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

Retrospective quality review of Department of Transportation (DOT) commercial drivers medical examination forms

OBJECTIVE

This study aimed to evaluate the quality of completion among both drivers and medical examiners in filling out Commercial Driver's (CD) Medical Examination Report Forms.

METHODS

This was a cross-sectional retrospective study of abstracted data from the year 2019. CD Medical Examination Report Forms, collected from a single nationally-based employer and initially reviewed by corporate medical directors, were evaluated by the study team for completeness of documentation provided by both drivers and medical examiners (MEs). Relevant findings included unanswered questions, inconsistency between responses, and lack of necessary elaboration for positive responses.

RESULTS

Among 1603 examinations, MEs completed the Medical Examination Report Form incompletely or incorrectly in 30% of examinations (n = 484). Drivers inconsistently filled out their health history with elaborations 38.7% of the time. Most commonly, they failed to elaborate on positive health history responses in 28.7% of examinations, but other types of errors were noted as well.

CONCLUSIONS

A considerable proportion of drivers or examiners (n = 890, 55%) failed to adequately or correctly complete CD Medical Examination Report forms.

Working conditions of commercial drivers: a scoping review of psychosocial work factors, health outcomes, and interventions

BACKGROUND

Psychosocial work factors significantly influence both organisational and worker health. Poor management of these factors can create precarious working conditions, risking drivers' health. This review maps evidence on the health impact of these factors and health interventions targeting the working conditions and unhealthy habits of commercial drivers.

METHOD

The search was conducted in four main databases (PubMed, Central, JSTOR and Dimensions Ai) and other sources like Google Scholar. In All, 28,039 articles were retrieved and through a rigorous screening process, 68 records were included in this scoping review.

RESULTS

This review found that drivers work in precarious conditions like long driving hours, low job resources and social support, low job control, poor remuneration, workplace abuse and sexual harassment, work-family conflict, lone driving hour, irregular shift work, lack or insufficient breaks during work hours and difficult access to social protection and sanitation facilities. These precarious working conditions may expose drivers to mental health issues, cardiovascular diseases, HIV/AIDs, stroke, chronic fatigue, kidney and bladder issues and musculoskeletal pains. Most health promotion interventions target behaviour at the individual level, such as the benefits of a healthy diet and exercise, with little effort to improving working conditions.

CONCLUSION

Employers in the road transport sector need to implement health promotion interventions that focus on drivers' well-being. Additionally, improving working conditions and enforcing occupational health and safety standards in the road transport sector are essential for creating a safe and healthy workplace for all commercial drivers.

A review of truck driver persona construction for safety management

The trucking industry urgently requires comprehensive methods to evaluate driver safety, given the high incidence of serious traffic accidents involving trucks. The concept of a "truck driver persona" emerges as a crucial tool in enhancing driver safety and enabling precise management of road transportation safety. Currently, the road transport sector is only beginning to adopt the user persona approach, and thus the development of such personas for road transport remains an exploratory endeavor. This paper delves into three key aspects: identifying safety risk characteristic parameters, exploring methods for constructing personas and designing safety management interventions. Initially, bibliometric methods are employed to analyze safety risk factors across five domains: truck drivers, vehicles, roads, the environment, and management. This analysis provides the variables necessary to develop personas for road transportation drivers. Existing methods for constructing user personas are then reviewed, with a particular focus on their application in the context of road transportation. Integrating contemporary ideas in persona creation, we propose a framework for developing safety risk personas specific to road transportation drivers. These personas are intended to inform and guide safety management interventions. Moreover, the four stages of driver post-evaluation are integrated into the persona development process, outlining tailored safety management interventions for each stage: pre-post, pre-transit, in-transit, and on-post. These interventions are designed to be orderly and finely tuned. Lastly, we offer optimization recommendations and suggest future research directions based on safety risk factors, persona construction, and safety management interventions. Overall, this paper presents a safety management-oriented research technology system for constructing safety risk personas for truck drivers. We argue that improving the design of the persona index system, driven by big data, and encompassing the entire driver duty cycle-from pre-post to on-post-will significantly enhance truck driver safety. This represents a vital direction for future development in the field.

