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.

Driver's license, head protection devices and severity of motorcyclists' injuries in traffic accidents.

OBJECTIVES: to describe traffic accidents involving motorcyclists and analyze the association between possession of a motorcycle driver's license and use of helmets according to the severity of injuries. METHODS: a cross-sectional study was conducted among all patients hospitalized in the traumatology and orthopedics sector of a public reference hospital in northeastern Brazil. RESULTS: 170 patients were surveyed, the majority were male (95.9%). Their ages ranged from 18 to 67 years. Most were black or brown (52.3%), had completed elementary school (58.9%) and had monthly income smaller than two minimum wages (56.5%). An association was found between being licensed to drive a motorcycle and wearing a helmet. Among those who suffered moderate injuries, this association was OR=5.66(1.85-17.23) and among those who suffered severe injuries it was OR=13.57(2.82-65.14). CONCLUSIONS: people who were licensed to drive motorcycles used a helmet as protective equipment more often and, in accidents, suffered fewer injuries.

Multifactorial assessment of braking time predictors in a driving simulator among older adults according to gender.

CONTEXT: Vehicle driving depends on the integration of motor, visual, and cognitive skills to respond appropriately to different situations that occur in traffic. OBJECTIVES: To analyze a model of performance predictor for braking time in the driving simulator, using a battery of tests divided by gender. METHODS: Selected were 100 male drivers with a mean age of 72.6 ± 5.7 years. Sociodemographic variables, braking time in the driving simulator, and motor, visual, and cognitive skills were evaluated. RESULTS: Comparing genders, men were older than women (p = 0.002) and had longer driving times (p = 0.001). Men had more strength in hand grip (p ≤ 0.001). In the linear regression analysis, the model explained 68 % of the braking time in men and 50.8 % in women. In the stepwise multiple linear regression analysis, the variable that remained in the model was the strength of the right plantar flexors, which explained 13 % of the braking time in women and men, and the cognitive variables explained 38.9 %. CONCLUSION: Sociodemographic, motor, visual, and cognitive variables, explained a substantial portion of the variability in braking time for both older women and men, the specific variables driving this performance differed between the sexes. For older women, factors such as muscle strength emerged as critical determinants of braking ability, highlighting the importance of physical health in maintaining driving skills. On the other hand, cognitive conditions emerged as the primary predictor of braking performance in older men, underscoring the role of mental acuity and decision-making processes in safe driving.

Evaluation of harmful drinking among professional drivers by direct ethanol biomarkers and its relation with psychological distress.

OBJECTIVE: This study aimed to evaluate the alcohol consumption among professional truck and bus drivers using direct ethanol biomarkers, and to explore its relationship with anxiety, depression, and stress. METHODS: The assessment of potential harmful drinking was conducted through the measurement of direct biomarkers: phosphatidylethanol (PEth), ethyl glucuronide (EtG), and ethyl sulfate (EtS), using dried blood spots (DBS). Additionally, self-reported data from the Alcohol Use Disorders Identification Test (AUDIT-C) were used. Emotional states, including depression, anxiety, and stress, were evaluated using the Depression, Anxiety, and Stress Scale (DASS-21). RESULTS: A total of 97 drivers participated in the study, with the majority being male (96%) and identified as truck drivers (75.3%). Among them, 43.3% reported working more than 10 h daily. The majority of volunteers exhibited normal levels of stress (81.4%), anxiety (83%), and depression (86.6%). According to the AUDIT-C assessment, 30.9% were categorized as having a moderate risk, while 11.3% were deemed to be at high risk for harmful alcohol consumption behavior. Ethyl glucuronide (EtG) and ethyl sulfate (EtS) levels, indicating recent ethanol consumption, were detected in 14.4% of the drivers. In contrast, the long half-life metabolite PEth (16:0-18:1) was present in 88.7% of the volunteers. A moderate correlation (rs = 0.45, p < .01) was observed between PEth levels and AUDIT-C scores. The Receiver Operating Characteristic (ROC) curve, utilizing a PEth threshold of ≥ 59.0 ng ml-1, displayed 78% sensitivity and 73% specificity in effectively distinguishing high risk for alcohol intake. Notably, no significant associations were found between alcohol consumption and levels of stress, depression, and anxiety. CONCLUSIONS: The study findings indicate a noteworthy proportion of drivers engaging in regular alcohol consumption alongside a demanding workload. Notably, PEth measurements highlighted an underreporting within the AUDIT-C self-reports. These results lend robust support for the utilization of biomarkers in assessing alcohol consumption patterns among drivers.

