Selected risk factors of diabetes mellitus among road transport drivers

A Cross-Sectional Study of Determinants of Type 2 Diabetes Mellitus Among Professional Drivers in the Perambalur Municipality Area of Tamil Nadu, India

Background Professional drivers have a powerful impact on public safety. They are also at a higher risk of obesity, hypertension, and type 2 diabetes mellitus (T2DM) because of their lifestyle. Diabetes and its complications can affect driving and cause increased road traffic accidents. This study aimed to estimate the prevalence of T2DM and determine the risk factors contributing to the development of T2DM among professional drivers in the Perambalur Municipality of Tamil Nadu, India. Methodology This cross-sectional study was carried out between September 2022 and December 2022 among 118 private bus drivers and full-time, professional, three-wheeler drivers in the Perambalur Municipality. A pre-tested semi-structured proforma was used to collect information on the driver's socio-demographic profile and to inquire about their diabetes history, which was verified with their records. We elicited the risk factors of T2DM among those drivers. We recorded the anthropometric measurements and blood pressure. Data analysis was done using IBM SPSS Statistics for Windows, Version 21.0 (Released 2012; IBM Corp., Armonk, New York, United States). Results Out of 118 study participants, the majority were in the age group of 51-65 (37.3%). Seventy-seven of the participants have completed their secondary education, and 38 of them belong to the class 2 socioeconomic class. Three-fourths of the sample (83.1%) belonged to nuclear families. Around one-third were current smokers, one-fourth had the habit of chewing tobacco, and more than half of the participants consumed alcohol. Nearly 83.7% had moderate physical activity, followed by 11.9% who had heavy activity, and 5.1% who did not do any physical activity. The prevalence of T2DM among professional drivers was 11.9%. The risk factors that contributed to the development of T2DM among professional drivers were age, education, smoking, tobacco chewing, hypertension, elevated BMI, and elevated WC, which are statistically significant (p˂0.05). Conclusion We found the proportion of obesity, hypertension, and diabetes to be higher among professional drivers than among the general population. This demands an urgent need for preventive and health-promotive interventions to address these chronic diseases.

Level of Knowledge and Awareness of Diabetic Emergencies Among Turkish Bus Drivers: Example of the Mediterranean Region

The objective of this research was to determine the level of knowledge and awareness of diabetic emergencies among Turkish bus drivers. Methods. The universe of this descriptive and cross-sectional study was all the individuals working as bus drivers in the Mediterranean Region between January-June 2019, and the study sample was 1292 drivers who met the inclusion criteria of the research. Data were collected by the Personal Information Form and the Diabetic Emergency Information and Awareness Survey Form. Descriptive statistics, the Mann-Whitney U test and the Kruskal-Wallis test were used in data evaluation. Results. The average age of bus drivers participating in the study was 38.29 ± 9.44 years, while their average work experience was 12.50 ± 8.92 years. Among them, 14.9% of bus drivers had a diabetic family member; 23.7% of bus drivers had a first aid certificate; 11.5% of bus drivers received diabetes-related training. The average score of drivers for the level of knowledge and awareness regarding diabetic emergencies was found to be 15.39 ± 4.72. There was a statistically significant difference between the drivers’ average scores for the level of knowledge and awareness and their age, education status, work experience, the presence of chronic disease, the presence of a diabetic family member, the presence of a first aid certificate, diabetes-related training, the place of receiving this training variables (p < 0.05). Conclusions. Bus drivers were found to have above average levels of knowledge and awareness of diabetic emergencies. Bus drivers are recommended to be trained on diabetic emergencies and raising awareness of diabetes mellitus to ensure a proper intervention in case of emergencies in individuals with diabetes mellitus during travels.

