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1.
BMC Public Health ; 24(1): 2775, 2024 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-39390468

RESUMO

OBJECTIVES: Long-haul truck drivers experience multiple challenges, including increased health risks. A large percentage of professional truck drivers (PTDs) suffer from numerous chronic physical health conditions such as obesity, hypertension, diabetes, heart disease, sleep disorders, etc.) as well as poor mental health and social challenges. Furthermore, this population experiences numerous barriers related to accessing health care services including primary care and resources to improve their health. PTDs living in rural and remote areas are at higher risk. The objective of this study is to understand the views of PTDs and the trucking industry on health and personalized healthcare interventions and services. METHODS: In-depth semi-structured interviews were conducted with twenty-six individuals with contextual knowledge and experience in the trucking ecosystem, to better understand the needs, expectations, and preferences of PTDs based in New Brunswick (Canada), related to their health (physical, mental, and social). Analysis of the audiotape recording was conducted using thematic content analysis. RESULTS: Three major themes emerged from the qualitative analysis describing PTDs' health needs, existing health and preventive services, as well as recommendations for personalized healthcare interventions and services to be implemented: (1) "My life as a trucker!" Understanding needs and challenges, (2) "Taking care of myself, do you think it is easy while you're on the road?" Describing drivers and motivators for better health, and (3) "Can you hear what we need?" Translating needs into recommendations for tailored health services and preventative services. CONCLUSION: A highly demanding work environment and lack of timely access to integrated primary care negatively affect PTDs' health. Results of this study shed light on how to tailor primary care to improve its responsiveness and adequacy to PTDs' needs and realities. PTDs-sensitive integrated services, including multicomponent interventions (health education, coaching for lifestyle changes, and social support), are still lacking within the New Brunswick health system.


Assuntos
Veículos Automotores , Pesquisa Qualitativa , Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Novo Brunswick , Feminino , Entrevistas como Assunto , Necessidades e Demandas de Serviços de Saúde , Acessibilidade aos Serviços de Saúde , Avaliação das Necessidades , Condução de Veículo/psicologia , Caminhoneiros
2.
BMC Public Health ; 24(1): 2623, 2024 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-39334100

RESUMO

BACKGROUND: Truck drivers are a vital workforce, but have higher rates of obesity and other chronic diseases than the general population. The occupation's sedentary nature, limited physical activity opportunities and access to healthy food, and irregular sleeping patterns contribute to poor health. This systematic review and meta-analysis aimed to evaluate the effectiveness of interventions on health behaviours and cardiometabolic biomarkers of health in truck drivers. METHODS: A systematic search was conducted in February 2024, and reported according to PRISMA 2020 guidelines. Experimental studies targeting physical activity, sedentary behaviour, sleep, diet, weight loss, drug/alcohol use, and/or smoking were eligible. Two reviewers independently screened and completed data extraction and risk of bias assessment. Data were combined at the study level. Pooled statistics were calculated using mean differences (MD) or standardised mean differences (SMD) for outcomes that were reported in ≥2 studies. Pre- and post-intervention means and standard deviations (SD) for the intervention and control groups were used to compute effect sizes. RESULTS: Nineteen studies (n=2137 participants) were included. Meta-analyses found a small-to-moderate increase in fruit and vegetable consumption (SMD 0.32, p=0.03) with no other significant effects on other outcome variables. CONCLUSIONS: Interventions are moderately effective in increasing truck drivers' fruit and vegetable consumption, but not other outcomes. There is a dearth of research in the driver population compared to other occupational groups. Future interventions should consider workplace and environmental factors to promote the health and wellbeing of truck drivers. TRIAL REGISTRATION: The study protocol was registered on PROSPERO (CRD42021283423).