Crash Risk Predictors in Older Drivers: A Cross-Sectional Study Based on a Driving Simulator and Machine Learning Algorithms.

The ability to drive depends on the motor, visual, and cognitive functions, which are necessary to integrate information and respond appropriately to different situations that occur in traffic. The study aimed to evaluate older drivers in a driving simulator and identify motor, cognitive and visual variables that interfere with safe driving through a cluster analysis, and identify the main predictors of traffic crashes. We analyzed the data of older drivers (n = 100, mean age of 72.5 ± 5.7 years) recruited in a hospital in São Paulo, Brazil. The assessments were divided into three domains: motor, visual, and cognitive. The K-Means algorithm was used to identify clusters of individuals with similar characteristics that may be associated with the risk of a traffic crash. The Random Forest algorithm was used to predict road crash in older drivers and identify the predictors (main risk factors) related to the outcome (number of crashes). The analysis identified two clusters, one with 59 participants and another with 41 drivers. There were no differences in the mean of crashes (1.7 vs. 1.8) and infractions (2.6 vs. 2.0) by cluster. However, the drivers allocated in Cluster 1, when compared to Cluster 2, had higher age, driving time, and braking time (p < 0.05). The random forest performed well (r = 0.98, R2 = 0.81) in predicting road crash. Advanced age and the functional reach test were the factors representing the highest risk of road crash. There were no differences in the number of crashes and infractions per cluster. However, the Random Forest model performed well in predicting the number of crashes.

Adaptation to the driving simulator and prediction of the braking time performance, with and without distraction, in older adults and middle-aged adults.

CONTEXT: Many studies show the importance of evaluating the adaptation time of subjects in a virtual driving environment, looking forwards to a response as closest as a possible real vehicle. OBJECTIVES: This study aimed to identify and analyze the adaptation to the driving simulator in older adults and middle-aged adults with and without a distraction, and a secondary aim was to identify predictors of safe performance for older adults' drives. DESIGN: Male and female middle-aged adults (n = 62, age = 30.3 ± 7.1 years) and older adults (n = 102, age = 70.4 ± 5.8 years) were evaluated for braking time performance in a driving simulator; cognition performance assessment included the Mini-Mental State Examination; motor evaluation included ankle flexor muscle strength with the isokinetic dynamometer and handgrip strength; the postural balance was evaluated with Timed Up and Go test, with and without a cognitive distraction task. RESULTS: Older adults (men and women) and middle-aged adult women require more time to adapt to the driving simulator. The distractor increases the adaptation time for all groups. The main predictors of braking time for older women are age, muscle strength, and postural balance associated with distraction, and for older men, muscle strength. CONCLUSIONS: Age, sex, and distractor interfere in the adaptation of the virtual task of driving in a simulator. The evaluation model developed with multi-domains demonstrated the ability to predict which skills are related to braking time with and without the presence of the distractor.