Demographic and Cardiovascular Risk Factors Associated with Drug Use in Truck Drivers in the State of São Paulo, Brazil: A Cross-Sectional Study

The aim of the study is to analyze the association between risk factors for the health of truck drivers and previous use of illicit drugs. A cross-sectional study examined the data from 2071 truck drivers between 2010 and 2016. Demographic variables, risk factors for cardiovascular disease (CVD) and the use of illicit drugs were analyzed. The stepwise logistic regression model was used for the adjusted analysis. The dependent variable was the previous use of illicit drugs, and independent variables were those with p < 0.1 at a bivariate analysis. The average age of the truck drivers was 42.27 ± 11.07 years, and the previous use of illicit drugs was reported or detected in 388 (18.7%) drivers. Compared to non-users, drug users were younger (37.25 ± 9.45 vs. 43.43 ± 11.1 years; p < 0.001) and single (43.3% vs. 28.4%; p < 0.001). The independent variables for illicit drugs were age (OR = 0.93 (95% CI: 0.91-0.95; p < 0.001)), smoking (OR = 2.18 (95% CI: 1.39-3.44; p = 0.001)), alcohol consumption (OR = 1.626 (95% CI: 1.06-2.49; p = 0.026)) and driving hours per day (OR = 1.08 (95% CI: 1.01-1.15; p = 0.012)). Users of illicit drugs had multiple risk factors for CVD and traffic accidents.

Overweight, underweight, and obesity among male long-distance professional drivers in Iran

OBJECTIVE

Long-distance professional drivers, as an occupational group, are hypothesized to have a higher risk of overweight and obesity. The aim of this study was to estimate the prevalence and risk factors of overweight, underweight, and obesity in long-distance professional drivers.

METHODS

A cross-sectional study was conducted on 36 625 male long-distance professional drivers age ≥20 years, from April 2013 to Sept. 2016. Drivers were interviewed and underwent clinical and laboratory examinations including measures of blood pressure (BP), blood tests, anthropometric data, and visual and hearing acuity. The mean (standard deviation [SD]) age of participants was 41.9 (10.2) years with a mean (SD) duration of a professional driving of 15.3 (9.6) years and mean (SD) body mass index (BMI) was 25.7 (4.0) kg/m² .

RESULTS

The prevalence of overweight and obesity was 39.1% (95% confidence interval (CI) 38.6, 39.6) and 10.8% (95% CI 10.5, 11.1), respectively. A total percentage of 2.7 (95% CI 2.5, 2.9) were underweight. A total percentage of 10.6 had BMI 30-40 kg/m² and 0.2% had BMI ≥40 kg/m² . Using a stepwise binary logistic regression model for overweight, underweight, and obesity, age had a significant independent relationship with underweight, overweight, and obesity. Duration of work, BP, fasting plasma glucose, triglyceride, and cholesterol had significant independent positive association and smoking had a negative association with overweight/obesity when other covariates were considered.

CONCLUSIONS

These findings indicate that overweight and obesity are prevalent among long-distance professional drivers in Iran and appears to be similar to the general population.

Prevalence of hypertension among professional drivers: Evidence from 2000 to 2017-A systematic review and meta-analysis

Background:

Hypertension is one of the leading causes of premature deaths worldwide. Drivers have an additional risk of hypertension when compared to the general population because of the nature of their profession. Hence, the current review was done to estimate the global burden of hypertension among professional drivers.

Methods:

We conducted a systematic search for articles on the prevalence of hypertension among drivers published from 2000 to 2017 in Medline and Embase. Meta-analysis was performed using the random-effects model and pooled prevalence of hypertension was reported. Heterogeneity was assessed using the likelihood ratio (LR) test and publication bias was assessed using Egger's test.

Results:

In total, 26 studies with 15,702 drivers were included. The pooled prevalence of hypertension among the drivers worldwide was 34% (95% confidence interval [CI]: 27–40%). World Health Organization (WHO) region-wise estimates showed that prevalence was highest among the drivers in the Western Pacific region (56%) and lowest in the Eastern Mediterranean and African region (21%). Studies showed significant evidence of heterogeneity (Χ² = 1816.1, P < 0.001) but there was no significant publication bias (P = 0.967).

Conclusion:

More than one-third of drivers have hypertension globally which is in excess of the general population. Hence, more focus needs to be given for allocating resources and developing workplace interventions for prevention and control of hypertension.