Assuntos
Comportamentos Relacionados com a Saúde , Veículos Automotores , Humanos , Condução de Veículo/psicologia , Saúde Ocupacional , Promoção da Saúde/métodos , Comportamento Sedentário , Exercício Físico , Dieta , Masculino , Caminhoneiros
3.
J Forensic Sci ; 69(2): 698-701, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38066716

RESUMO

Electrocution deaths are mostly accidental. However, reconstruction of events in unusual electrocution death is challenging. This article reports an accidental death due to electrocution in a highly unusual circumstance, in which a truck driver reversing his vehicle was electrocuted when his truck inadvertently touched an overhead high-voltage wire. The electric injury marks were present over the sole of the right foot. The scene investigation revealed that the high-voltage wire was loose and was below the level of the prescribed height. The truck was passing over an elevated area made up of dirt and stone. The interior of the cabin of the truck revealed a few non-insulated metallic areas over the floor of the truck, between the accelerator and the brake, which were attributed as the sources of entry of electricity into the body. The electric injury marks were different than those usually seen in high-voltage electrocution as there was an intermediate object (truck) involved, and the contact period between the truck and the electric wire was minimal. This fatality was attributed to the non-proper insulation of the interior of the truck, the negligent driving of the truck driver over the elevated surface, and the loose high-voltage wire without proper maintenance.


Assuntos
Traumatismos por Eletricidade , Caminhoneiros , Humanos , Eletricidade , Acidentes , Veículos Automotores
4.
Workplace Health Saf ; 72(1): 6-12, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37646375

RESUMO

BACKGROUND: Chronic health conditions are highly prevalent among truck drivers due to many unique occupational and environmental stressors. Health promotion programs are shown to be effective in improving truck driver health outcomes; however, there is no research on whether such programs can increase the length of a driver's Department of Transportation (DOT) medical certificate. The purpose of this quality improvement project was to evaluate Fit to Pass (FTP), a remotely accessible health promotion program available for truck drivers on improved health outcomes and increased DOT medical certificate length. METHOD: Program evaluation included an evaluation of the FTP coaching guide against evidence-based practice guidelines. An analysis of a limited dataset of 22 truck driver records examined the effectiveness of the program in achieving improved health outcomes and increased medical certification length. FINDINGS: A review of the literature revealed three major themes: (a) motivational interviewing to increase driver intention and self-efficacy; (b) mobile health care technology to connect hard-to-reach truck drivers; and (c) effectiveness of structured multicomponent health promotion programs. After participation in FTP, truck drivers experienced a mean decrease in weight and body mass index (BMI) of 4.6 lbs and 1.3 kg/m2, respectively. The lengths of initial DOT medical certificates were compared with DOT medical certificates received at the time of recertification (post-FTP). Only eight participants had the potential for improvement in certificate length. Of those, three truck drivers achieved an increased DOT medical certificate length at the time of recertification. CONCLUSION/APPLICATIONS TO PRACTICE: FTP offers tailored and comprehensive health coaching for truck drivers using current evidence-based practice guidelines to educate and reinforce healthy lifestyle habits. Analysis of a limited dataset revealed a mean decrease in BMI and a trend of increased DOT medical certification lengths after participation in FTP; however, further research with larger sample sizes is recommended.


Assuntos
Condução de Veículo , Caminhoneiros , Humanos , Avaliação de Programas e Projetos de Saúde , Veículos Automotores , Promoção da Saúde , Estilo de Vida
5.
J Occup Environ Med ; 66(1): 20-27, 2024 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-37800354

RESUMO

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.


Assuntos
Condução de Veículo , Veículos Automotores , Humanos , Masculino , Saúde Pública , Caminhoneiros , Canadá/epidemiologia , Inquéritos e Questionários
6.
Accid Anal Prev ; 195: 107405, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38064941

RESUMO

The platooning technology allows for two or more trucks running in convoy at a pre-defined distance between each other, being virtually connected using connectivity technology and automated driving support systems. It is recognized that truck platooning systems bring economical and environmental advantages. Thus, it is time for a transition from the existing truck freight activity towards truck platooning systems. This requires an important improvement in terms of in-vehicle technology, together with infrastructure improvement and truck drivers' acquisition of new technology-related skills. A holistic approach is previewed to identify both the requirements for the development of truck platooning services and the requests for their safe deployment in the real world. Then, qualitative data were collected from truck drivers working for two different Portuguese freight companies using Focus Groups (FG). Thus, three FG sessions were organized and carried out with a total of 22 truck drivers. Considering that age and experience on the job are important factors to take into consideration for technological changes on the job, their potential impact on truck drivers' activity was addressed on the focus group discussions. Anyway, the potential users' attitudes regarding any innovation on the job were addressed as a prevention of further negative attitudes or misuse. Having safety in mind as a permanent attitude toward on job innovation is actually the most important factor toward success.


