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Apostolopoulos Y, Sönmez S, Thiese MS, Olufemi M, Gallos LK. A blueprint for a new commercial driving epidemiology: An emerging paradigm grounded in integrative exposome and network epistemologies. Am J Ind Med 2024; 67:515-531. [PMID: 38689533 DOI: 10.1002/ajim.23588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/29/2024] [Accepted: 04/15/2024] [Indexed: 05/02/2024]
Abstract
Excess health and safety risks of commercial drivers are largely determined by, embedded in, or operate as complex, dynamic, and randomly determined systems with interacting parts. Yet, prevailing epidemiology is entrenched in narrow, deterministic, and static exposure-response frameworks along with ensuing inadequate data and limiting methods, thereby perpetuating an incomplete understanding of commercial drivers' health and safety risks. This paper is grounded in our ongoing research that conceptualizes health and safety challenges of working people as multilayered "wholes" of interacting work and nonwork factors, exemplified by complex-systems epistemologies. Building upon and expanding these assumptions, herein we: (a) discuss how insights from integrative exposome and network-science-based frameworks can enhance our understanding of commercial drivers' chronic disease and injury burden; (b) introduce the "working life exposome of commercial driving" (WLE-CD)-an array of multifactorial and interdependent work and nonwork exposures and associated biological responses that concurrently or sequentially impact commercial drivers' health and safety during and beyond their work tenure; (c) conceptualize commercial drivers' health and safety risks as multilayered networks centered on the WLE-CD and network relational patterns and topological properties-that is, arrangement, connections, and relationships among network components-that largely govern risk dynamics; and (d) elucidate how integrative exposome and network-science-based innovations can contribute to a more comprehensive understanding of commercial drivers' chronic disease and injury risk dynamics. Development, validation, and proliferation of this emerging discourse can move commercial driving epidemiology to the frontier of science with implications for policy, action, other working populations, and population health at large.
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Affiliation(s)
| | - Sevil Sönmez
- College of Business, University of Central Florida, Orlando, Florida, USA
| | - Matthew S Thiese
- Rocky Mountain Center for Occupational and Environmental Health, University of Utah, Salt Lake City, Utah, USA
| | - Mubo Olufemi
- Rocky Mountain Center for Occupational and Environmental Health, University of Utah, Salt Lake City, Utah, USA
| | - Lazaros K Gallos
- DIMACS, Center for Discrete Mathematics & Theoretical Computer Science, Rutgers University, Piscataway, New Jersey, USA
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Lemke MK, Thiese MS, Hege A, Ogbonnaya UC, Hegmann KT. Metabolic syndrome among commercial truck drivers: The relationship between condition prevalence and crashes. Am J Ind Med 2023; 66:54-64. [PMID: 36268908 DOI: 10.1002/ajim.23437] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 09/27/2022] [Accepted: 10/03/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND Metabolic syndrome (MetS) is especially prevalent among US truck drivers. However, there has been limited research exploring associations between MetS conditions with roadway crashes among truck drivers. The objective of this paper is to assess relationships between specific combinations of individual MetS components and crashes and near-misses. METHODS Survey, biometric, and anthropometric data were collected from 817 truck drivers across 6 diverse US states. Survey data focused on demographics and roadway safety outcomes, and anthropometric/biometric data corresponded to five MetS conditions (waist circumference blood pressure, hemoglobin A1c, triglycerides, and high-density lipoprotein [HDL] cholesterol). Logistic regression was used to calculate odds ratios of lifetime crashes and near-miss 1-month period prevalence associated with: 1) specific MetS conditions regardless of presence or absence of other MetS conditions, and 2) specific MetS conditions and counts of other accompanying MetS conditions. RESULTS Hypertension was the MetS characteristic most strongly associated with lifetime crash and 1-month near-miss outcomes, while high triglycerides, low HDL cholesterol, and large waist circumference were most commonly present among groups of conditions associated with crashes and near-misses. Overall, an increasing number of specific co-occurring MetS conditions were associated with higher reporting of roadway crashes. CONCLUSIONS Specific combinations and higher prevalence of MetS conditions were associated with increased frequency of reported crashes. Moreover, when the co-occurrence of MetS conditions is aggregated, a dose-response relationship with crashes appears. These results suggest that policy changes and interventions addressing MetS may increase driver health and reduce crash risk.