Health promotion of long-haul truck drivers and their families

OBJECTIVES

to describe the development of a Health Information and Communication Technology for the health care of long-haul truck drivers and their families.

METHODS

this is a description of the development of an Information and Communication Technology, developed from March to September 2023, following the systematization of the experience in five steps: 1) starting point, 2) initial questions, 3) recovery of the lived process, 4) background reflection, and 5) arrival points.

RESULTS

the technology called "Work-Family Balance," electronically available, presents resources for the health care of long-haul truck drivers. It is anchored in studies on the health of long-haul truck drivers, notes from the International Labor Organization, the Strategic Action Plan for Confronting Chronic Diseases and Non-Communicable Diseases in Brazil, 2021-2030, and the Declaration by the International Association of Family Nursing.

FINAL CONSIDERATIONS

the theoretical improvement of nursing can potentially improve the health care of long-haul truck drivers, prevent Chronic Non-Communicable Diseases, and promote work-life balance to achieve the goals of Agenda 2030.

Long-Haul Truck Drivers' Perceptions of Truck Stops and Rest Areas: Focusing on Health and Wellness

The work and life routine of long-haul truck drivers (LHTDs) involve the use of truck stops and rest areas to meet their basic human needs. These extensions of their workspaces on the road do not always offer adequate physical structures and services that drivers need for optimal health. This study aimed to evaluate long-haul truck drivers' perceptions of food services, safety, physical activity, rest, and personal hygiene offered at truck stops and rest areas, as well as the correlation between these perceptions and sociodemographic, health, and work conditions variables. A cross-sectional, quantitative, and descriptive study was conducted with long-haul truck drivers from the southern region of Brazil. For data collection, a sociodemographic questionnaire and a Likert scale on food, rest, personal hygiene, safety, and physical activity services offered at truck stops and rest areas along Brazilian roads from March to August 2023 were used. The data were analyzed with simple frequency descriptive statistics. The sample consisted of 175 long-haul truck drivers. Out of these, 70.29% declared that the services of the truck stops and rest areas were charged; more than half (53.59%) of the professionals evaluated the rest service as "good" or "excellent"; the food services were "good" or "excellent" for 42.24% of the drivers. The spaces for physical activities were the worst evaluated as "bad" or "terrible" by 41.61%, followed by bathroom services (28.42%) and safety (34.24%). Rest and feeding services had better evaluations, while the services of bathroom, safety, and physical activity presented worse evaluations. Variables such as nationality, weekly working days, and marital status presented positive significance and influenced drivers' perceptions of the services offered at truck stops and rest areas. Drivers who were Brazilian and worked more than five days a week negatively evaluated the services of rest (p = 0.018), safety [0.020], physical activity (0.003), and bathrooms (0.020). In addition, the physical activity services were better evaluated by single drivers than married drivers. These findings suggest that the work conditions and nationality may influence LHTDs' perceptions of services and structures of truck stops and rest areas. These findings may reflect a lack of investments and support efforts to improve basic services such as personal hygiene, a safe environment, and physical exercises, which are fundamental to the health of the workers and aimed at reducing vulnerability and a sedentary lifestyle and meeting the basic human needs of LHTDs.

Risk Factors for Chronic Non-Communicable Diseases of Long-Haul Truck Drivers during the COVID-19 Pandemic: An Integrative Review

Long-haul truck drivers are responsible for transporting goods valued at millions of dollars of the world economy, and may have their health affected by living and working conditions. This study analyzed and synthesized scientific findings about risk factors for the development of chronic non-communicable diseases in long-haul truck drivers. An integrative literature review was conducted. We identified 23 studies that met the inclusion criteria and evaluated the health of 7363 drivers. The biological risk factors identified were age, gender, race/ethnicity, genetics, and comorbidities, and were considered to be non-modifiable for chronic diseases. The behavioral risks considered to be modifiable were sedentary lifestyle, smoking, alcohol consumption, overweight, diet, stress, anxiety, and unfavorable socioeconomic conditions. Environmental risks involved working conditions such as the following: number of working hours per day, week, and month; time away from home; risk of musculoskeletal injury; and opportunities for rest, hours of sleep, and access to health services. The results were presented in two categories: (1) biological, behavioral, and environmental risks, and (2) general recommendations to promote physical, cognitive, and emotional health. Macro-structural changes are needed to reorganize work and rest, improve access to health services to control modifiable risk factors, and to support behavioral and environmental changes to reduce chronic non-communicable diseases and deaths.