Assuntos
Condução de Veículo , Humanos , Acidentes de Trânsito/prevenção & controle , Caminhoneiros , Veículos Automotores , Coleta de Dados
7.
J Am Assoc Nurse Pract ; 36(1): 38-45, 2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-38038951

RESUMO

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.


Assuntos
Condução de Veículo , Veículos Automotores , Humanos , Masculino , Feminino , Condução de Veículo/psicologia , Saúde Mental , Caminhoneiros , Sono , Acessibilidade aos Serviços de Saúde
8.
Accid Anal Prev ; 198: 107450, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38340471

RESUMO

Forward collision warning (FCW) systems have been widely used in trucks to alert drivers of potential road situations so they can reduce the risk of crashes. Research on FCW use shows, however, that there are differences in drivers' responses to FCW alerts under different scenarios. Existing FCW algorithms do not take differences in driver response behavior into account, with the consequence that the algorithms' minimum safe distance assessments that trigger the warnings are not always appropriate for every driver or situation. To reduce false alarms, this study analyzed truck driver behavior in response to FCW warnings, and k-means clustering was adopted to classify driver response behavior into three categories: Response Before Warning (RBW), Response After Warning (RAW), and No Response (NR). Results showed that RBW clusters tend to occur at long following distances (>19 m), and drivers applied braking before the warning. In RAW clusters, deceleration after warning is significantly more forceful than before warning. NR clusters occur at short distances, and deceleration fluctuates only slightly. To optimize the FCW algorithm, the warning distance was divided into reaction distance and braking distance. The linear support vector machine was used to fit the driver reaction distance. The long short-term memory method was used to predict braking distance based on each of the three response scenarios: R2 was 0.896 for RAW scenarios, 0.927 for RBW scenarios, and 0.980 for NR scenarios. Verification results show that the optimized truck FCW algorithm improved safety by 1 % to 5.1 %; accuracy reached 97.92 %, and the false alarm rate was 1.73 %.


Assuntos
Acidentes de Trânsito , Condução de Veículo , Humanos , Acidentes de Trânsito/prevenção & controle , Equipamentos de Proteção , Caminhoneiros , Veículos Automotores , Algoritmos , Tempo de Reação/fisiologia
9.
Accid Anal Prev ; 199: 107511, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38387154

RESUMO

BACKGROUND: Monitoring of long-haul truck driver fatigue state has attracted considerable interest. Conventional fatigue driving detection methods based on the physiological and visual features are scarcely applicable, due to the intrusiveness, reliability, and cost-effectiveness concerns. METHODS: We elaborately developed a fatigue driving detection method by fusion of non-visual features derived from the customized wristbands, vehicle-mounted equipment, and trip logs. To capture the spatiotemporal information within the sequential data, the bidirectional long short-term memory network with attention mechanism was proposed to determine whether the truck driver was fatigued within a fine-grained episode of one minute. The model was validated using a natural driving dataset with nine truck drivers on real-world roads in Guiyang, China during June and July 2021. RESULTS: Our approach yielded 99.21 %, 84.44 %, 82.01 %, 99.63 %, and 83.21 % in accuracy, precision, recall, specificity, and F1-score, respectively. Compared with the mainstream visual-based methods, our approach outperformed particularly in terms of precision and recall. Photoplethysmogram stood out as the most important feature for truck driver fatigue state detection. Vehicle load, driving forward angle, cumulative driving time, midnight, and recent working hours were found to be positively associated with the probability of fatigue driving, while the galvanic skin response, vehicle acceleration, current time, and recent rest hours had a negative relationship. Specifically, truck drivers were more likely to fatigue when driving at 20-40 km/h, braking abruptly at 5-10 m/s2, with vehicle loads over 70 tons, and driving more than 100 min consecutively. CONCLUSIONS: Our study is among the first to harness the natural driving dataset to delve into the real-life fatigue pattern of long-haul truck drivers without disruptions on routine driving tasks. The proposed method holds pragmatic prospects by providing a privacy-preserving, robust, real-time, and non-intrusive technical pathway for truck driver fatigue monitoring.