Factors Associated with Untreated Decayed Teeth in Male Sales Workers: An Internet Survey

The purpose of this study was to identify factors associated with untreated decayed teeth (DT) in male sales workers. The participants were recruited by screening a pool of Japanese registrants in an online database for eligibility for inclusion in the study. Between 20 February 2015 and 11 March 2015, those deemed eligible were asked to complete a questionnaire on the status of their oral health. Responses from a total of 142 male sales workers aged between 30 and 49 years were analyzed. Of these, 40 reported DT and 102 no untreated decayed teeth (NDT). The percentage of participants with DT was higher than that with NDT among night shift workers (p<0.001). A higher percentage of participants with DT reported pain when eating or drinking something cold (p=0.041), pain in the teeth or gingiva (p<0.001), or frequent stomatitis (p=0.030). A higher percentage of participants with DT reported eating between meals (p=0.027) and a lower percentage visiting a dental clinic in the past 6 months (p=0.017) compared with among participants with NDT. Those with NDT were more likely to report an inability to visit a dental clinic when they wanted to (p=0.033), but those with DT were more likely to report that their reasons for not visiting a dental clinic were that multiple visits were required for treatment (p=0.012) or that they did not like the treatment (p=0.005). Working the night shift (Odds Ratio [OR], 3.492; 95% Confidence Interval [CI], 1.347-8.725) and visiting a dental clinic in the past 6 months (OR, 0.084; 95%CI, 0.010-0.733) were identified as independent variables correlated with leaving DT untreated. Requiring oral health education and dental checkups at least once every 6 months may have a positive effect on oral health among male sales workers, especially those doing night shifts.

Factors associated with obesity in urban collective transportation workers of the Metropolitan Region of Belo Horizonte, Minas Gerais, Brazil

OBJECTIVE

To analyze the demographic, behavioral and occupational factors associated with obesity among urban collective transportation workers of the Metropolitan Region of Belo Horizonte, Minas Gerais State, Brazil.

METHOD

This is a cross-sectional study conducted with 1,448 drivers and collectors in the Metropolitan Region of Belo Horizonte. Anthropometric, demographic, behavioral data, as well as participants' link to the company and bus conditions were gathered in 2012 through a questionnaire applied by an interviewer. To calculate obesity, the body mass index cut off point was ≥ 30 kg/m2. Prevalence ratios (PR) and respective 95% confidence intervals (95%CI) were adjusted by Poisson's multivariate regression.

RESULTS

The prevalence of obesity among urban collective transportation workers was 16.1%. Female sex (PR = 1.84; 95%CI 1.37 - 2.49), aging 30 to 39 years old (PR = 1.66; 95%CI 1.17 - 2.37) and 40 to 49 years old (PR = 1.59; 95%CI 1.04 - 2.42), being in the same job role from 5.01 to 10 years (PR = 1.52; 95%CI 1.04 - 2,42) and from 20.01 to 47 years (PR = 1.90; 95%CI 1.21 - 3.00), and physical inactivity (PR = 1.32; 95%CI 1.01 - 1.73) remained independently associated with obesity after multivariate adjustment data.

CONCLUSION

These findings highlight the need to consider actions that encourage employees to participate in healthy activities when discussing health promotion for public transport workers, as well as actions to improve the organization and management of work, so it becomes a health and well-being feature for this population.

Prevalence, awareness, and determinants of type 2 diabetes mellitus among commercial taxi drivers in buffalo city metropolitan municipality South Africa: A cross-sectional survey

Undiagnosed type 2 diabetes mellitus constitutes a significant threat to the health of commercial taxi drivers, safety of the passengers and other road users. This study determines the prevalence of pre-diabetes and type 2 diabetes mellitus among commercial taxi drivers in Buffalo City Metropolitan Municipality (BCMM), Eastern Cape and examines the factors associated with type 2 diabetes mellitus.A cross-sectional survey of 403 commercial taxi drivers was undertaken using the World Health Organization (WHO) STEPwise approach. Anthropometric, blood pressure, and blood glucose measurements followed standard procedure. Diabetes status was determined using the fasting blood glucose (FBG) test. Diabetes was defined as a FBG ≥7.0mmol/L or self-reported history of diabetes or current diabetes medication use (treatment), while pre-diabetes was defined as a FBG of 5.6 to 6.9 mmol/L. Awareness of diabetes was defined as a self-reported history of diabetes.The mean age of the study participants was 43.3 ± 12.5years. Prevalence of pre-diabetes and diabetes were 17% (95% CI: 13.4-20.6) and 16% (95% CI: 12.4-19.6), respectively. Of those who had diabetes (n = 63), the majority were aware of their diabetes status (n = 43) and were on treatment (n = 30). In the unadjusted logistic regression, age, ever married, hypertension, obesity, and driving for more than 5 years were independently associated with diabetes. However, only age >35 (adjusted odds ratio [AOR]= 3.65, CI: 1.17-11.32), ever married (AOR= 3.26, CI: 1.52-6.99) and hypertension (AOR= 3.23, CI: 1.56-6.69) were associated with diabetes in the adjusted logistic regression model.The prevalence of diabetes among commercial taxi drivers in this study is high, almost twice the national prevalence of diabetes in South Africa. Periodic health screening among this sub-population group is important to bridge the gap of undiagnosed diabetes in South Africa.