A blueprint for a new commercial driving epidemiology: An emerging paradigm grounded in integrative exposome and network epistemologies

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.

The interaction of occupational stress and job burnout on depressive symptoms in railway workers in Fuzhou city

BACKGROUND

To explore the relationship between occupational stress, burnout and depressive symptoms among railroad workers in Fuzhou, and to analyze the interaction of burnout and occupational stress on depressive symptoms.

METHODS

In this study, 861 railway employees of Fuzhou railway bureau were randomly selected from January to April, 2022. Occupational stress inventory revised edition (OSI-R), China job burnout inventory (CMBI) and Symptom Checklist-90 (SCL-90) were used to investigate the occupational stress, job burnout and depressive symptoms of railway workers. Interactions associated with depressive symptoms were assessed by linear hierarchical regression analysis and SPSS macros (PROCESS).

RESULTS

Occupational stress, job burnout and depressive symptoms accounted for 50.58%, 93.47%, and 11.19% of the study population, respectively. There were intergroup differences between age, marriage status, and length of service (P < 0.05). Occupational stress and job burnout are the main risk factors for depressive symptoms (OR: 2.01, 95% CI: 1.17-3.45; 1.94, 1.69-2.23, respectively). More importantly, further analysis of the interaction between occupational stress and job burnout showed that those with high levels of job burnout had a high-risk effect on depressive symptoms at high levels of occupational stress.

CONCLUSION

Occupational stress and job burnout are risk factors for depressive symptoms among railroad workers in Fuzhou City. The interaction of job burnout and occupational stress increases the risk of depressive symptoms.

Exploring the challenges faced by Dutch truck drivers in the era of technological advancement

Introduction

Despite their important role in the economy, truck drivers face several challenges, including adapting to advancing technology. The current study investigated the occupational experiences of Dutch truck drivers to detect common patterns.

Methods

A questionnaire was distributed to professional drivers in order to collect data on public image, traffic safety, work pressure, transport crime, driver shortage, and sector improvements.

Results

The findings based on 3,708 respondents revealed a general dissatisfaction with the image of the industry and reluctance to recommend the profession. A factor analysis of the questionnaire items identified two primary factors: 'Work Pressure', more common among national drivers, and 'Safety & Security Concerns', more common among international drivers. A ChatGPT-assisted analysis of textbox comments indicated that vehicle technology received mixed feedback, with praise for safety and fuel-efficiency improvements, but concerns about reliability and intrusiveness.

Discussion

In conclusion, Dutch professional truck drivers indicate a need for industry improvements. While the work pressure for truck drivers in general may not be high relative to certain other occupational groups, truck drivers appear to face a deficit of support and respect.

MyD88 in myofibroblasts enhances nonalcoholic fatty liver disease-related hepatocarcinogenesis via promoting macrophage M2 polarization

BACKGROUND

Nonalcoholic fatty liver disease (NAFLD) is a major cause of chronic liver diseases and has emerged as the leading factor in the pathogenesis of hepatocellular carcinoma (HCC). MyD88 contributes to the development of HCC. However, the underlying mechanism by which MyD88 in myofibroblasts regulates NAFLD-associated liver cancer development remains unknown.

RESULTS

Myofibroblast MyD88-deficient (SMAMyD88-/-) mice were protected from diet-induced obesity and developed fewer and smaller liver tumors. MyD88 deficiency in myofibroblasts attenuated macrophage M2 polarization and fat accumulation in HCC tissues. Mechanistically, MyD88 signaling in myofibroblasts enhanced CCL9 secretion, thereby promoting macrophage M2 polarization. This process may depend on the CCR1 receptor and STAT6/ PPARβ pathway. Furthermore, liver tumor growth was attenuated in mice treated with a CCR1 inhibitor. CCLl5 (homologous protein CCL9 in humans) expression was increased in myofibroblasts of HCC and was associated with shorter survival of patients with HCC. Thus, our results indicate that MyD88 in myofibroblasts promotes NAFLD-related HCC progression and may be a promising therapeutic target for HCC treatment.