Assuntos
Condução de Veículo , Veículos Automotores , Humanos , Acidentes de Trânsito , Reprodutibilidade dos Testes , Caminhoneiros , China
10.
Sci Rep ; 14(1): 6378, 2024 03 16.
Artigo em Inglês | MEDLINE | ID: mdl-38493230

RESUMO

Sleep-disordered breathing (SDB) is prevalent among professional drivers. Although SDB is a known risk factor for truck collisions attributed to microsleep-related behaviors at the wheel (TC-MRBs), the usefulness of overnight pulse oximetry for predicting TC-MRBs is debatable. This retrospective study assessed the association between overnight pulse oximetry parameters, the Epworth Sleepiness Scale (ESS), and TC-MRBs, confirmed by dashcam footage. This study included 108 matched professional truck drivers (TC-MRBs: N = 54; non-TC-MRBs: N = 54), with a mean age and body mass index of 41.9 ± 11.3 years and 23.0 ± 3.7 kg/m2, respectively. Night-time drivers, 4% oxygen desaturation index (ODI), and nadir oxygen saturation (SpO2) were associated with TC-MRBs (odds ratio [95% confidence interval]: 25.63 [5.88-111.77], p < 0.0001; 2.74 [1.02-7.33], p = 0.045; and 3.87 [1.04-14.39], p = 0.04, respectively). The area under the curve of 4% ODI and nadir SpO2 for TC-MRBs were 0.50 and 0.57, respectively. In conclusion, night-time driving, 4% ODI, and nadir SpO2 were significantly associated with TC-MRBs in professional truck drivers. However, the sensitivity of overnight pulse oximetry parameters to predict TC-MRBs in a real-world application was poor. Therefore, combining subjective and objective assessments such as dashcam video footage may be needed to achieve high accuracy for predicting TC-MRBs among professional truck drivers.


Assuntos
Síndromes da Apneia do Sono , Caminhoneiros , Humanos , Estudos Retrospectivos , Veículos Automotores , Síndromes da Apneia do Sono/etiologia , Oximetria , Fatores de Risco , Oxigênio
11.
Rev Bras Enferm ; 77Suppl 2(Suppl 2): e20230511, 2024.
Artigo em Inglês, Português | MEDLINE | ID: mdl-39356927

RESUMO

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.


Assuntos
Promoção da Saúde , Humanos , Brasil , Promoção da Saúde/métodos , Promoção da Saúde/tendências , Condução de Veículo/psicologia , Veículos Automotores , Caminhoneiros
12.
BMJ Open ; 14(8): e085058, 2024 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-39097316

RESUMO

OBJECTIVES: The purpose of this study was to systematically summarise the empirical evidence on the prevalence of HIV among long-distance truck drivers (LDTDs) from all parts of the world. DESIGN: A systematic review and meta-analysis were conducted. DATA SOURCES: We searched PubMed, ProQuest Central, PubMed Central, Cumulated Index to Nursing and Allied Health Literature and Global Index Medicus to identify relevant information published from 1989 to 16 May 2023. ELIGIBILITY CRITERIA: Peer-reviewed publications of English language reporting on the prevalence of HIV among LDTDs were included. Non-empirical studies like literature reviews were excluded. DATA EXTRACTION AND SYNTHESIS: Using a standardised data abstraction form, we extracted information on study characteristics and HIV prevalence levels. Crude prevalence estimates per 100 participants were computed and later transformed using logit transformation to have them follow a normal distribution. A meta-analysis of prevalences using the random effects model was performed. The I2 statistic was used to quantify the degree of heterogeneity across studies. A subgroup analysis using meta-regression was performed to investigate factors that could explain variability across studies. The Joanna Briggs Institute tools and Newcastle-Ottawa Scale were used to assess the quality of the included studies. To assess the certainty of evidence, the Grading of Recommendations Assessment, Development, and Evaluation approach was used. RESULTS: Of the 1787 articles identified, 42 were included. Most of the included studies were conducted in sub-Saharan Africa (45.23%, n=19) and Asia and the Pacific (35.71%, n=15). The pooled prevalence of HIV was 3.86%, 95% CI (2.22% to 6.64%). The burden of HIV was highest in sub-Saharan Africa at 14.34%, 95% CI (9.94% to 20.26%), followed by Asia and the Pacific at 2.12%, 95 CI (0.94% to 4.7%) and lastly Western, Central Europe and North America at 0.17%, 95% CI (0.03% to 0.82%). The overall heterogeneity score was (I2=98.2%, p<0.001). CONCLUSION: The global burden of HIV among LDTDs is 3.86%, six times higher than that of the general population globally. Compared with other regions, the burden of HIV is highest in sub-Saharan Africa at 14.34%, where it is estimated to be 3% in the general population. Thus, LDTDs endure a disproportionately high burden of HIV compared with other populations. Consequently, more LDTD-centred HIV research and surveillance is needed at national and regional levels to institute tailored preventive policies and interventions. PROSPERO REGISTRATION NUMBER: CRD42023429390.


