Research gaps and needs for preventing worker fatigue in the transportation and utilities industries.

BACKGROUND: The transportation and utilities industries include establishments engaged in the movement of passengers and freight, or the provision of public power, water, and other services. Along with the warehousing industry, they make up the US National Occupational Research Agenda's Transportation, Warehousing and Utilities (TWU) industry sector. In 2018 the sector composed 5% of the US workforce, with approximately 8 million workers. TWU workers experienced 19% of all fatalities among U.S. workers in 2018 and 7% of total occupational injuries and illnesses. METHODS: Around-the-clock operations, heavy workloads, long and irregular shifts, complicated schedules, and time pressures characterize work across the US TWU sector. However, there are considerable differences in worker priorities and concerns between TWU industries. Major areas of concern within the sector include disparities in work schedules; required training for employee fatigue awareness and prevention; physical and mental job demands; and safety culture. RESULTS: Strategies for fatigue mitigation are critical to reduce the prevalence of injuries, safety-critical events, and crashes in TWU workers. Further research on the incidence and characterization of fatigue among TWU workers will guide the development of effective mitigation strategies. The influence of work scheduling on missed sleep opportunities and disrupted circadian rhythms should be determined. Evaluation of fatigue mitigation strategies can lead to the adoption of the most effective ones for each TWU industry. CONCLUSION: Implementation of effective strategies is critical for the health, safety, wellbeing, and productivity of workers in the TWU sector.

A Descriptive Study of Musculoskeletal Injuries in Long-Haul Truck Drivers: A NIOSH National Survey.

Long-haul truck drivers are significantly affected by musculoskeletal injuries with incidence rates 3.5 times higher than the national average. Yet, little is known about injuries that affect long-haul trucks drivers. In 2010, interviewers collected data from 1,265 long-haul truck drivers at 32 truck stops across the United States. These surveys were analyzed to describe all self-reported musculoskeletal injuries. Injuries to the arm (26.3%) and back (21.1%) were the two areas most reported in the survey. Musculoskeletal injuries were most often caused by falls (38.9%) and contact with an object or equipment (33.7%) resulting most commonly in sprains/strains (60%). This large scale survey highlights the significance of musculoskeletal injuries in long-haul truck drivers and suggests the need to develop interventions to prevent injuries and improve recovery once injuries occur.

A Pilot Study of Healthy Living Options at 16 Truck Stops Across the United States.

PURPOSE: There is a growing body of evidence that the built environment influences diet and exercise and, as a consequence, community health status. Since long-haul truck drivers spend long periods of time at truck stops, it is important to know if this built environment includes resources that contribute to the emotional and physical well-being of drivers. SETTING: The truck stop environment was defined as the truck stop itself, grocery stores, and medical clinics near the truck stop that could be accessed by a large truck or safely on foot. DESIGN: Researchers at the National Institute for Occupational Safety and Health (NIOSH) developed and utilized a checklist to record the availability of resources for personal hygiene and comfort, communication and mental stimulation, health care, safety, physical activity, and nutrition at truck stops. SUBJECTS: The NIOSH checklist was used to collect data at a convenience sample of 16 truck stops throughout the United States along both high-flow and low-flow truck traffic routes. MEASURES: The checklist was completed by observation within and around the truck stops. RESULTS: No truck stops offered exercise facilities, 94% lacked access to health care, 81% lacked a walking path, 50% lacked fresh fruit, and 37% lacked fresh vegetables in their restaurant or convenience store. CONCLUSION: The NIOSH found that most truck stops did not provide an overall healthy living environment.

NIOSH national survey of long-haul truck drivers: Injury and safety.

