing research frameworks by contextualizing COVID-19 stressors holistically within the complex system of endemic chronic stressors and interrelated health and safety afflictions. Syndemic-informed prevention efforts can then be implemented that simultaneously tackle multiple afflictions and the macro-level forces that result in the emergence of commercial drivers' health and safety disparities over time.

CONCLUSIONS

The impacts of the COVID-19 pandemic on commercial drivers cannot be adequately understood or acted upon in isolation from the endemic chronic stressors and interrelated health and safety disparities that characterize the profession. Instead, commercial driver COVID-19 research and prevention needs syndemic frameworks to holistically understand the impacts of COVID-19 on commercial driver stress, health, and safety, and to identify high-leverage preventive actions.

Risk Factors for Depressive Symptoms in Long-Haul Truck Drivers

Work-related stress is a salient risk factor for depression. While long-haul truck drivers (LHTDs) face a myriad of occupational pressures and demands, little research has examined predictors of depressive symptoms in this occupational group. The purpose of this study was to identify predictors of depressive symptoms in LHTDs. A cross-sectional study was used to examine depressive symptoms, health and working conditions in a sample of 107 LHTDs (mean age of 50.7 ± 12.3; 95.6% were men) at truck stops from five Western Canadian cities. The findings show that 44% of LHTDs reported symptoms of depression in the past 12 months. Severe work-related stress, the use of psychiatric medications and broken sleep were significant predictors of depressive symptomology accounting for 41% of the variance. The findings suggest that LHTDs experience a host of occupational stressors that are embedded within the transportation industry that may increase the risk for depressive symptoms. Mental health promotion efforts that improve sleep quality, decrease work-related demands and pressures, and increase the use of psychiatric medication may reduce rates of depressive symptoms among LHTDs.

Comparing the Effects of FIFO/DIDO Workers Being Home versus Away on Sleep and Loneliness for Partners of Australian Mining Workers

Fly in Fly out/Drive in Drive out (FIFO/DIDO) is a prevalent work arrangement in the Australian mining industry and has been associated with adverse outcomes such as psychological stress, sleep disturbances, fatigue, and work/life interference. FIFO/DIDO work arrangements have the potential to not only impact the FIFO/DIDO worker, but also the partner of the FIFO/DIDO worker. However, there is sparse empirical evidence on the impact of FIFO/DIDO work arrangements on partners' sleep and subsequent performance. Therefore, the primary aim of this study was to describe and compare partners' sleep quality, sleep duration, sleepiness, and loneliness when the FIFO/DIDO workers were at home (off-shift) and away (on-shift). A secondary aim of this study was to examine whether differences in partners' sleep quality and sleep duration as a result of FIFO/DIDO worker's absence could be partially explained through the presence of dependents in the home, relationship duration, chronotype, duration in a FIFO/DIDO role, and loneliness. Self-reported questionnaires were completed by 195 female and 4 male participants, mostly aged between 18 and 44 years and who had been in a relationship with a FIFO/DIDO mining worker for more than five years. Of note, most participants subjectively reported poor sleep quality, insufficient sleep duration, excessive sleepiness, and moderate to extreme loneliness compared to the general population regardless of whether the FIFO/DIDO workers were at home or away. Compared to when the FIFO/DIDO workers were at home, partners experienced reduced sleep quality and increased loneliness when the FIFO/DIDO workers were away. Secondary analyses revealed that loneliness may partially underpin the negative effect that FIFO/DIDO workers' absence has on sleep quality. Further research is needed to understand the factors that contribute to poor sleep quality, insufficient sleep duration, excessive sleepiness, and loneliness of FIFO/DIDO partners to inform appropriate strategies to support FIFO/DIDO partners' health and wellbeing not only in the mining population, but other industries that incorporate similar FIFO/DIDO work arrangements (e.g., emergency services, offshore drilling, and transport).