Assuntos
Saúde Global , Infecções por HIV , Humanos , Condução de Veículo/estatística & dados numéricos , Infecções por HIV/epidemiologia , Prevalência , Caminhoneiros/estatística & dados numéricos
13.
Int J Occup Saf Ergon ; 30(2): 425-435, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38326221

RESUMO

Objectives. In developing physical activity (PA) promotion measures in the workplace, individual needs of the target groups must be considered. For this reason, this study aimed to qualitatively identify the individual needs for an increase of PA in truck drivers, representing a neglected working group in terms of PA promotion. Methods. Semi-structured interviews were conducted (N = 19; mean age 50.5 years, SD 11.4 years; 10.5% female). The interview guide was based on the COM-B model to identify needs related to PA behavior in terms of capabilities, opportunities and motivation. The interviews were transcribed and coded by two independent investigators. Results. Altogether, the codes encompassed 395 statements, and the code system contained 14 codes. Three additional codes described further individual needs related to other health behaviors (nutrition, recreation) or external incentives for health interventions. Conclusion. The results reveal a variety of needs that are fundamental to the development of PA-promoting interventions for truck drivers. These needs appear to be closely linked, so a combination of capabilities, opportunities and/or motivation should be considered when developing holistic interventions. An example would be linking automatic motivation and psychological capabilities that encompass motivational techniques combined with information for psychoeducation of truck drivers.


Assuntos
Exercício Físico , Promoção da Saúde , Motivação , Caminhoneiros , Local de Trabalho , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Condução de Veículo/psicologia , Exercício Físico/psicologia , Comportamentos Relacionados com a Saúde , Promoção da Saúde/métodos , Entrevistas como Assunto , Saúde Ocupacional , Pesquisa Qualitativa , Caminhoneiros/psicologia , Local de Trabalho/psicologia
14.
Front Public Health ; 12: 1386521, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39114508

RESUMO

Background: Road traffic accidents (RTAs) are among the leading causes of injuries, fatalities, and the resulting increase in financial burdens worldwide. Every year, RTAs cause numerous serious injuries and fatalities in Ethiopia. it is important to understand how prevalent near-miss crash accidents are, and which by definition could have injured the victim but did not result in an actual accident. The determinants of these near-misses are essential in road crash accident reduction strategies. In spite of the fact that near-miss accidents are much more common than actual losses or injuries, very little research has been conducted on them. Thus, this study was intended to assess the near-miss accidents and associated factors among truckers in Gamo zone, southern Ethiopia. Methodology: The community-based cross-sectional study was employed from May 12 to July 10,2022, using a structured interviewer-administered questionnaire. A simple random sampling technique was used to select participants. The data were analyzed using the statistical package for social sciences. A binary and multivariate logistic regression model was used to identify the determinants of near-miss accidents. A statistical significance level was set at p < 0.05. Results: About 72.5% of truckers had experienced near-miss road traffic accidents. The majority of the near-miss accidents were caused by speeding, followed by driving on the wrong side of the road and skidding, 65 (22.6%), 39 (13.5%), and 38 (13.2%), respectively. Driving frequency per week, location of accidents, condition of the road, sleeping status, and weather conditions were significantly associated with near-miss accidents. Conclusion: The prevalence of near-miss accidents is high in the Gamo zone. Being a younger and less educated driver, high driving frequency per week, driving on major roads and junctions, foggy weather, and inadequate sleep all contribute to the occurrence of accidents. Road safety measures that could address these identified factors are required to mitigate potential RTAs.


