References: Truck Driver Safety and Health

References on research into heart disease and mortality in truck drivers

Koda, S., N. Yasuda, Y. Sugihara, H. Ohara, H. Udo, T. Otani, A. Hisashige, T. Ogawa and H. Aoyama (2000). “Analyses of Work-Relatedness of Health Problems among Truck Drivers by Questionnaire Survey [English Abstract].” Sangyo Eiseigaku Zasshi 42(1): 6-16.

In order to estimate occupational risk factors for health problems among truck drivers, a questionnaire survey of working conditions, job content in truck transportation, subjective symptoms and present illnesses was carried out among 541 truck transportation workers in 1997. The valid response rate was 85.7%, and 134 local truck drivers, 199 long-distance truck drivers and 71 clerical workers were analyzed.

The prevalence rates of working factors affecting health problems of truck drivers were significantly higher than those of clerical workers in the items on irregular shift work, working environment, working posture, handling heavy materials, job stress due to overloading and long working time and limited time off. The prevalence rates for subjective symptoms (ringing in the ears, neck pain and low back pain) and present illnesses (hypertension, ulcers in the digestive tract, back injuries, whiplash injuries and hemorrhoids) among truck drivers were significantly higher than those of clerical workers. Odds ratios for hypertension, heart diseases and related subjective symptoms among local truck drivers were significantly increased by job career, twisting posture, vibration and driving stress. Odds ratios for fatigue symptoms were significantly increased by the shortage of recess, vibration and driving stress.

Bigert, C., P. Gustavsson, J. Hallqvist, C. Hogstedt, M. Lewne, N. Plato, C. Reuterwall and P. Scheele (2003). “Myocardial Infarction among Professional Drivers.” Epidemiology 14(3): 333-9.

Background: Professional drivers are at an increased risk of myocardial infarction but the underlying causes for this increased risk are uncertain.

Methods: We identified all first events of myocardial infarction among men age 45-70 years in Stockholm County for 1992 and 1993. We selected controls randomly from the population. Response rates of 72% and 71% resulted in 1067 cases and 1482 controls, respectively. We obtained exposure information from questionnaires. We calculated odds ratios (ORs), with and without adjustment for socioeconomic status, tobacco smoking, alcohol drinking, physical inactivity at leisure time, overweight status, diabetes and hypertension.

Results: The crude OR among bus drivers was 2.14 (95% confidence interval = 1.34-3.41), among taxi drivers 1.88 (1.19-2.98) and among truck drivers 1.66 (1.22-2.26). Adjustment for potential confounders gave lower ORs: 1.49 (0.90-2.45), 1.34 (0.82-2.19) and 1.10 (0.79-1.53), respectively. Additional adjustment for job strain lowered the ORs only slightly. An exposure-response pattern (by duration of work) was found for bus and taxi drivers.

Conclusions: The high risk among bus and taxi drivers was partly explained by unfavorable life-style factors and social factors. The work environment may contribute to their increased risk. Among truck drivers, individual risk factors seemed to explain most of the elevated risk.

Malinauskiene, V. (2003). “Truck Driving and Risk of Myocardial Infarction.” Przeglad Lekarski 60 Suppl 6: 89-90.

Aim of the study: To investigated the effect ischemic heart disease of risk factors on elevated first myocardial infarction risk among truck drivers.

Materials and methods: We carried out a case-control study among men aged 25-64, Kaunas in 1997-2000. We identified myocardial infarction cases (n = 448) from the myocardial infarction hospital register (International Classification of Diseases, 10-th revision, code 121). Controls (N = 1777) were selected on the basis of age, gender and city district of residence. We obtained information on sociodemographic, psychosocial and behavioral factors. We used the International Standard Classification of Occupations (ISCO) to code for occupations and conducted logistic regression analysis to evaluate the effect of ischemic heart disease risk factors on myocardial infarction risk for truck drivers.