Sleep and Mental Health in Truck Drivers: Descriptive Review of the Current Evidence and Proposal of Strategies for Primary Prevention

Background: Professional truck drivers (TDs) are exposed to stressful working (and living) conditions and are vulnerable. They report physical and mental health problems and psychological distress more frequently than the general population and their problems can affect safety on the roads. Actions to improve TDs’ health and reduce the risks of (co-)morbidity or unsafe driving are imperative. Methods: The published studies dealing with the TDs’ sleep habits and mental health were reviewed to define the scenario and organize the preventive strategies proposed thus far. Results: Awareness among TDs of the high risk for health and safety due to (often co-existing) untreated sleep and mental health problems is critical. Alcohol and prescribed or illicit drugs are often misused to compensate for depression, anxiety, job strain, fatigue, and social isolation. Polypharmacy and dependence increase the chance of unsafe behaviors on the road. The TDs’ access to healthcare services is scant, and participation in industry-sponsored wellness programs is limited. Conclusions: Primary prevention is a first unavoidable step to deal with sleep and mental health problems. Educational programs, online support and tele-health assessment/monitoring would help improve the well-being, safety and health of professional TDs and increase safety on the road.

Comparison of risk factors for tooth loss between professional drivers and white-collar workers: an internet survey

This cross-sectional study was conducted to examine tooth loss and associated factors among professional drivers and white-collar workers. The participants were recruited by applying screening procedures to a pool of Japanese registrants in an online database. The participants were asked to complete a self-reported questionnaire. A total of 592 professional drivers and 328 white-collar workers (male, aged 30 to 69 years) were analyzed. A multiple logistic regression analysis was performed to identify differences between professional drivers and white-collar workers. The results showed that professional drivers had fewer teeth than white-collar workers (odds ratio [OR], 1.74; 95% confidence interval [95% CI], 1.150-2.625). Moreover, a second multiple logistic regression analysis revealed that several factors were associated with the number of teeth among professional drivers: diabetes mellitus (OR, 2.68; 95% CI, 1.388-5.173), duration of brushing teeth (OR, 1.66; 95% CI, 1.066-2.572), frequency of eating breakfast (OR, 2.23; 95% CI, 1.416-3.513), frequency of eating out (OR, 1.70; 95% CI, 1.086-2.671) and smoking status (OR, 2.88; 95% CI, 1.388-5.964). These findings suggest that the lifestyles of professional drivers could be related to not only their general health status, but also tooth loss.

Lone workers attitudes towards their health: views of Ontario truck drivers and their managers

BACKGROUND

Truck driving is the second most common occupation among Canadian men. Transportation of goods via roads is of crucial importance for the Canadian economy. The industry is responsible annually for $17 billion in GDP and is projected to increase by 28% over the next 10 years. Recruitment is an issue with 20% of drivers projected to retire or leave the profession in the next 10 years. Despite the reliance on transport truck drivers for the delivery of goods which affects Canada's economy and daily living of residents, little is known about the health care needs of this large cohort of primarily male lone workers from a drivers' perspective. Transport truck drivers are independent workers whose non traditional workplace is their tractor, the truck stops and the journey on the road.The objective of this study was to obtain a contextually informed description of lifestyle issues, health and disease risk factors experienced by drivers and perceived by their managers in the truck driving occupation.