Associação entre horas de trabalho e de descanso e o uso de substâncias psicoativas entre motoristas profissionais de caminhão / Association between hours of work and rest and the use of psychoactive substances among professional truck drivers

OBJETIVO: Investigar a associação de horas diárias de trabalho e de descanso com o uso de substâncias psicoativas entre motoristas profissionais de caminhão. MÉTODOS: Estudo transversal conduzido em 2016 com 354 motoristas profissionais de caminhão que aguardavam a inspeção da mercadoria transportada em um Posto de Controle Fiscal localizado na cidade de Itatiaia, RJ, Brasil. A associação entre horas diárias de trabalho (exposição), horas diárias de descanso (exposição) e uso de substâncias psicoativas (desfecho) foi investigada por meio de modelos de regressão linear que estimaram coeficientes de regressão (ß) e respectivos erros-padrão, considerando p < 0,05. RESULTADOS: Mostraram-se positivas as associações entre horas diárias de trabalho e uso de anfetamina (ß = 0,91; erro-padrão = 0,19; p < 0,01) e de cocaína/crack (ß = 1,32; erro-padrão = 0,35; p < 0,01) e negativa a associação entre horas diárias de descanso e uso de anfetamina (ß = -0,43; erro-padrão = 0,09; p < 0,01). CONCLUSÃO: Horas diárias de trabalho e de descanso parecem ser determinantes do uso de anfetamina e de cocaína/ crack entre motoristas profissionais de caminhão.

OBJECTIVE: To investigate the association of hours of work and rest with use of psychoactive substances among professional truck drivers. METHODS: Cross-sectional study conducted in 2016 with 354 professional truck drivers waiting for the inspection of the goods transported at a Fiscal Control Post located in the city of Itatiaia, RJ, Brazil. The association between daily working hours (exposure), daily rest hours (exposure) and use of psychoactive substances (outcome) was investigated using linear regression models that estimated regression coefficients (ß) and respective standard error, considering p < 0.05. RESULTS: They were positive the associations between daily working hours and use of amphetamine (ß = 0.91; standard error = 0.19; p < 0.01) and cocaine/crack (ß = 1.32; standard error = 0.35; p < 0.01) and the association between daily rest hours and use of amphetamine (ß = - 0.43; standard error = 0.09; p < 0.01) was negative. CONCLUSION: Daily hours of work and rest seem to be determinants of the use of amphetamine and cocaine/crack among professional truck drivers.

Implicit attitudes towards risky driving behaviors: Evidence of validity for the implicit association test.

INTRODUCTION: Attitudes toward risky driving behaviors are commonly evaluated through direct self-report measures. Nevertheless, these instruments have limitations, such as socially-desirable responding. This study examines the validity of the Implicit Association Test (IAT) as an indirect measure of attitudes towards risky driving. An IAT with "risky" vs. "safe" driving behaviors categories was evaluated. METHOD: A sample of 100 participants (ranging from 18 to 70 years of age) completed the IAT and measures of attitudes, driving styles, personality traits, risk-taking (IOWA Gambling Task), and social desirability (Driver Social Desirability Scale). RESULTS: A high level of internal consistency was found for IAT scores. The IAT was correlated with driving styles (risky, dissociative, and careful dimensions), risk-related personality traits (impulsive/sensation seeking and aggression/hostility) and risk-taking measures. IAT scores were also associated with self-reported risky driving behaviors (r = 0.33). As expected, a higher level of negative implicit attitudes was found among young drivers. The driver social desirability scale was correlated with most self-report measures, but not with the IAT. CONCLUSION: The present study provides reliability and validity evidence for the IAT as an indirect measure of attitudes towards risky driving. The IAT can serve as an important complement to conventional self-report measures of driving attitudes. Practical Applications: Potential use of global measure of implicit attitudes toward risky driving behaviors in the evaluation, education, and training of drivers are discussed.

Is the perceived neighborhood built environment associated with domain-specific physical activity in Latin American adults? An eight-country observational study.