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Affiliation(s)
- Michael K Lemke
- Department of Social Sciences, University of Houston-Downtown, Houston, Texas, USA
| | - Matthew S Thiese
- Rocky Mountain Center for Occupational and Environmental Health, School of Medicine, University of Utah and Weber State University, Salt Lake City, Utah, USA
| | - Adam Hege
- Department of Public Health & Exercise Science, Appalachian State University, Boone, North Carolina, USA
| | - Uchenna C Ogbonnaya
- Rocky Mountain Center for Occupational and Environmental Health, School of Medicine, University of Utah and Weber State University, Salt Lake City, Utah, USA
| | - Kurt T Hegmann
- Rocky Mountain Center for Occupational and Environmental Health, School of Medicine, University of Utah and Weber State University, Salt Lake City, Utah, USA
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Mabry JE, Camden M, Miller A, Sarkar A, Manke A, Ridgeway C, Iridiastadi H, Crowder T, Islam M, Soccolich S, Hanowski RJ. Unravelling the Complexity of Irregular Shiftwork, Fatigue and Sleep Health for Commercial Drivers and the Associated Implications for Roadway Safety. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14780. [PMID: 36429498 PMCID: PMC9690622 DOI: 10.3390/ijerph192214780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 11/01/2022] [Accepted: 11/05/2022] [Indexed: 06/16/2023]
Abstract
Fatigue can be a significant problem for commercial motor vehicle (CMV) drivers. The lifestyle of a long-haul CMV driver may include long and irregular work hours, inconsistent sleep schedules, poor eating and exercise habits, and mental and physical stress, all contributors to fatigue. Shiftwork is associated with lacking, restricted, and poor-quality sleep and variations in circadian rhythms, all shown to negatively affect driving performance through impaired in judgment and coordination, longer reaction times, and cognitive impairment. Overweight and obesity may be as high as 90% in CMV drivers, and are associated with prevalent comorbidities, including obstructive sleep apnea, hypertension, and cardiovascular and metabolic disorders. As cognitive and motor processing declines with fatigue, driver performance decreases, and the risk of errors, near crashes, and crashes increases. Tools and assessments to determine and quantify the nature, severity, and impact of fatigue and sleep disorders across a variety of environments and populations have been developed and should be critically examined before being employed with CMV drivers. Strategies to mitigate fatigue in CMV operations include addressing the numerous personal, health, and work factors contributing to fatigue and sleepiness. Further research is needed across these areas to better understand implications for roadway safety.
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Affiliation(s)
- Jessica Erin Mabry
- Division of Freight, Transit, and Heavy Vehicle Safety, Virginia Tech Transportation Institute, Blacksburg, VA 24061, USA
| | - Matthew Camden
- Division of Freight, Transit, and Heavy Vehicle Safety, Virginia Tech Transportation Institute, Blacksburg, VA 24061, USA
| | - Andrew Miller
- Division of Freight, Transit, and Heavy Vehicle Safety, Virginia Tech Transportation Institute, Blacksburg, VA 24061, USA
| | - Abhijit Sarkar
- Division of Freight, Transit, and Heavy Vehicle Safety, Virginia Tech Transportation Institute, Blacksburg, VA 24061, USA
| | - Aditi Manke
- Division of Freight, Transit, and Heavy Vehicle Safety, Virginia Tech Transportation Institute, Blacksburg, VA 24061, USA
| | - Christiana Ridgeway
- Division of Freight, Transit, and Heavy Vehicle Safety, Virginia Tech Transportation Institute, Blacksburg, VA 24061, USA
| | - Hardianto Iridiastadi
- Division of Freight, Transit, and Heavy Vehicle Safety, Virginia Tech Transportation Institute, Blacksburg, VA 24061, USA
- Faculty of Industrial Technology, Institut Teknologi Bandung, Bandung 40132, Indonesia
| | - Tarah Crowder
- Division of Freight, Transit, and Heavy Vehicle Safety, Virginia Tech Transportation Institute, Blacksburg, VA 24061, USA
| | - Mouyid Islam
- Division of Freight, Transit, and Heavy Vehicle Safety, Virginia Tech Transportation Institute, Blacksburg, VA 24061, USA
| | - Susan Soccolich
- Division of Freight, Transit, and Heavy Vehicle Safety, Virginia Tech Transportation Institute, Blacksburg, VA 24061, USA
| | - Richard J. Hanowski
- Division of Freight, Transit, and Heavy Vehicle Safety, Virginia Tech Transportation Institute, Blacksburg, VA 24061, USA
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Izadi N, Najafi A, Saraei M. Metabolic syndrome and its determinants among professional drivers: a systematic review and meta-analysis. J Diabetes Metab Disord 2021; 20:2015-2023. [PMID: 34900837 DOI: 10.1007/s40200-021-00928-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 10/23/2021] [Indexed: 11/29/2022]
Abstract
Background Drivers are one of the trade unions that are most exposed to various health-related risks, especially metabolic diseases. The present study aimed to systematically assess the overall prevalence of metabolic syndrome and its determinants among drivers in the world. Methods All retrospective, cross-sectional, or prospective studies evaluating the prevalence and risk for metabolic syndrome and its main components among male professional drivers were eligible for the initial assessment. PRISMA guideline was used. Two blinded reviewers independently screened the titles and abstracts of the manuscripts followed by a deep assessment of the full texts for determining the inclusion appropriateness. Results In the final, 12 articles were eligible for the final analysis. Overall, 19,350 professional male drivers with a total average age of 43.06 years (ranged from 35.5 to 51.1 years) were included in the study. The prevalence of metabolic syndrome was estimated to be 32.8% (95%CI: 32.1% to 33.5%), and the major determinants of appearing this syndrome among professional drivers were advanced age, years of driving experience, higher body mass index, smoking, high cholesterol dietary regimen, high Framingham risk score, low regular exercising, history of diabetes mellitus, history of gout, and shift work pattern. Conclusion According to the 32.8% prevalence rate of metabolic syndrome among drivers, managerial measures are needed to prevent and control metabolic disturbances among professional drivers are recommended.