CONCLUSION

This study demonstrates that MyD88 in myofibroblasts can promote nonalcoholic fatty liver disease-related hepatocarcinogenesis by enhancing macrophage M2 polarization, which might provide a potential molecular therapeutic target for HCC.

Sleep, mental health, and access to health care of women truck drivers

BACKGROUND

The numbers of women in trucking are growing steadily, yet because they represent a minority group, little is known about their health issues. Most studies of truck drivers have focused on the mental and physical health, sleep, and health care access of male truck drivers.

PURPOSE

The purpose of this study was to characterize chronic stress, sleep, and mental health service and overall access to care among women truck drivers.

METHODOLOGY

Twenty-five female truck drivers were a subsample of participants from a larger parent study of truck drivers. After approval from the institutional review board, participants completed a 59-item Qualtrics survey; data were transferred from Qualtrics to SPSS v. 24 for analysis.

RESULTS

No acute sleepiness or excess daytime sleepiness was observed, but participants only slept 6 hr per night, and all experienced poor sleep quality. Although 28% of participants met or exceeded the threshold score for posttraumatic stress disorder (PTSD), only 8% sought care for feelings of upset or distress. Also, 80% of the women had health insurance, yet there were those who did not seek care because of job-related conflicts.

CONCLUSION/IMPLICATIONS

Participants were sleep deprived and experienced poor-quality sleep. Mental health and other health services utilization was low. Implications for practice include consideration of telehealth services to improve health care access and screening and referral as needed to mental health care providers by Department of Transportation medical examiners. Future research should include younger women truck drivers to determine the potential contribution of perimenopause/menopause to some of the health issues experienced by this group of workers.

Health Comparisons Between Truck Drivers and the General Population Using the Canadian Community Health Survey

BACKGROUND

This study examined and compared risk factors and health conditions of truck drivers compared with the general Canadian population.

METHODS

This study used the Canadian Community Health Survey consisting of 991 male truck drivers and 29,958 male respondents of the general population.

RESULTS

Compared with the general population, truck drivers were older, less educated, had lower incomes, worked more hours, and were more likely to be widowed/separated/divorced. In addition, truck drivers had significantly higher rates of cardiovascular disease and obesity and were more likely to be sedentary, smoke, drive when fatigued, and eat unhealthy compared with the general population.

CONCLUSIONS

Multicomponent interventions are needed to address the poor lifestyle practices of truckers to reduce the high rates of morbidity.

Job Stress and Sleep Disturbances Among Career Firefighters in Northern California

OBJECT

This study examined the association between job stress and sleep disturbance among career firefighters.

METHODS

A cross-sectional survey study was conducted with 154 career firefighters working in Northern California, US job stress was measured using the short form of the Effort-Reward Imbalance questionnaire and sleep was measured with the Patient-Reported Outcomes Measurement Information System Sleep Disturbance.

RESULTS

Approximately 75% experienced sleep disturbance. For firefighters' job stress, high effort (odds ratio [OR] = 3.68; 95% confidence interval [CI]: 1.25-10.80), high effort-reward ratio (OR = 3.55; 95% CI: 1.23-10.23), and high overcommitment (OR = 9.09; 95% CI: 2.30-35.85) were significantly associated with increased likelihood of sleep disturbance, after adjustment for other factors.

CONCLUSIONS

Job stress significantly affected firefighters' sleep health, suggesting the need to design effective health promotion interventions to reduce job stress and improve sleep quality for these public service workers.

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.

Metabolic syndrome among commercial truck drivers: The relationship between condition prevalence and crashes

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.

Association of psychological symptoms with job burnout and occupational stress among coal miners in Xinjiang, China: A cross-sectional study

Objective

The study aimed to investigate the influencing factors of psychological symptoms in relation to job burnout and occupational stress among coal miners in Xinjiang, so as to provide data support for enterprises in an effort to help them identify internal psychological risk factors and improve the mental health of coal miners.