Factors Associated with Common Mental Disorders in Truck Drivers

Abstract This study aimed to identify the risk factors of Common Mental Disorders (CMD) using a sample of 565 Brazilian truck drivers. For data capture were applied the Self-Reporting Questionnaire (SRQ-20), Scale subscale of Psychosocial risks and questionnaire with socio-demographic, working and occupational stressors. The results obtained by multivariate binary logistic regression analysis, have explained the 39.9% of variation on CMD. The occupational stressor working hours is the predictor variable with highest impact, may implying in an increase of 5.41 times more chance of the trucker to present CMD. The results indicate actions by management level as work organization and public authorities with regard to the external work conditions.

Work-Life Conflict among U.S. Long-Haul Truck Drivers: Influences of Work Organization, Perceived Job Stress, Sleep, and Organizational Support

Work-life balance and job stress are critical to health and well-being. Long-haul truck driving (LHTD) is among the unhealthiest and most unsafe occupations in the U.S. Despite these disparities, there are no extant published studies examining the influence of work, stress and sleep outcomes on drivers’ work-life balance. The current study investigated whether adverse work organization, stress, and poor sleep health among LHTDs are significantly associated with work-life conflict. Logistic regression was used to examine how work organization characteristics, job stress, and sleep influenced perceived stress and a composite measure of work-life conflict among a sample of 260 U.S. LHTDs. The pattern of regression results dictated subsequent analyses using structural equation modeling (SEM). Perceived job stress was the only statistically significant predictor for work-life balance. Fast pace of work, sleep duration and sleep quality were predictors of perceived job stress. SEM further elucidated that stress mediates the influences of fast work pace, supervisor/coworker support, and low sleep duration on each of the individual work-life balance indicators. There is an urgent need to address work conditions of LHTDs to better support their health, well-being, and work-life balance. Specifically, the findings from this study illustrate that scheduling practices and sleep outcomes could alleviate job stress and need to be addressed to more effectively support work-life balance. Future research and interventions should focus on policy and systems-level change.

The Impact of Work Organization, Job Stress, and Sleep on the Health Behaviors and Outcomes of U.S. Long-Haul Truck Drivers

Background. Compared with other occupations, long-haul truck drivers (LHTD) engage in excessively unhealthy behaviors and experience disproportionately poor health outcomes. Health promotion efforts targeting LHTDs focus on improving individual-level behaviors; however, this occupation is replete with adverse work organization characteristics, high job stress, and compromised sleep health, which are hypothesized to cause poor health behaviors and outcomes among LHTDs. Therefore, the purpose of this study was to explore the connections between work characteristics, job stress, and sleep outcomes, and health behaviors and physical and mental health outcomes among LHTDs. Method. This was a cross-sectional study, using interviewer-administered surveys with LHTDs (n = 260). Bivariate correlation analysis was used to explore the associations among work organization, job stress, sleep health, and health behaviors and outcomes. Logistic regression analyses were used to determine whether these work organization, job stress, and sleep factors predicted health behaviors and outcomes. Results. Long work hours of more than 11 hours daily (odds ratio [OR] = 2.34) resulted in increased odds of high caffeine consumption. High job stress (OR = 0.48) and poor sleep quality (OR = 0.42) led to decreased odds for spending at least 1 hour daily for cooking/eating. Low sleep duration, less than 7 hours daily (OR = 2.55), led to increased odds of a physical health diagnosis. Both high job stress (OR = 3.58) and poor sleep quality (OR = 2.22) resulted in increased odds of a mental health diagnosis. Conclusion. Health promotion efforts targeting LHTDs need to be coupled with upstream policy, environmental, and systems-level change, especially at the governmental and trucking industry levels.

Occupational health disparities among U.S. long-haul truck drivers: the influence of work organization and sleep on cardiovascular and metabolic disease risk

OBJECTIVE

The organization of work has undergone vast transformations over the past four decades in the United States and has had profound impacts on worker health and wellbeing. The profession of commercial truck driving is one of the best examples. Particularly for long-haul truck drivers, changes in work organization have led to disproportionately poor physiological, psychological, and sleep health outcomes.