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Affiliation(s)
- Nazanin Izadi
- Occupational Sleep Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Arezu Najafi
- Occupational Sleep Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Saraei
- Occupational Sleep Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Ebrahimi MH, Jahanfar S, Shayestefar M. The Relationship between the Metabolic Syndrome and the Risk of Obstructive Sleep Apnea Evaluated by STOP-Bang Questionnaire in Professional Drivers in Shahroud, Iran, in 2020: A Case-Control Study. J Obes Metab Syndr 2021; 30:55-62. [PMID: 33582659 PMCID: PMC8017324 DOI: 10.7570/jomes20105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/05/2020] [Accepted: 01/20/2021] [Indexed: 11/02/2022] Open
Abstract
Background The present study was conducted to investigate the relationship between metabolic syndrome and the risk of respiratory and sleep disorders in professional drivers. Methods This case-control study was conducted on professional drivers in Shahroud, Iran. The snoring, tiredness during daytime, observed apnea, high blood pressure, body mass index, age, neck circumference, gender (STOP-Bang) questionnaire was first used to assess obstructive sleep apnea (OSA). Then, based on the questionnaire scores, the participants were divided into two groups: those with and those without OSA. The relationship between this disorder and metabolic syndrome was then studied. Data were analyzed using descriptive and analytical tests (P<0.05). Results Based on the STOP-Bang questionnaire, 214 drivers with a high risk of OSA and 214 drivers with low risk were recruited for the study. According to the Adult Treatment Panel III criteria, 204 drivers (47.7%) had metabolic syndrome. There was a significant relationship between driver's license class and the risk of OSA. Metabolic syndrome components including fasting blood sugar, triglycerides, and hypertension, but not high-density lipoprotein cholesterol, were able to predict OSA in the professional drivers. Conclusion Given the high prevalence of metabolic syndrome and OSA, especially in drivers of high risk who may spend long hours transporting good and operating passenger vehicles, screening and treating these disorders are crucial in this part of the population. The researchers recommend holding regular training sessions about these disorders for professional drivers.