Assuntos
Acidentes de Trânsito , Condução de Veículo , Caminhoneiros , Humanos , Acidentes de Trânsito/prevenção & controle , Acidentes de Trânsito/estatística & dados numéricos , Condução de Veículo/estatística & dados numéricos , Estudos Transversais , Etiópia/epidemiologia , Fatores de Risco , Inquéritos e Questionários , Caminhoneiros/estatística & dados numéricos
15.
Health Policy Plan ; 39(4): 355-362, 2024 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-38441272

RESUMO

HIV status awareness is critical for ending the HIV epidemic but remains low in high-HIV-risk and hard-to-reach sub-populations. Targeted, efficient interventions are needed to improve HIV test-uptake. We examined the incremental cost-effectiveness of offering the choice of self-administered oral HIV-testing (HIVST-Choice) compared with provider-administered testing only [standard-of-care (SOC)] among long-distance truck drivers. Effectiveness data came from a randomized-controlled trial conducted at two roadside wellness clinics in Kenya (HIVST-Choice arm, n = 150; SOC arm, n = 155). Economic cost data came from the literature, reflected a societal perspective and were reported in 2020 international dollars (I$), a hypothetical currency with equivalent purchasing power as the US dollar. Generalized Poisson and linear gamma regression models were used to estimate effectiveness and incremental costs, respectively; incremental effectiveness was reported as the number of long-distance truck drivers needing to receive HIVST-Choice for an additional HIV test-uptake. We calculated the incremental cost-effectiveness ratio (ICER) of HIVST-Choice compared with SOC and estimated 95% confidence intervals (CIs) using non-parametric bootstrapping. Uncertainty was assessed using deterministic sensitivity analysis and the cost-effectiveness acceptability curve. HIV test-uptake was 23% more likely for HIVST-Choice, with six individuals needing to be offered HIVST-Choice for an additional HIV test-uptake. The mean per-patient cost was nearly 4-fold higher in HIVST-Choice (I$39.28) versus SOC (I$10.80), with an ICER of I$174.51, 95% CI [165.72, 194.59] for each additional test-uptake. HIV self-test kit and cell phone service costs were the main drivers of the ICER, although findings were robust even at highest possible costs. The probability of cost-effectiveness approached 1 at a willingness-to-pay of I$200 for each additional HIV test-uptake. HIVST-Choice improves HIV-test-uptake among truck drivers at low willingness-to-pay thresholds, suggesting that HIV self-testing is an efficient use of resources. Policies supporting HIV self-testing in similar high risk, hard-to-reach sub-populations may expedite achievement of international targets.


Assuntos
Infecções por HIV , Autoteste , Humanos , Infecções por HIV/diagnóstico , Infecções por HIV/prevenção & controle , Análise Custo-Benefício , Quênia/epidemiologia , Caminhoneiros , Programas de Rastreamento
16.
J Forensic Sci ; 69(4): 1449-1455, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38706115

RESUMO

Highways, the lifeline of the Brazilian economy, transport approximately 75% of the country's economic activity, highlighting its importance. However, professional drivers, accustomed to long daily journeys, make use of tablets widely available in Gas Station, which are known as "Rebites," which could contain a mixture of legal and illegal compounds. Thus, this study aims at the chemical characterization of these through different analytical methods. Initially, we performed a comprehensive screening of compounds present in seven samples collected across the country using high-resolution mass spectrometry (HRMS). The findings revealed caffeine as the main compound, alongside theophylline, lidocaine, and clobenzorex, among others. In the next step, we employ quantitative nuclear magnetic resonance (qNMR) to quantify the caffeine content in the tablets. The results indicated a caffeine concentration ranging between 14% and 31% (m/m), which may imply a daily overdose of this compound from around four tablets. In summary, this investigation provides a chemical characterization of real samples of "Rebites" freely obtained along Brazilian highways. Caffeine emerged as the predominant active compound, with its concentration determined by qNMR analysis. The notable presence of caffeine, combined with other stimulants, depressants, and hallucinogens, underscores the need for strict quality control measures regarding "Rebites" to safeguard public health.