METHODS

Using a grounded theory approach, 4 focus groups were conducted with drivers (n = 16) and managers (n = 10) from two trucking companies in Southwestern Ontario to identify the lived experience of the drivers as it relates to preventable risks to health and wellness. A semi structured guided interview was used to explore the lifestyle context of transport truck driving and organizational aspects of the occupation (workplace culture, working conditions and health and wellness promotion).

RESULTS

The predominant themes described stress, workplace, communication, lifestyle, driving culture, family, and fatigue concerns. In terms of the transportation work environment, drivers and managers were aware of the profession's potential to foster lifestyle related chronic diseases but described challenges in making the profession more amenable to a healthy lifestyle.

CONCLUSIONS

Workplace environmental determinants are significant in shaping health behaviours. Chronic disease health risks were the main health concerns identified. Health risks were exacerbated by working conditions (job demands, work hours, financial pressure and the sedentary nature of the job). Workplace health strategies will need to take into account the unique challenges of the occupation.

Health promotion in the Danish maritime setting: challenges and possibilities for changing lifestyle behavior and health among seafarers

BACKGROUND

Seafaring is a risky occupation when compared to land-based industries as incidence rates of mortality and morbidity are higher. This trend is partly due to a higher number of accidents but also higher incidence of lifestyle-related diseases like cardiovascular disease and lung cancer. In Denmark, the proportion of smokers as well as of overweight and obese persons is higher among seafarers compared to the general population. This high burden of risk indicates that this occupational group might be a growing challenge at sea in regard to safety and health issues and there is a need to further our understanding of the health promotion approaches that work.

METHODS

A single-group pre-post design was conducted in 2008-2009 in order to identify changes in lifestyle related behaviors and health risk factors among seafarers (N: 606) in two Danish shipping companies after implementing two structural health promotion interventions (healthy cooking courses for ship cooks and improvement of fitness facilities) as well as health education interventions (smoking cessation courses, individual exercise guidance and extra health check-ups) at the maritime workplace. Baseline and follow-up data were collected with a self-administrated standardized questionnaire and individual health profiling assessing parameters such as physical health and physical fitness. In addition, qualitative interviews with participants and non-participants were conducted in order to gain in-depth information on experiences with the intervention processes.

RESULTS

Significant changes were identified for levels of fitness, daily sugar intake and metabolic syndrome. However, these results were not associated with participating in the health educational interventions. One possible explanation for the improved fitness rate could be the upgrading of fitness equipment onboard the ships provided by the management level. The decrease in daily sugar intake and prevalence of seafarers with metabolic syndrome might be associated with the cooking course intervention which aimed at providing healthier daily meals on board.

CONCLUSION

The findings suggest that a multicomponent health promotion intervention program has the potential to achieve change in seafarers' health behavior and health parameters. In the future, studies with more rigorous designs, separately testing the contribution of different types of interventions are needed.

Medical risk factors of diabetes mellitus among professional drivers

Background

Road transport drivers are one of the professional groups whose activities have a strong impact of public safety. In view of the natural professional activity, the drivers are at a higher risk of obesity, hypertension and hyperlipidemia, and carbohydrate metabolism disorders such as diabetes mellitus.

Materials and methods

Medical documentation was the source of data for the reported study. It derived from medical examinations of 1903 drivers applying for driving license.

Results

Hyperglycemia was found in 52.1% of the drivers, 9.1% of them were in diabetic stage, and with HbA₁C criteria 77.6% of these drivers were in this stage. Excessive body weight was recorded in 65.6% of the study population, 44.8% were diagnosed with overweight and 20.8% with obesity. High blood pressure was recorded in 16.4% of drivers.

Conclusion

High prevalence of excessive body weight and high blood pressure and hyperlipidemia are risk factors for diabetes mellitus in professional drivers that indicates a need to undertake multidimensional actions target on this particular profession and involving various health care sectors. Prophylactic and detailed pre-placement examinations should be considered, depending on the rate and the intensity of disorders. These should be coupled with an introduction of primary and secondary prophylactic activities and monitoring of relevant treatment.