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Affiliation(s)
- Mohammad Hossein Ebrahimi
- Environmental and Occupational Health Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Shayesteh Jahanfar
- MPH Program, School of Health Sciences, Central Michigan University, MI, USA
| | - Mina Shayestefar
- School of Allied Medical Sciences, Semnan University of Medical Sciences, Semnan, Iran
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Roche J, Vos AG, Lalla-Edward ST, Venter WDF, Scheuermaier K. Relationship between sleep disorders, HIV status and cardiovascular risk: cross-sectional study of long-haul truck drivers from Southern Africa. Occup Environ Med 2021; 78:oemed-2020-107208. [PMID: 33622782 DOI: 10.1136/oemed-2020-107208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 02/01/2021] [Accepted: 02/04/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Long-haul truck drivers (TDs) may have lifestyles that promote cardiovascular disease (CVD), including diet, sleep and activity issues. Most studies conducted among truckers investigated the relationship between poor sleep and cardiometabolic health, but none assessed whether suspected obstructive sleep apnoea (OSA) and shortened sleep were associated with markers of cardiometabolic risk. We determined whether sleep disorders and circadian misalignment were associated with chronic inflammation and CVD risk in TDs from Southern Africa. METHODS Participants were recruited at roadside wellness centres in Gauteng and Free State Provinces, South Africa. OSA risk was assessed using the Berlin Questionnaire, while sleep duration and sleep quality were assessed using items from the Pittsburgh Sleep Quality Index. Clinical information, neck circumference (NC), metabolic profile, elevated BP, HIV status and C-reactive protein (CRP) were collected. CVD risk was assessed using the Framingham Risk Score (FRS). RESULTS Out of 575 participants aged on average 37.7 years, 17.2% were at OSA risk, 72.0% had elevated BP, 9.4% had HIV and 28.0% were obese. Mean sleep duration was 7.4±1.8 hours, and 49.6% reported working night shift at least once a week. Shortened sleep, OSA risk, age, body mass index, NC and years as full-time TD were associated with greater FRS independently of HIV status and night shift. Working night shift was associated with higher CRP levels in HIV+ compared with HIV- participants. CONCLUSIONS Circadian misalignment in HIV, and OSA and short sleep duration in all truckers were associated with increased CVD risk. Truckers should be given careful attention in terms of health management and sleep education.
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Affiliation(s)
- Johanna Roche
- Wits Sleep Lab, Brain Function Research Group, School of Physiology, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa
| | - Alinda G Vos
- Julius Global Health, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands
- Ezintsha, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa
| | - Samanta T Lalla-Edward
- Ezintsha, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa
| | - W D Francois Venter
- Ezintsha, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa
| | - Karine Scheuermaier
- Wits Sleep Lab, Brain Function Research Group, School of Physiology, University of the Witwatersrand Faculty of Health Sciences, Johannesburg, South Africa
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Wadley AL, Iacovides S, Roche J, Scheuermaier K, Venter WDF, Vos AG, Lalla-Edward ST. Working nights and lower leisure-time physical activity associate with chronic pain in Southern African long-distance truck drivers: A cross-sectional study. PLoS One 2020; 15:e0243366. [PMID: 33270793 PMCID: PMC7714191 DOI: 10.1371/journal.pone.0243366] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 11/19/2020] [Indexed: 12/28/2022] Open
Abstract
Background In South Africa, the trucking industry employs over 70,000 people and the prevalence of chronic pain in this occupational group was reported at 10%. We investigated factors associated with chronic pain in truck drivers including mental health, physical activity, and sleep, as no study has done so. Methods Southern African male, long-distance truck drivers were recruited at truck stops in Gauteng and Free State Provinces, South Africa (n = 614). Chronic pain was defined as pain present for at least the last three months. Depressive symptoms were assessed with the Patient Health Questionnaire-9, post-traumatic stress disorder with the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), exposure to traumatic events with the Life Events Checklist-5 (LEC-5) and daytime sleepiness with the Epworth Sleepiness Scale. Sleep quality was measured on a four-point Likert scale. Leisure-time physical activity was measured using the Godin-Shephard leisure-time physical activity questionnaire. Associations between these factors, demographic factors and chronic pain were investigated. Results Multivariate analysis showed that working ≥ 2 nights/week (OR = 2.68, 95% CI = 1.55–4.68) was associated with chronic pain and physical activity was protective (OR = 0.97, 95% CI 0.95–0.98). In an exploratory analysis, greater depressive symptoms (p = 0.004), daytime sleepiness (p = 0.01) and worse sleep quality (p = 0.001) was associated with working ≥ 2 nights/week. Lower leisure-time physical activity was associated with worse sleep quality (p = 0.006), but not daytime sleepiness or depressive symptoms (p>0.05). Conclusions There is a clear relationship between working nights and activity levels, and chronic pain, sleep quality, and depression in truck drivers.