BACKGROUND: Characteristics of the neighborhood built environment are associated with physical activity (PA). However, few studies with representative samples have examined environmental correlates of domain-specific PA in Latin America. We examined the associations of the perceived neighborhood built environment with domain-specific PA in a large sample of adults from eight Latin American countries. METHODS: This study examined data from 8185 adults (aged 18-65 years) from eight Latin American countries. The Neighbourhood Environment Walkability Survey - Abbreviated (NEWS-A) scale was used to assess perceptions of land use mix-diversity, land use mix-access, street connectivity, walking/cycling facilities, aesthetics, safety from traffic, and safety from crime. Perceived proximity from home to public open spaces (metropolitan parks, playgrounds, public squares) and to shopping centers was also measured. Transport-related and leisure-time PA were assessed using the long form of the International Physical Activity Questionnaire. Both logistic and linear regression models were estimated on pooled data. RESULTS: Perceptions of higher land use mix-access (OR: 1.40; 95% CI: 1.22,1.61), the existence of many alternative routes in the neighbourhood (1.12; 1.04,1.20), slow speed of traffic (1.19; 1.03,1.35) and few drivers exceeding the speed limits (1.09; 1.03,1.15) were associated with greater odds of reporting at least 10 min/week of transport-related PA. Perceptions of higher levels of land use mix-diversity, better aesthetics and greater safety from crime, the presence of crosswalks and pedestrian signals, and greater proximity of shopping centers were associated with more min/week of transport-related PA. Perceptions of higher land use mix-diversity (1.12; 1.05,1.20), higher land use mix-access (1.27; 1.13,1.43), more walking/cycling facilities (1.18; 1.09,1.28), and better aesthetics (1.10; 1.02,1.18) were associated with greater odds of engaging in at least 10 min/week of leisure-time PA versus none. Perceptions of higher land use mix-diversity were associated with more min/week of leisure PA. CONCLUSIONS: Different perceived neighborhood built environment characteristics were associated with domain-specific PA among adults from Latin America countries. Interventions designed to modify perceptions of the neighbourhood built environment might influence initiation or maintenance of domain-specific PA. TRIAL REGISTRATION: ClinicalTrials. Gov NCT02226627 . Retrospectively registered on August 27, 2014.

Traffic campaigns and overconfidence: An experimental approach.

We use a controlled experiment to analyze the impact of watching different types of educational traffic campaign videos on overconfidence of undergraduate university students in Brazil. The videos have the same underlying traffic educational content but differ in the form of exhibition. We find that videos with shocking content (Australian school) are more effective in reducing drivers' overconfidence, followed by those with punitive content (American school). We do not find empirical evidence that videos with technical content (European school) change overconfidence. Since several works point to a strong association between overconfidence and road safety, our study can support the conduit of driving safety measures by identifying efficient ways of reducing drivers' overconfidence. Finally, this paper also introduces how to use machine learning techniques to mitigate the usual subjectivity in the design of the econometric specification that is commonly faced in many researches in experimental economics.

Risk perception: A study using dashcam videos and participants from different world regions.

Objective: Research has shown that perceived risk is a vital variable in the understanding of road traffic safety. Having experience in a particular traffic environment can be expected to affect perceived risk. More specifically, drivers may readily recognize traffic hazards when driving in their own world region, resulting in high perceived risk (the expertise hypothesis). Oppositely, drivers may be desensitized to traffic hazards that are common in their own world region, resulting in low perceived risk (the desensitization hypothesis). This study investigated whether participants experienced higher or lower perceived risk for traffic situations from their region compared to traffic situations from other regions. Methods: In a crowdsourcing experiment, participants viewed dashcam videos from four regions: India, Venezuela, United States, and Western Europe. Participants had to press a key when they felt the situation was risky. Results: Data were obtained from 800 participants, with 52 participants from India, 75 from Venezuela, 79 from the United States, 32 from Western Europe, and 562 from other countries. The results provide support for the desensitization hypothesis. For example, participants from India perceived low risk for hazards (e.g., a stationary car on the highway) that were perceived as risky by participants from other regions. At the same time, support for the expertise hypothesis was obtained, as participants in some cases detected hazards that were specific to their own region (e.g., participants from Venezuela detected inconspicuous roadworks in a Venezuelan city better than did participants from other regions). Conclusion: We found support for the desensitization hypothesis and the expertise hypothesis. These findings have implications for cross-cultural hazard perception research.

Sleep misalignment and circadian rhythm impairment in long-haul bus drivers under a two-up operations system.