METHODS

The present study examined disparities in cardiometabolic disease risk among long-haul truck drivers and the general population, and the influence of work organization and sleep in generating these outcomes. Researchers collected survey data from 260 drivers, and blood assay samples from 115 of those drivers, at a large highway truck stop in North Carolina. Comparisons were made for cardiovascular and metabolic risk against the 2011-2012 National Health and Nutrition Examination Survey (NHANES). In addition, logistic regression was used to explore predictive relationships between work organization and sleep and risk for cardiovascular and metabolic disease.

RESULTS

There were statistically significant mean differences between the long-haul truck driver sample and the NHANES sample for both cardiovascular (3.71 vs. 3.10; p <0.001) and metabolic (4.31 vs. 3.09; p <0.001) disease risk. The truck driver sample was less physically active and had lower HDL cholesterol along with greater levels of smoking, BMI, and metabolic syndrome diagnosis. More years of driving experience and poor sleep quality were statistically significant predictors for both cardiovascular and metabolic disease risk.

CONCLUSIONS

Study findings implicate elements of the occupational milieu experienced by long-haul truck drivers that induce disproportionate cardiometabolic disease risk. Sleep quality, largely compromised by poor work conditions and workplace environments, plays a significant role in increased risks for cardiometabolic disease. There is an urgent need for longitudinal studies of this critical occupational sector as well as intervention research centered on policy and systems level change.

Can subjective sleep problems detect latent sleep disorders among commercial drivers?

INTRODUCTION

Long-haul truck drivers experience poor sleep health and heightened accident rates, and undiagnosed sleep disorders contribute to these negative outcomes. Subjective sleep disorder screening tools may aid in detecting drivers' sleep disorders. This study sought to evaluate the value of subjective screening methods for detecting latent sleep disorders and identifying truck drivers at-risk for poor sleep health and safety-relevant performance.

MATERIALS AND METHODS

Using cross-sectional data from 260 long-haul truck drivers, we: 1) used factor analysis to identify possible latent sleep disorders; 2) explored the construct validity of extracted sleep disorder factors by determining their associations with established sleep disorder risk factors and symptoms; and 3) explored the predictive validity of resulting sleep disorder factors by determining their associations with sleep health and safety-relevant performance.

RESULTS

Five latent sleep disorder factors were extracted: 1) circadian rhythm sleep disorders; 2) sleep-related breathing disorders; 3) parasomnias; 4) insomnias; 5) and sleep-related movement disorders. Patterns of associations between these factors generally corresponded with known risk factors and symptoms. One or more of the extracted latent sleep disorder factors were significantly associated with all the sleep health and safety outcomes.

DISCUSSION

Using subjective sleep problems to detect latent sleep disorders among long-haul truck drivers may be a timely and effective way to screen this highly mobile occupational segment. This approach should constitute one component of comprehensive efforts to diagnose and treat sleep disorders among commercial transport operators.

Work, sleep, and cholesterol levels of U.S. long-haul truck drivers

Long-haul truck drivers in the United States experience elevated cardiovascular health risks, possibly due to hypercholesterolemia. The current study has two objectives: 1) to generate a cholesterol profile for U.S. long-haul truck drivers; and 2) to determine the influence of work organization characteristics and sleep quality and duration on cholesterol levels of long-haul truck drivers. Survey and biometric data were collected from 262 long-haul truck drivers. Descriptive analyses were performed for demographic, work organization, sleep, and cholesterol measures. Linear regression and ordinal logistic regression analyses were conducted to examine for possible predictive relationships between demographic, work organization, and sleep variables, and cholesterol outcomes. The majority (66.4%) of drivers had a low HDL (<40 mg/dL), and nearly 42% of drivers had a high-risk total cholesterol to HDL cholesterol ratio. Sleep quality was associated with HDL, LDL, and total cholesterol, and daily work hours were associated with LDL cholesterol. Workday sleep duration was associated with non-HDL cholesterol, and driving experience and sleep quality were associated with cholesterol ratio. Long-haul truck drivers have a high risk cholesterol profile, and sleep quality and work organization factors may induce these cholesterol outcomes. Targeted worksite health promotion programs are needed to curb these atherosclerotic risks.