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Affiliation(s)
- Antonia L. Wadley
- Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- * E-mail:
| | - Stella Iacovides
- Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Johanna Roche
- Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Karine Scheuermaier
- Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - W. D. Francois Venter
- Ezintsha, A Sub-Division of Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Alinda G. Vos
- Ezintsha, A Sub-Division of Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Samanta T. Lalla-Edward
- Ezintsha, A Sub-Division of Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Guest AJ, Chen YL, Pearson N, King JA, Paine NJ, Clemes SA. Cardiometabolic risk factors and mental health status among truck drivers: a systematic review. BMJ Open 2020; 10:e038993. [PMID: 33099498 PMCID: PMC7590350 DOI: 10.1136/bmjopen-2020-038993] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE This study aimed to systematically review and summarise the literature on cardiometabolic risk factors, lifestyle health behaviours and mental health status of truck drivers globally to ascertain the scale of these health concerns. DESIGN Systematic review reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. DATA SOURCES PubMed, Scopus, PsycINFO and Web of Science were searched in January 2019 and updated in January 2020, from the date of inception to 16 January 2020. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Papers were included if they (1) reported independent data on truck drivers, (2) included quantitative data on outcomes related to cardiometabolic markers of health, mental health and/or health behaviours, (3) were written in English and (4) were published in a peer-reviewed journal. Grey literature was ineligible for this review. DATA EXTRACTION AND SYNTHESIS One reviewer independently extracted data and assessed methodological quality using a checklist based on the National Heart, Lung and Blood Institute Quality Assessment tool. 20% were independently assessed for eligibility and quality by a second reviewer. Due to heterogeneity of the outcomes, results were narratively presented. RESULTS 3601 titles and abstracts were screened. Seventy-three studies met the inclusion criteria. Truck driving is associated with enforced sedentarism, long and irregular working hours, lack of healthy foods, social isolation and chronic time pressures. Strong evidence was observed for truck drivers to generally exhibit poor cardiometabolic risk profiles including overweight and obesity, hypertension, hypercholesterolaemia, high blood glucose, poor mental health and cigarette smoking. CONCLUSIONS Improving truck driver health is vital for the longevity of the trucking industry, and for the safety of all road users. The workplace plays a vital role in truck driver health; policies, regulations and procedures are required to address this health crisis. PROSPERO REGISTRATION NUMBER CRD42019124499.
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Affiliation(s)
- Amber J Guest
- School of Sport Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
| | - Yu-Ling Chen
- School of Sport Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
| | - Natalie Pearson
- School of Sport Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
| | - James A King
- School of Sport Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and the University of Leicester, Leicester, UK
| | - Nicola J Paine
- School of Sport Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
| | - Stacy A Clemes
- School of Sport Exercise and Health Sciences, Loughborough University, Loughborough, Leicestershire, UK
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and the University of Leicester, Leicester, UK
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Lemke MK, Apostolopoulos Y, Sönmez S. A novel COVID-19 based truck driver syndemic? Implications for public health, safety, and vital supply chains. Am J Ind Med 2020; 63:659-662. [PMID: 32452556 PMCID: PMC7283783 DOI: 10.1002/ajim.23138] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/13/2020] [Accepted: 05/14/2020] [Indexed: 01/05/2023]
Abstract
U.S. long-haul truck drivers traverse great distances and interact with numerous individuals, rendering them vulnerable to acquiring and transmitting coronavirus disease 2019 (COVID-19). Together, the unique co-occurrence of pronounced health disparities and known COVID-19 infection, morbidity, and mortality risks suggest the possibility of a novel COVID-19 based truck driver syndemic due to advanced driver age and endemic health issues. In turn, COVID-19 sequelae may perpetuate existing health disparities. The co-occurrence of afflictions may also result in compromised safety performance. To curb the likelihood of a COVID-19 based truck driver syndemic, several action stepsare needed. First, key COVID-19 metrics need to be established for this population. Second, relationships between long-haul trucker network attributes and COVID-19 spread need to bedelineated. Third, mutually reinforcing interactions between endemic health disparities and COVID-19 vulnerability need to be elucidated. Finally, grounded in the aforementioned steps, policies and interventions need to be identified and implemented.
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Affiliation(s)
| | - Yorghos Apostolopoulos
- Complexity & Computational Population Health GroupTexas A&M University College Station Texas
| | - Sevil Sönmez
- College of Business AdministrationUniversity of Central Florida Orlando Florida
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Crain TL, Brossoit RM, Robles-Saenz F, Tran M. Fighting fatigue: A conceptual model of driver sleep in the gig economy. Sleep Health 2020; 6:358-365. [PMID: 32205095 DOI: 10.1016/j.sleh.2020.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 01/23/2020] [Accepted: 02/03/2020] [Indexed: 01/09/2023]
Abstract
The purpose of this paper was to integrate the sleep science, occupational health, and organizational psychology literature to develop a conceptual model of driver sleep and fatigue in the gig economy. We develop an integrative framework, which proposes that aspects of the on-demand driving context influence driver sleep health and fatigue. Driver outcomes include safety incidents, injuries, health, job attitudes, interpersonal behavior, and performance. In addition, moderators, such as driver demographics and health conditions, can interact with aspects of the driver context. A number of practical implications are provided, addressing the ways in which occupational health researchers, online labor platform companies, and drivers can improve sleep health. This is the first paper to provide a broad understanding of how scientists, through both research and practice, can help improve sleep, a primary issue in the ridesharing industry.