OBJECTIVES: The objective of the study was to describe working and sleep conditions and to assess how sleep opportunities are associated with obtained sleep and alertness, in a sample of long-haul bus drivers working with a two-up operations system. METHODS: Measures of subjective sleep and sleepiness, actigraphy, circadian temperature rhythm, and psychomotor vigilance tasks were obtained from a sample of 122 drivers from Argentina. Variables were compared between high and low fatigue risk groups, which were formed using a median split of a fatigue risk score. The score was calculated based on drivers' total working hours, maximum shift duration, minimum short break duration, maximum night work per seven days, and long break frequencies. RESULTS: Considering a standardized one-day period, sleep in the bus accounted for 1.9±0.1 h of total sleep (57±1% efficiency), sleep at destination for 1.6±0.2 h of total sleep (90±1% efficiency), and sleep at home for 3.8±0.2 h of total sleep (89±1% nap efficiency and 90±1% anchor sleep efficiency). In drivers exposed to high-risk working schedules, the circadian temperature rhythm was weaker (lower % of variance explained by the model) (22.0±1.7% vs. 27.6±2.0%, p <0.05) and without a significant acrophase. CONCLUSIONS: Drivers obtained a total amount of weekly sleep similar to the recommended levels for adults, but distributed at different locations and at different times during the day. High-risk working schedules were associated with disruption of circadian temperature rhythms. These results point out to the need of the implementation of shift-work scheduling strategies to minimize sleep misalignment and circadian desynchronization in long-haul bus drivers.

Psychosocial risk factors at work associated with the level of physical activity among motorcycle taxi drivers.

Objective: To analyze the association of psychosocial risk factors at work, sociodemographic, and occupational characteristics with the level of physical activity among motorcycle taxi drivers.Methods: Cross-sectional study with 750 male motorcycle taxi drivers from the municipality of Jequié, Bahia, Brazil. A form containing sociodemographic and occupational characteristics was utilized. The psychosocial risk factors at work were evaluated by the Job Content Questionnaire and the level of physical activity by the International Physical Activity Questionnaire. The adjusted associations were analyzed by means of the Poisson regression with robust variance. Results: the prevalence of an insufficiently active level of physical activity was of 59.6%. The crude prevalence ratios (PR) showed an association between physical inactivity in motorcycle taxi drivers and high strain job (PR: 1.31), with 5 or more years of experience (PR: 1.67), in night shifts (PR: 1.36) and 40 or more years old (PR: 1.77). In the multivariate model, adjusted by income, work in high strain is kept associated to a situation of being insufficiently active (PR: 1.13), duration of employment of five or more years raised by 51.0% the frequency of insufficiently active physical activity (PR: 1.51) and the work in predominantly nocturnal shifts increased it by 26.0% (PR: 1.26). It is made evident that age was an effect modifier (p < 0.001) and its interaction was evaluated by including the corresponding product term (job Demand-Control model), which shows that the association between highly straining work and being insufficiently active was observed only among the youngest (21-39 years old) (PR: 1,21).Conclusions: the age and exposure to unfavorable working conditions, like long duration of employment, night work and work under high psychological demand and low control, have an influence on the insufficient physical activity among motorcycle taxi drivers.

The effects of Chile's 2005 traffic law reform and in-country socioeconomic differences on road traffic deaths among children aged 0-14 years: A 12-year interrupted time series analysis.