Methods

A cross-sectional study was carried out. A total of 12 coal mines were selected using the stratified cluster random sampling method and 4,109 coal miners were investigated by means of online electronic questionnaires. The Symptoms Check List-90 (SCL-90), Chinese Maslach Burnout Inventory (CMBI), and Job Demand-Control (JDC) model were respectively used to measure the status of psychological symptoms, job burnout, and occupational stress among coal miners. The mediation analysis was performed through structural equation modeling (SEM) by using Analysis of Moment Structure (AMOS).

Results

The prevalence of psychological symptoms was higher in the occupational stress group than in the non-occupational stress group, and increased with job burnout (P < 0.05). The multivariate logistic regression analysis results showed that mild (OR = 1.401, 95% CL: 1.165, 1.685), moderate (OR = 2.190, 95% CL: 1.795, 2.672), or severe levels of burnout (OR = 6.102, 95% CL: 3.481, 10.694) and occupational stress (OR = 1.462, 95% CL: 1.272, 1.679) were risk factors for psychological symptoms in coal miners. The results of structural equation modeling indicated that occupational stress (β = 0.11, P = 0.002) and job burnout (β = 0.46, P = 0.002) had significant positive direct effects on psychological symptoms, and job burnout was an intermediate variable between occupational stress and psychological symptoms.

Conclusion

High levels of job burnout and occupational stress were risk factors for psychological symptoms. Both occupational stress and job burnout had direct effects on psychological symptoms, and occupational stress could also have an indirect effect on coal miners' psychological symptoms through the intermediate variable of job burnout.

The self-reported stress and stressors in tram and long-haul truck drivers

Work stress may compromise professional drivers' health and driving capacity. Differences between driver groups in terms of on-duty stress are understudied. Therefore, we examined self-reported stress (Stockholm University Stress Scale) of shift-working tram and long-haul truck drivers (n = 75) across 2-3 weeks. Furthermore, stressors were self-reported retrospectively and categorised as related to the job, driving conditions, personal, or other causes. Stress levels were generally low, but moderate to high stress (≥6) was more frequently reported among the tram drivers. Stressors related to the job (54%) and driving conditions (19% of all shifts) were frequently reported among the tram and truck drivers, respectively. Moderate to high stress was associated with categorised stressors related to the job and other causes among the tram drivers, and all categorised stressors among the truck drivers. Altogether, self-reported stress and stressors differ by driver group, but the role of shift type is less significant.

A systematic review of trucking food, physical activity, and tobacco environments and tractor-trailer drivers’ related patterns and practices in the United States and Canada, 1993–2021

•

The built environment is recognized to influence health patterns and practices.

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No review has explored trucking food, physical activity, and tobacco environments.

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Trucking built environment science is underdeveloped and requires validated tools.

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Future research should explore truckers’ views on built environment interventions.

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More emphasis on the trucking built environment and health equity is warranted.

Truckers in the United States (U.S.) and Canada are at high risk for noncommunicable disease. Although trucking built environments have been highlighted for intervention, no systematic review has assessed aspects of trucking environments that may influence food, physical activity (PA), and smoking patterns/practices. The purpose of this systematic review was to characterize the state of the science on trucking food, PA, and tobacco environments and to examine truckers’ food, PA, and tobacco patterns/practices. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used. Five databases were selected for searching in April 2020 and 2021 using key terms constructed by a librarian. Peer-reviewed research with data about U.S. and Canadian truckers’ (i.e., drivers operating 18-wheelers or tractor trailers) food, PA, and/or tobacco environments and related patterns/practices were included. Quality was assessed using the Mixed Method Appraisal Tool. Thirty-eight studies were identified. Results included data from at least 16,600 truckers and 282 trucking settings in the U.S. (n = 32) and Canada (n = 6). Most studies were classified as quantitative descriptive and of poor quality (average score 3 of 7). The few studies (n = 4) that measured trucking food and PA environments characterized trucking sites as poor. Fifteen (47%) presented data about truckers’ perceptions of food or PA environments and highlighted prominent environmental barriers. Truckers’ food, PA, and smoking patterns and practices suggested poor diet quality, sedentary practices, and a high prevalence of smoking. The science of trucking food, PA, and tobacco environments is underdeveloped and requires much more focus using validated measures.