Assuntos
Cafeína , Espectroscopia de Ressonância Magnética , Espectrometria de Massas , Brasil , Humanos , Cafeína/análise , Comprimidos , Drogas Ilícitas/análise , Drogas Ilícitas/química , Veículos Automotores , Caminhoneiros
17.
Sci Rep ; 14(1): 9925, 2024 04 30.
Artigo em Inglês | MEDLINE | ID: mdl-38688926

RESUMO

Drowsiness while driving negatively impacts road safety, especially in truck drivers. The present study investigated the feasibility and alerting effects of a daylight-supplementing in-truck lighting system (DS) providing short-wavelength enriched light before, during, and after driving. In a within-participants design, eight truck drivers drove a fully-loaded truck under wintry Scandinavian conditions (low daylight levels) with a DS or placebo system for five days. Subjective and objective measures of alertness were recorded several times daily, and evening melatonin levels were recorded three times per study condition. DS significantly increased daytime light exposure without causing negative side effects while driving. In addition, no negative carry-over effects were observed on evening melatonin and sleepiness levels or on nighttime sleep quality. Moreover, objective alertness (i.e., psychomotor vigilance) before and after driving was significantly improved by bright light exposure. This effect was accompanied by improved subjective alertness in the morning. This field study demonstrated that DS was able to increase daytime light exposure in low-daylight conditions and to improve alertness in truck drivers before and after driving (e.g., during driving rest periods). Further studies are warranted to investigate the effects of daylight-supplementing in-cabin lighting on driving performance and road safety measures.


Assuntos
Condução de Veículo , Iluminação , Melatonina , Veículos Automotores , Humanos , Masculino , Pessoa de Meia-Idade , Regiões Árticas , Ritmo Circadiano/fisiologia , Luz , Melatonina/metabolismo , Desempenho Psicomotor/efeitos da radiação , Estações do Ano , Caminhoneiros , Vigília/fisiologia , Vigília/efeitos da radiação
18.
Workplace Health Saf ; 72(8): 314-326, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38722109

RESUMO

BACKGROUND: Long-haul truck drivers (LHTDs) face a number of occupational hazards. One such hazard is exposure to diesel engine exhaust (DEE). However, this concept has yet to be analyzed. To address this gap, a concept analysis was conducted to explore the effects of DEE in relation to lung cancer. METHODS: Walker and Avant's eight-step concept analysis method was utilized: concept selection, analysis purpose, concept uses, defining attributes, model case, borderline case, antecedents and consequences, and empirical referents. PubMed, Scopus, and CINAHL databases were searched for relevant literature. FINDINGS: Diesel engine exhaust was identified as a mixture of gases and particulates that are considered carcinogenic. Defining attributes of DEE for truckers include respiratory effects such as decreased peak flow and increased airway resistance leading to symptoms such as a phlegm-producing cough, eye and throat irritation, exacerbation of asthma symptoms, and allergic responses. The identified level of DEE exposure associated with these attributes is 75 µg EC/m3 for 1 to 2 hours daily or a long-term exposure of 10 µg EC/m3. The conceptual definition of DEE in truckers was illustrated by the attributes, antecedents, consequences, model case, and empirical referents. CONCLUSION: Lung cancer was identified as a significant consequence of occupational DEE exposure for LHTDs. This analysis highlights the need for future research to develop interventions that will safeguard truckers from the adverse health effects of DEE exposure.


Assuntos
Neoplasias Pulmonares , Veículos Automotores , Exposição Ocupacional , Emissões de Veículos , Humanos , Neoplasias Pulmonares/etiologia , Neoplasias Pulmonares/epidemiologia , Exposição Ocupacional/efeitos adversos , Poluentes Ocupacionais do Ar/efeitos adversos , Condução de Veículo , Caminhoneiros
19.
Accid Anal Prev ; 206: 107694, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39003873

RESUMO

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.


Assuntos
Acidentes de Trânsito , Condução de Veículo , Veículos Automotores , Gestão da Segurança , Humanos , Acidentes de Trânsito/prevenção & controle , Fatores de Risco , Segurança , Medição de Risco , Caminhoneiros
20.
Front Public Health ; 12: 1352979, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38726231

RESUMO

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.


Assuntos
Condução de Veículo , Veículos Automotores , Humanos , Países Baixos , Condução de Veículo/estatística & dados numéricos , Veículos Automotores/estatística & dados numéricos , Inquéritos e Questionários , Masculino , Adulto , Pessoa de Meia-Idade , Feminino , Segurança , Idoso , Caminhoneiros
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