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Affiliation(s)
- Tori L Crain
- Department of Psychology, Colorado State University, 1876 Campus Delivery, Fort Collins, CO 80523-1876.
| | - Rebecca M Brossoit
- Department of Psychology, Colorado State University, 1876 Campus Delivery, Fort Collins, CO 80523-1876
| | - Faviola Robles-Saenz
- Department of Psychology, Colorado State University, 1876 Campus Delivery, Fort Collins, CO 80523-1876
| | - Molly Tran
- Department of Nursing and Health Sciences, Elmhurst College, 190 Prospect Avenue, Elmhurst, IL 60126
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Shayestefar M, Sadeghniiat Haghighi K, Jahanfar S, Delvarianzadeh M, Nematzadeh F, Ebrahimi MH. Assessment of the relationship between metabolic syndrome and obstructive sleep apnea in male drivers of Shahroud city in 2018: a cross sectional study. BMC Public Health 2019; 19:1058. [PMID: 31387558 PMCID: PMC6685249 DOI: 10.1186/s12889-019-7361-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 07/23/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Metabolic syndrome involves a set of metabolic risk factors that directly increases the risk of atherosclerotic cardiovascular disease. Physical inactivity due to driving can increase the risk of metabolic syndrome. It is also known that sleep disorders (sleep apnea) can result in MetS. Driving in Iran is considered a very popular but risky occupation, so paying attention to this profession is of special importance. Therefore, the researchers aimed to investigate the association between sleep disorders and metabolic syndrome in drivers in Shahroud city in 2018. METHODS This cross-sectional study was carried out on 948 drivers from Shahroud city in 2018. After obtaining consent from participants, 3 questionnaires including demographic, Epworth Sleepiness Scale and STOP-BANG were completed. Clinical and anthropometric measurements were assessed, including blood pressure, waist circumference, hip circumference, weight, height, and body mass index. In addition, blood was drawn to measure High Density Lipoprotein, Low Density Lipoprotein, Triglyceride, cholesterol, and Fasting Blood Sugar levels. The relationship between metabolic syndrome and sleep disorders was then studied. In this study, statistical analyses were performed using SPSS software version 23 at a significance level of 0.05. RESULTS Mean age of drivers was 44.15 ± 11.66 (years). The mean waist circumference and mean hip circumference in subjects with a Class 1 Driver's License (a certificate for trucks and buses) were higher than those with a Class 2 Driver's License (a certificate for motorcars, minibuses, vans, etc. (seating< 20)) (P = 0.01 and P = 0.003, respectively). Moreover, the BMI in subjects with a Class 1 Driver's License was higher compared to subjects with a Class 2 Driver's License. The correlation between metabolic syndrome with sleep apnea based on STOP-BANG questionnaire was significant (p < 0.001) irrespective of definition (ATP and IDF). CONCLUSIONS According to the results of this study, there was a bi-directional association between sleep disorders and Mets, so this group should pass periodic medical examinations and training courses. Moreover, their families should be informed of prevention and treatment of this syndrome.
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Affiliation(s)
- Mina Shayestefar
- School of Allied Medical Sciences, Semnan University of Medical Sciences, Semnan, Iran
| | | | - Shayesteh Jahanfar
- MPH Program, School of Health Science, Central Michigan University, Mount Pleasant, USA
| | - Mehri Delvarianzadeh
- School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Farzaneh Nematzadeh
- Student Research Committee, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mohammad Hossein Ebrahimi
- Environmental and Occupational Health Research centre, Shahroud University of Medical Sciences, Shahroud, Iran.
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Useche SA, Montoro L, Alonso F, Pastor JC. Psychosocial Work Factors, Job Stress and Strain at the Wheel: Validation of the Copenhagen Psychosocial Questionnaire (COPSOQ) in Professional Drivers. Front Psychol 2019; 10:1531. [PMID: 31312166 PMCID: PMC6614297 DOI: 10.3389/fpsyg.2019.01531] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 06/17/2019] [Indexed: 12/20/2022] Open
Abstract
Introduction Psychosocial work environment has been related to many negative health outcomes in different workforces. However, evidence in this regard is still limited in the case of transport workers, and most of the tools used in research, often excessively generic, do not fully consider the specific key stressors, and adverse issues present in the psychosocial environment of professional driving. Objective Thus, the purpose of this study was to obtain a complete description of the validation of measurement applied to psychosocial factors at work in professional drivers, using the Enterprise version (2018) of COPSOQ-III. Methods The data was collected from 726 Spanish professional drivers, and the analyses were conducted using the competitive Confirmatory Factor Analysis or CFA, obtaining basic psychometric properties and an optimized structure for the instrument applied to active transport workers. Results The results suggest a clear factorial structure, high factorial weights, internal consistency, and an improved adjustment to the psychosocial conditions of this group, excluding a set of items with low psychometrical adjustment and keeping the five-factor structure of the questionnaire: demands, influence and development, interpersonal relationships and leadership, job insecurity, and strain-effects and outcomes. Conclusion Overall, what was found in this study supports the hypothesis that the validated version of COPSOQ in professional drivers, together with complementary information sources specific for their work environment, may have a relevant research value and some important practical implications for the improvement of the occupational safety, and health within the typically vulnerable industry of transportation.