Perceived stress, mental health, organizational factors, and self-reported risky driving behaviors among truck drivers circulating in France

INTRODUCTION

The growth of the European market for road-freight transport has recently led to important changes. The growing number of foreign pavilion drivers transiting in France, which plays a bridging role among European countries, has influenced the lives of truck drivers by increasing competition, pressure on day-to-day activities, and constraints related to delivery deadlines. Adding this new pressure to those inherent in the road-freight transport sector has raised concerns, especially ones linked to levels of perceived stress by truck drivers.

METHOD

With safety concerns in mind, we devised a questionnaire aimed at understanding how French truck drivers and non-French truck drivers, passing through four highway rest areas in France perceive stress, organizational factors, mental health, and risky driving behaviors. A sample of 515 truck drivers took part in the survey (260 French nationals), 97.9% of whom were male.

RESULTS

The results of a structural equation model indicated that perceived stress can increase self-reported risky driving behaviors among truck drivers. Furthermore, organizational factors and mental health were closely linked to perceived stress. Finally, some differences were found between French and non-French truck drivers with respect to mind-wandering and mental health, and to perceive driving difficulties to overcome and driving skills. Practical Applications: Several recommendations based on the findings are provided to policymakers and organizations.

Occupational Stress and Burnout in the Fire Service: Examining the Complex Role and Impact of Sleep Health

The occupational stress inherent in firefighting poses both physiological and psychological risks to firefighters that have been found to possess a reciprocal nature. That is, the nature of these relationships in terms of indicator and impact are elusive, especially as it relates to sleep health (e.g., quality, quantity, hygiene, etc.) as a specific physiological risk and burnout as a specific psychological risk. A series of mediation models were assessed to examine the reciprocal relationships between occupational stress, burnout, and sleep health in a sample of 161 career firefighters. The mediation models confirmed reciprocity among the variables in so much that relationships were best described by the underlying mechanism at work. Comprehensive assessments of both subjective and objective markers of sleep health should be incorporated into firefighter research to supplement behavioral health assessments and interventions, especially related to burnout and occupational stress.

More Than Just "Stressful"? Testing the Mediating Role of Fatigue on the Relationship Between Job Stress and Occupational Crashes of Long-Haul Truck Drivers

Introduction

Recent evidence consistently highlights the adverse work environment of long-haul professional drivers, whose task structure typically involves the performance of extensive shifts, driving under stressful working conditions. In this regard, job stress and fatigue - that are highly prevalent in this workforce - seem to play a crucial role in explaining this group's negative traffic safety outcomes. The aim of this study was to assess whether work-related fatigue is a mechanism that mediates the relationship between job stress, health indicators and occupational traffic crashes of long-haul truck drivers (LHTD).

Methods

The data used in this study were collected from 521 Spanish long-haul truck drivers (97% males) from all 17 regions of Spain, with a mean age of 47 years.

Results

Utilizing structural equation models (SEM), it was found that work-traffic crashes of long-haul truck drivers could be explained through work-related fatigue that exerts a full mediation between job stress (job strain), health-related factors and traffic crashes suffered during the previous two years.

Discussion

Overall, the findings of this research support that a) stressful working conditions and health issues of drivers have significant effects on traffic crashes, and b) fatigue is a mechanism relating stress-related factors and work-traffic crashes of long-haul drivers. This study highlights the need of stress- and fatigue-management policies and interventions, in order to reduce the crash risk of long-haul truck drivers.

The Roles of General and Domain-Specific Perceived Stress in Healthy Aging

OBJECTIVES

Theoretical and empirical evidence suggests the existence of a general perceived stress factor overarching different life domains. The present study investigated the general perceived stress relative to domain-specific perceived stress as predictors of 26 diverse health outcomes, including mental and physical health, health behaviors, cognitive functioning, and physiological indicators of health.

METHOD

A bifactor exploratory structural equational modelling (BiESEM) approach was adopted in two aging samples from the Health and Retirement Study (HRS; N = 8325 in Sample 1, N = 7408 in Sample 2).