OBJECTIVES: This study assessed the effect of Chile's 2005 traffic law reform (TLR) on the rates of road traffic deaths (RTD) in children aged 0-14 years, adjusting for socioeconomic differences among the regions of the country. METHODS: Free-access sources of official and national information provided the data for every year of the study period (2002-2013) and for each of the country's 13 upper administrative divisions with respect to RTD in child pedestrians and RTD in child passengers (dependent variables), and the following control variables: the number of road traffic tickets processed, investment in road infrastructure, poverty, income inequality, insufficient education, unemployment, population aged 0-14 years, and prevalence of alcohol consumption in the general population. Interrupted time series analyses (level and slope change impact model), using generalized estimating equation methods, were conducted to assess the impact of the TLR (independent variable) on the dependents variables. RESULTS: There was a significant interaction between time and Chile's 2005 TLR for a reduction in child pedestrians (incidence rate ratio [IRR] 0.87, 95% confidence interval [CI] 0.79-0.96) and passengers RTD (IRR for interaction 0.80, 95% CI 0.67-0.96) trends. In addition, in child pedestrians, RTD rates were affected by poverty (IRR 1.04, 95% CI 1.02-1.05), income inequality (IRR 1.02, 95% CI 1.00-1.04), and unemployment (IRR 0.94, 95% CI 0.90-0.98), whereas in the case of child passengers, poverty (IRR 1.05, 95% CI 1.01-1.08) and income inequality (IRR 0.93, 95% CI 0.91-0.95) were significant. CONCLUSIONS: Large-scale legislative actions can be effective road safety measures if they are aimed at promoting behavioral change in developing countries, improving the safety of children on the road. Additionally, regional socioeconomic differences are associated with higher RTD rates in this population, making this an argument in favor of road safety policies that consider these inequalities. The number of road traffic tickets processed and the investment in road infrastructure were not significant.

Brazilian adaptation of the driving anger expression inventory: testing its psychometrics properties and links between anger behavior, risky behavior, sensation seeking, and hostility in a sample of Brazilian undergraduate students.

INTRODUCTION: In Brazil, driver aggressiveness in road traffic is a critical issue and could be an important contributing factor to the high number of traffic accidents. Because no instruments are available in Portuguese to register driving aggressiveness or driving anger in Brazil, we adapted English instruments into the Brazilian context. The aims of this study were to provide a Brazilian adaptation of the Driving Anger Expression Inventory (DAX) and to try to validate it by testing its psychometric properties and investigating its relationships with risky driving behaviors (DBQ), road accidents, driving sensation seeking, and hostility. METHOD: The Brazilian adaptations of the DAX, DBQ, the Driving Sensation Seeking Scale (DSSS) and the hostility Scale were administered to a sample of 512 undergraduate students (with a mean age of 23.7 years, 52.1% men). RESULTS: Confirmatory factor analysis of the Brazilian DAX (DAX-BR) items yielded a four-factor solution with 43 items, which obtained the best goodness-of-fit to the data. Cronbach's alpha for the DAX-BR factors ranged from 0.69 to 0.88. Other results on validity were a positive correlation (range 0.39-0.59) between the factors of the DAX-BR, DSSS, and DBQ. CONCLUSION: DAX-BR as the same structure as the original and is a reliable instrument for use with young drivers. Other studies should be conducted to further validate the DAX-BR in different types of populations such as older and more experienced drivers, professional drivers, and traffic regulation offenders whose driver's license has been taken away. Practical applications: This Brazilian version can be recommended for the assessment of driving anger expression in Brazil among young drivers in view of helping them driver more safely, and in particular to reduce traffic violations.

Anger while driving in Mexico City.

This study aims to analyze the level of anger developed by drivers in Mexico City and also understand the behavior that those drivers use to express that anger, using four different survey methods. The first focuses on personal information, the second Driving Anger Expression Inventory (DAX), the third refers to a shorten version of Driving Anger Scale (DAS) and the fourth being the Dula Dangerous Driving Index (DDDI). These have previously been applied and validated in several different countries. The questionnaires were filled out online by 626 drivers. Using the data collected through the online platform, it was possible to identify the kind of reactions volunteers displayed while driving. Also, it was possible to identify that people in Mexico City developed anger depending on their driving area. Our analyses shows that in the Adaptive/Constructive Expression subscale, males and females show a significant difference in their mean score, with women express their anger in a more constructive way than males.

The effects of musical auditory stimulation on heart rate autonomic responses to driving: A prospective randomized case-control pilot study.