Results: We found that truck rivers were at increased risk for the development of first myocardial infarction (age-adjusted odds ratio 2.36; 95% CI 1.67-3.35). After adjustment for smoking, hypertension, obesity, stress the odds ratio remained stable (2.26; 95% CI 1.58-3.24) as compared to other employed men. The logistic regression analysis within the subpopulation of truck drivers showed that the odds ratio for arterial hypertension was 3.20, for smoking–2.48. The effect of obesity and stress decreased to insignificant level.

Conclusions: Truck drivers are at increased risk for the development of first myocardial infarction. Arterial hypertension and smoking are significant risk factors of myocardial infarction for truck drivers.

Robinson, C. F. and C. A. Burnett (2005). “Truck Drivers and Heart Disease in the United States, 1979-1990.” Am J Ind Med 47(2): 113-9.

Background: Studies of truck drivers and cardiovascular disease (CVD), myocardial infarction, or ischemic heart disease (IHD) are limited, although studies of other professional drivers reported increased risk.

Methods: US mortality data from 1979 to 1990 for ages 15-90 were used to calculate proportional mortality ratios (PMRs) for heart disease and lung cancer for short and long haul truck drivers. Analysis was performed for Black (998 short haul and 13,241 long haul) truck drivers and White (4,929 short and 74,315 long haul) truck drivers separately.

Results: The highest significantly elevated proportionate heart disease (IHD, acute myocardial infarction (AMI), and other forms of heart disease) and lung cancer mortality was found for White and Black male long haul truck drivers age 15-54. Mortality was not significantly elevated for short haul truck drivers of either race or gender, nor for truck drivers who died after age 65, except for lung cancer among White males. An indirect adjustment suggested that smoking could explain the excess IHD mortality, but no direct data for smoking or the other known risk factors for heart disease were available and occupational exposures were not measured.

Conclusions: The highest significant excess proportionate mortality for lung cancer, IHD and AMI was found for long haul truck drivers who were under age 55 at death. A cohort or longitudinal study of heart disease among long haul truck drivers, that obtains data for occupational exposures as well as lifestyle risk factors, could help explain inconsistencies between the findings of this and previous studies.

Laden, F., J. E. Hart, T. J. Smith, M. E. Davis and E. Garshick (2007). “Cause-Specific Mortality in the Unionized Us Trucking Industry.” Environmental Health Perspectives 115(8): 1192-1196.

Background: Occupational and population-based studies have related exposure to fine particulate air pollution, and specifically particulate matter from vehicle exhausts, to cardiovascular diseases and lung cancer.

Objectives: We have established a large retrospective cohort to assess mortality in the unionized U.S. trucking industry. To provide insight into mortality patterns associated with job-specific exposures, we examined rates of cause-specific mortality compared with the general U.S. population.

Methods: We used records from four national trucking companies to identify 54,319 male employees employed in 1985. Cause-specific mortality was assessed through 2000 using the National Death Index. Expected numbers of all and cause-specific deaths were calculated stratifying by race, 10-year age group, and calendar period using U.S. national reference rates. Standardized mortality ratios (SMRs) and 95% confidence intervals (Cls) were calculated for the entire cohort and by job tide.

Results: As expected in a working population, we found a deficit in overall and all-cancer mortality, likely due to the healthy worker effect. In contrast, compared with the general U.S. population, we observed elevated rates for lung cancer, ischemic heart disease, and transport-related accidents. Lung cancer rates were elevated among all drivers (SMR = 1.10; 95% CI, 1.02-1.19) and dockworkers (SMR = 1.10; 95% CI, 0.94-1.30); ischemic heart disease was also elevated among these groups of workers [drivers, SMR = 1.49 (95% CI, 1.40-1.59); dockworkers, SMR = 1.32 (95% CI, 1.15-1.52)], as well as among shop workers (SMR = 1.34; 95% CI, 1.05-1.72).

Conclusions: In this detailed assessment of specific job categories in the U.S. trucking industry, we found an excess of mortality due to lung cancer and ischemic heart disease, particularly among drivers.