RESULTS

Across the two samples, perceived stress was well-represented by a bifactor structure where there was a robust general perceived stress factor representing a general propensity towards stress perception. Meanwhile, after controlling for the general perceived stress factor, specific factors that represent perceived stress in different life domains were still clearly present. Results also suggested age, sex, race, education, personality traits, and past and recent stressor exposure as possible factors underlying individual differences in the general perceived stress factor. The general perceived stress factor was the most robust predictor of the majority of health outcomes, as well as changes in mental health outcomes. The specific factor of perceived neighborhood stress demonstrated incremental predictive effects across different types of health outcomes.

DISCUSSION

The current study provides strong evidence for the existence of a general perceived stress factor that captures variance shared among stress across life domains, and the general perceived stress factor demonstrated substantial prospective predictive effects on diverse health outcomes in older adulthood.

Driver-passenger communicative stress and psychological distress among Chinese bus drivers: the mediating effect of job burnout

BACKGROUND

This study aimed to investigate the relationship between driver-passenger communicative stress and psychological distress among bus drivers, as well as whether job burnout mediates the effect of driver-passenger communicative stress on psychological distress.

METHODS

A questionnaire consisting of a 12-item version of the General Health Questionnaire (GHQ-12), a one-item driver-passenger communicative stress scale, the Maslach Burnout Inventory-General Survey (MBI-GS), as well as sociodemographic and work factors, was distributed to 310 bus drivers in Shanghai, of which 307 completed it (99.0% response rate). A parallel multiple mediation model with bootstrap approach, was calculated to test the mediating effect.

RESULTS

Driver-passenger communicative stress, emotional exhaustion and cynicism were positively associated with psychological distress. Communicative stress was significantly positively linked with two of the three dimensions of burnout (emotional exhaustion and cynicism) and dependent variable. Emotional exhaustion and cynicism were positively associated with the dependent variable. The results indicate that emotional exhaustion and cynicism partially mediated the effect of communicative stress on psychological health, and that 60.0% of this effect can be explained by mediating effects, in which emotional exhaustion and cynicism weighed 63.2% and 36.8%, respectively.

CONCLUSIONS

Communicative stress had effects on psychological distress among Chinese bus drivers, and job burnout was a mediator in this relationship.

Relationship between sleep disorders, HIV status and cardiovascular risk: cross-sectional study of long-haul truck drivers from Southern Africa

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.

Cardiometabolic risk factors and mental health status among truck drivers: a systematic review

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.

Truck Drivers' Cigarette Smoking and Preferred Smoking Cessation Methods

Introduction:

Some studies show that truck drivers use tobacco and other stimulants to stay awake as they drive. Despite their increased risks for many of tobacco-related health disparities, there is limited engagement of truck drivers in smoking cessation programs. The objective of this study was to describe smoking characteristics and identify their preferred smoking cessation methods among truck drivers.

Methods:

This was a cross-sectional mixed methods study. Participants were truck drivers recruited at trucking companies in Utah in 2019. Participants were either individually interviewed (n = 4), or filled out a survey (n = 33). We conducted qualitative data analysis of the interviews followed by descriptive statistics of smoking and cessation characteristics from the survey.

Results:

Reasons for smoking included, staying awake, stress reduction, or something to do while driving. Of the drivers surveyed, 68.8% were daily smokers while 97% had smoked at least 100 cigarettes in their life time. The mean number of cigarettes per day (cpd) was 15.7, and 25 among those who had 10 or more cpd. Sixty-one percent had made at least a quit attempt. In addition to counseling or brief advice, 68% reported interest in using Nicotine Replacement Therapy (NRT) either as gum or patch to help them quit. 21% reported interest in telephone text messaging to engage them in treatment.

Conclusion:

Cigarette smoking is a public health problem among truck drivers. Our findings suggest that truck drivers are interested in quitting smoking. Evidence based interventions tailored to this population are needed to help them quit and reduce their smoking-related morbidity.

A novel COVID-19 based truck driver syndemic? Implications for public health, safety, and vital supply chains

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.

Psychosocial Work Factors, Job Stress and Strain at the Wheel: Validation of the Copenhagen Psychosocial Questionnaire (COPSOQ) in Professional Drivers

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.