Stress induced by driving has been revealed to increase the chances of cardiovascular complications and is involved or related to traffic accidents. In order to develop strategies to avoid health problems during driving we aimed to evaluate the acute effects of auditory stimulation with music on heart rate variability (HRV) during driving in congested urban traffic. This is a prospective cross-sectional randomized controlled pilot study conducted with five healthy women. Subjects were evaluated on two different random days, whose order of execution was established through a randomization process. In the music protocol the volunteers were exposed to music for the entire 20 min of traffic while in the control protocol the subjects performed the same procedures but were not exposed to any music. We noted that all Higuchi fractal dimension parameters except Kmax 10, Kmax 130 and Kmax 140 were reduced between pre-driving in the control protocol vs. driving in the control protocol. The same changes were noted between pre-driving in the music protocol vs. driving in the control protocol. In conclusion, musical auditory stimulation improved nonlinear HRV changes induced by driving.

Working conditions and sleepiness while driving among truck drivers.

Objective: The objective of this study is to identify the role of working conditions as predictors of sleepiness while driving among truck drivers. Methods: This was a cross-sectional study carried out among truck drivers who transported grains to Paranaguá Port, Paraná, Brazil. The truck drivers were interviewed and completed a self-administered questionnaire to collect data on sociodemographic and behavioral variables, working conditions, consumption of illicit psychoactive substances, and sleep patterns. Drivers were considered to be sleepy while driving if they reported a medium or high probability of napping while driving at night, during the daytime, or while stopped in traffic. The statistical analysis used logistic regression models progressively adjusted for age, behavioral variables, sleep duration, and other working conditions. Results: In total, 670 male drivers, with a mean age of 41.9 (±11.1) years, were enrolled. The prevalence of sleepiness while driving was 31.5%. After model adjustments, the following working conditions were associated with sleepiness while driving: Distance from the last shipment of more than 1,000 km (odds ratio [OR] = 1.54; 95% confidence interval [CI], 1.07-2.23) and a formal labor contract with a productivity-based salary (OR = 2.65; 95% CI, 1.86-3.78). Consumption of illicit psychoactive substances (OR = 1.99; 95% CI, 1.14-3.47) was also associated with sleepiness while driving. Conclusions: Distance traveled and a formal labor contract with productivity-based earnings were the working conditions associated with sleepiness while driving, regardless of other working or behavioral characteristics, age, consumption of illicit psychoactive substances, and sleep duration.

Prudent diet is associated with low sleepiness among short-haul truck drivers.

OBJECTIVES: The lifestyle of postindustrial society has undergone major shifts characterized by changes in demographic and epidemiologic profiles, eating habits, and job structures, with irregular working hours, particularly night shifts. The investigation of dietary patterns is of great importance for the discussion and devising of effective dietary strategies for shift and night workers in general, particularly in view of the increased sleepiness reported during night work. OBJECTIVE: We aimed to determine the association between dietary patterns of Brazilian truck drivers and sleepiness levels, according to work shift. METHODS: A cross-sectional study of 52 drivers (25 long haul and 27 short haul) at a freight company was carried out. This study entailed application of a structured questionnaire collecting sociodemographic, lifestyle, and nutritional status data. Assessment of dietary intake using a 24-h dietary recall and an evaluation of sleepiness by the Karolinska Sleepiness Scale were performed. The principal components of the diet were analyzed by factor analysis to derive dietary patterns. A linear mixed model was then applied to determine a model for sleepiness levels of the drivers as a function of dietary pattern, time of day, and work shift. RESULTS: Three intake patterns were derived: traditional, prudent, and Western. Associations of time of day (F = 23.629, P < 0.01) and shift type (F = 42.218, P < 0.01) on sleepiness were found. An association between diet and sleepiness was also evident, where the prudent pattern was associated with low sleepiness among short-haul truck drivers (F = 3.865, P = 0.02). CONCLUSIONS: The results of the present study revealed an association between dietary patterns and short-haul driving, in which the healthy pattern produced low sleepiness during the day. The sleepiness curve of long-haul drivers appears to have a flattening pattern, probably because of irregular working times.