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Affiliation(s)
- Sergio A Useche
- Development and Advising in Traffic Safety Research Group, University Research Institute on Traffic and Road Safety, University of Valencia, Valencia, Spain
| | - Luis Montoro
- FACTHUM.lab (Human Factor and Road Safety) Research Group, University Research Institute on Traffic and Road Safety, University of Valencia, Valencia, Spain
| | - Francisco Alonso
- Development and Advising in Traffic Safety Research Group, University Research Institute on Traffic and Road Safety, University of Valencia, Valencia, Spain
| | - Juan C Pastor
- Development and Advising in Traffic Safety Research Group, University Research Institute on Traffic and Road Safety, University of Valencia, Valencia, Spain
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Hege A, Lemke MK, Apostolopoulos Y, Whitaker B, Sönmez S. Work-Life Conflict among U.S. Long-Haul Truck Drivers: Influences of Work Organization, Perceived Job Stress, Sleep, and Organizational Support. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16060984. [PMID: 30893828 PMCID: PMC6466152 DOI: 10.3390/ijerph16060984] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 03/05/2019] [Accepted: 03/13/2019] [Indexed: 12/17/2022]
Abstract
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.
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Affiliation(s)
- Adam Hege
- Public Health Program, Department of Health & Exercise Science, Appalachian State University, Leon Levine Hall, 1179 State Farm Road, P.O. Box 32071, Boone, NC 28607, USA.
| | - Michael K Lemke
- Department of Social Sciences, University of Houston-Downtown, One Main Street, Houston, TX 77002, USA.
- Complexity & Computational Population Health Group, Texas A&M University, College Station, TX 77843, USA.
| | - Yorghos Apostolopoulos
- Complexity & Computational Population Health Group, Texas A&M University, College Station, TX 77843, USA.
- Department of Health & Kinesiology, Texas A&M University, College Station, TX 77843, USA.
| | - Brian Whitaker
- Department of Management, Appalachian State University, 416 Howard Street, P.O. Box 32089, Boone, NC 28608, USA.
| | - Sevil Sönmez
- College of Business Administration, University of Central Florida, 12744 Pegasus Drive, Orlando, FL 32816, USA.
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Hege A, Lemke MK, Apostolopoulos Y, Sönmez S. The Impact of Work Organization, Job Stress, and Sleep on the Health Behaviors and Outcomes of U.S. Long-Haul Truck Drivers. HEALTH EDUCATION & BEHAVIOR 2019; 46:626-636. [PMID: 30770029 DOI: 10.1177/1090198119826232] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
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.
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Affiliation(s)
- Adam Hege
- 1 Appalachian State University, Boone, NC, USA
| | - Michael K Lemke
- 2 University of Houston-Downtown, Houston, TX, USA.,3 Texas A&M University, College Station, TX, USA
| | - Yorghos Apostolopoulos
- 2 University of Houston-Downtown, Houston, TX, USA.,3 Texas A&M University, College Station, TX, USA
| | - Sevil Sönmez
- 4 College of Business Administration, University of Central Florida, Orlando, FL, USA
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Hege A, Lemke MK, Apostolopoulos Y, Sönmez S. Occupational health disparities among U.S. long-haul truck drivers: the influence of work organization and sleep on cardiovascular and metabolic disease risk. PLoS One 2018; 13:e0207322. [PMID: 30439996 PMCID: PMC6237367 DOI: 10.1371/journal.pone.0207322] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 10/29/2018] [Indexed: 01/01/2023] Open
Abstract
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.