Prevalence of undiagnosed diabetes mellitus and cardiovascular risk factors in Hong Kong professional drivers

AIMS

To investigate the prevalence of undiagnosed diabetes mellitus (DM) and cardiovascular risk factors among professional drivers in Hong Kong.

METHODS

Chinese professional drivers with no history of DM were invited to complete a questionnaire on their health status, followed by taking their body measurements, fasting blood glucose (FG) and lipids. 75g OGTT were performed when FG≥5.6 to <7.0mmol/L.

RESULTS

Of these 3376 drivers (male 92.6%, mean age 50.9±7.6 years), the prevalence of undiagnosed DM, prediabetes, and metabolic syndrome was 8.1% (272/3376, 95% CI 7.1-9.0%), 10.0% (337/3376, 95% CI 9.0-11.0%) and 26.8% (904/3376, 95% CI 25.3-28.3%) respectively, while the corresponding WHO Standard Population age-standardized prevalence was 7.8%, 9.0% and 24.7% respectively. Many of them were obese (51.2%), had hypertension (57.0%) and high cholesterol (58.7%), and a third had hypertriglyceridaemia (34.9%) and low HDL-cholesterol (29.3%). Their median working hours were 60.0 (IQR 14)h. Majority had exercise <1h/week (56.0%) and ate out ≥6times/week (54.9%).

CONCLUSIONS

Hong Kong professional drivers have higher prevalence of undiagnosed DM, cardiovascular risk factors and metabolic syndrome than the general population. Therefore, health care measures targeting against them should be taken to prevent and detect DM and cardiovascular diseases.

Unhealthy and healthy weight control behaviours among bus operators

BACKGROUND

Urban bus operators are an occupational group with high rates of overweight and obesity. Understanding methods bus operators use for weight control may be important; there may be increased risk for these workers to engage in less healthy weight management behaviours due to stressful working conditions.

AIMS

To examine the prevalence of unhealthy and healthy weight control behaviours used by bus operators and examine associations between use of unhealthy weight control behaviours and work-related and sociodemographic variables.

METHODS

Bus operators from four different transit garages were invited to complete a self-administered survey; height and weight were measured by research staff. Unhealthy and healthy weight control behaviours, work hours, work schedule and social support were measured with self-report items on the employee survey. Logistic regression analysis was conducted to estimate associations.

RESULTS

Nearly 60% of bus operators endorsed at least one unhealthy method; over 50% reported skipping meals, 30% fasted and 10% reported taking diet pills in the past year. Bus operator gender, race, body mass index status and hours worked per week showed significant associations with using at least one unhealthy weight control behaviour.

CONCLUSIONS

Worksite interventions should emphasize the benefit of healthy eating and physical activity but should also address the use of less healthy methods for weight control for individuals employed in transportation occupations.

Prevalence of metabolic syndrome in bus and truck drivers in Kashan, Iran

BACKGROUND

Bus and truck drivers are apparently more involved in metabolic syndrome and its complications due to their working conditions. The related impacts are not only harmful for driver's health, but also may endanger others. The present research was carried out to determine the prevalence of metabolic syndrome among bus and truck drivers in Kashan, a city in Iran.

MATERIALS

In 2007, 429 bus and truck male drivers were enrolled to this cross sectional study to examine the metabolic syndrome using ATPIII criteria. Statistical tests including Chi-Square test, T-student test and Pearson's correlation coefficient were used to analyze the data.

RESULTS

Prevalence of metabolic syndrome in subjects was 35.9%. Hypertension and diabetes were seen in 42.9% and 7% of the drivers respectively. Body mass index (BMI) in 41% of the drivers within the range of 25-30 was considered overweight and 23% of them were found to be obese. High triglyceride (53.4%) and low HDL-C levels (48.7%) were more common than other components of metabolic syndrome. A significant positive correlation was seen between BMI, diabetes, high blood pressure and metabolic syndrome (p < 0.001); but there was no positive correlation between metabolic syndrome and smoking (p < 0.06).

CONCLUSION

High prevalence of metabolic syndrome and other relevant risk factors for coronary heart diseases (CHD) were detected among the drivers. Based on these findings, it is recommended to consider training programs, establish pertinent health regulations, and focus on the metabolic syndrome complications in high risk group to improve and maintain their quality of life and to promote their public health.