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Affiliation(s)
- Adam Hege
- Appalachian State University, Department of Health & Exercise Science, Boone, NC, United States of America
| | - Michael K. Lemke
- University of Houston-Downtown, Department of Social Sciences, Houston, TX, United States of America
- Texas A&M University, Complexity & Computational Population Health Group, College Station, TX, United States of America
| | - Yorghos Apostolopoulos
- Texas A&M University, Complexity & Computational Population Health Group, College Station, TX, United States of America
- Texas A&M University, Department of Health & Kinesiology, College Station, TX, United States of America
| | - Sevil Sönmez
- University of Central Florida, College of Business Administration, Orlando, FL, United States of America
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Lemke MK, Apostolopoulos Y, Hege A, Newnam S, Sönmez S. Can subjective sleep problems detect latent sleep disorders among commercial drivers? ACCIDENT; ANALYSIS AND PREVENTION 2018; 115:62-72. [PMID: 29549772 DOI: 10.1016/j.aap.2018.03.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 01/31/2018] [Accepted: 03/06/2018] [Indexed: 06/08/2023]
Abstract
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.
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Affiliation(s)
- Michael K Lemke
- Complexity & Computational Population Health Group, Department of Kinesiology and Health Science, Stephen F. Austin State University, P.O. Box 13015, Nacogdoches, TX, 75962, USA.
| | - Yorghos Apostolopoulos
- Complexity & Computational Population Health Group, Department of Health & Kinesiology, Texas A&M University, 4243 TAMU, College Station, TX, 77843-4243, USA.
| | - Adam Hege
- Department of Health & Exercise Science, Appalachian State University, 111 Rivers Street, Boone, NC, 28608, USA.
| | - Sharon Newnam
- Accident Research Centre, Monash University, 21 Alliance Lane, Clayton, VIC, 3800, Australia.
| | - Sevil Sönmez
- Rosen College of Hospitality Management, University of Central Florida, 9907 Universal Blvd., Orlando, FL, 32819, USA.
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Thiese MS, Hanowski RJ, Moffitt G, Kales SN, Porter RJ, Ronna B, Hartenbaum N, Hegmann KT. A retrospective analysis of cardiometabolic health in a large cohort of truck drivers compared to the American working population. Am J Ind Med 2018; 61:103-110. [PMID: 29114913 DOI: 10.1002/ajim.22795] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2017] [Indexed: 11/08/2022]
Abstract
BACKGROUND Truck drivers face many health challenges, including lifestyle, diet, inactivity, stressors, and social support. METHODS A repeated cross-sectional analysis compared 88,246 truck drivers with data from (n = 11 918) the National Health and Nutrition Examination Survey (NHANES). Trends over time for body mass index (BMI), high blood pressure, diabetes mellitus, heart disease, and sleep disorders were analyzed, adjusting for potential confounders. RESULTS Truck drivers had significantly worsening health metrics between 2005 and 2012 compared to NHANES participants. Truck drivers were significantly more likely to be obese and morbidly obese with prevalence odds ratios (POR) and 95% confidence intervals (95%CI) of 1.99 (1.87, 2.13) and 2.34 (2.16, 2.54), respectively. Measured blood pressure, self-reported high blood pressure, diabetes mellitus, and heart disease all significantly increased. Also, sleep disorders increased among truck drivers from 2005 to 2012 (POR = 6.55, 95%CI 5.68, 7.55). CONCLUSION These data suggest disproportionate increases in poor health among truck drivers from 2005 to 2012.
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Affiliation(s)
- Matthew S. Thiese
- Department of Family and Preventive Medicine, Rocky Mountain Center for Occupational and Environment Health, School of Medicine; University of Utah; Salt Lake City Utah
| | - Richard J. Hanowski
- Center for Truck and Bus Safety; Virginia Tech Transportation Institute; Blacksburg Virginia
| | - Gary Moffitt
- Arkansas Occupational Health Clinic; Springdale Arkansas
| | - Stefanos N. Kales
- Department of Environmental Health; School of Public Health; Harvard University; Cambridge Massachusetts
| | - Richard. J. Porter
- Department of Civil and Environmental Engineering, Utah Traffic Lab; University of Utah; Salt Lake City Utah
| | - Brenden Ronna
- Department of Family and Preventive Medicine, Rocky Mountain Center for Occupational and Environment Health, School of Medicine; University of Utah; Salt Lake City Utah
| | | | - Kurt T. Hegmann
- Department of Family and Preventive Medicine, Rocky Mountain Center for Occupational and Environment Health, School of Medicine; University of Utah; Salt Lake City Utah
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Noone P. In This Issue of Occupational Medicine. Occup Med (Lond) 2017. [DOI: 10.1093/occmed/kqx065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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