Approximately 1,701,500 people were employed as heavy and tractor-trailer truck drivers in the United States in 2012. The majority of them were long-haul truck drivers (LHTDs). There are limited data on occupational injury and safety in LHTDs, which prompted a targeted national survey. The National Institute of Occupational Safety and Health conducted a nationally representative survey of 1265 LHTDs at 32 truck stops across the contiguous United States in 2010. Data were collected on truck crashes, near misses, moving violations, work-related injuries, work environment, safety climate, driver training, job satisfaction, and driving behaviors. Results suggested that an estimated 2.6% of LHTDs reported a truck crash in 2010, 35% reported at least one crash while working as an LHTD, 24% reported at least one near miss in the previous 7 days, 17% reported at least one moving violation ticket and 4.7% reported a non-crash injury involving days away from work in the previous 12 months. The majority (68%) of non-crash injuries among company drivers were not reported to employers. An estimate of 73% of LHTDs (16% often and 58% sometimes) perceived their delivery schedules unrealistically tight; 24% often continued driving despite fatigue, bad weather, or heavy traffic because they needed to deliver or pick up a load at a given time; 4.5% often drove 10miles per hours or more over the speed limit; 6.0% never wore a seatbelt; 36% were often frustrated by other drivers on the road; 35% often had to wait for access to a loading dock; 37% reported being noncompliant with hours-of-service rules (10% often and 27% sometimes); 38% of LHTDs perceived their entry-level training inadequate; and 15% did not feel that safety of workers was a high priority with their management. This survey brings to light a number of important safety issues for further research and interventions, e.g., high prevalence of truck crashes, injury underreporting, unrealistically tight delivery schedules, noncompliance with hours-of-service rules, and inadequate entry-level training.

Vital signs: seat belt use among long-haul truck drivers--United States, 2010.

BACKGROUND: Motor vehicle crashes were the leading cause of occupational fatalities in the United States in 2012, accounting for 25% of deaths. Truck drivers accounted for 46% of these deaths. This study estimates the prevalence of seat belt use and identifies factors associated with nonuse of seat belts among long-haul truck drivers (LHTDs), a group of workers at high risk for fatalities resulting from truck crashes. METHODS: CDC analyzed data from its 2010 national survey of LHTD health and injury. A total of 1,265 drivers completed the survey interview. Logistic regression was used to examine the association between seat belt nonuse and risk factors. RESULTS: An estimated 86.1% of LHTDs reported often using a seat belt, 7.8% used it sometimes, and 6.0% never. Reporting never using a belt was associated with often driving ≥10 mph (16 kph) over the speed limit (adjusted odds ratio [AOR] = 2.9), working for a company with no written safety program (AOR = 2.8), receiving two or more tickets for moving violations in the preceding 12 months (AOR = 2.2), living in a state without a primary belt law (AOR = 2.1); and being female (AOR = 2.3). CONCLUSIONS: Approximately 14% of LHTDs are at increased risk for injury and death because they do not use a seat belt on every trip. Safety programs and other management interventions, engineering changes, and design changes might increase seat belt use among LHTDs. IMPLICATIONS FOR PUBLIC HEALTH: Primary state belt laws can help increase belt use among LHTDs. Manufacturers can use recently collected anthropometric data to design better-fitting and more comfortable seat belt systems.

National Survey of US Long-Haul Truck Driver Health and Injury: health behaviors.

OBJECTIVE: To compare selected health behaviors and body mass index (modifiable risk factors) of US long-haul truck drivers to the US working population by sex. METHODS: The National Survey of US Long-Haul Truck Driver Health and Injury interviewed a nationally representative sample of long-haul truck drivers (n = 1265) at truck stops. Age-adjusted results were compared with national health surveys. RESULTS: Compared with US workers, drivers had significantly higher body mass index, current cigarette use, and pack-years of smoking; lower prevalence of annual influenza vaccination; and generally lower alcohol consumption. Physical activity level was low for most drivers, and 25% had never had their cholesterol levels tested. CONCLUSIONS: Working conditions common to long-haul trucking may create significant barriers to certain healthy behaviors; thus, transportation and health professionals should address the unique work environment when developing interventions for long-haul drivers.

Obesity and other risk factors: the national survey of U.S. long-haul truck driver health and injury.

BACKGROUND: Drivers of heavy and tractor-trailer trucks accounted for 56% of all production and nonsupervisory employees in the truck transportation industry in 2011. There are limited data for illness and injury in long-haul truck drivers, which prompted a targeted national survey. METHODS: Interviewers collected data during 2010 from 1,670 long-haul truck drivers at 32 truck stops across the 48 contiguous United States that were used to compute prevalence estimates for self-reported health conditions and risk factors. RESULTS: Obesity (69% vs. 31%, P < 0.01) and current smoking (51% vs. 19%, P < 0.01) were twice as prevalent in long-haul truck drivers as in the 2010 U.S. adult working population. Sixty-one percent reported having two or more of the risk factors: hypertension, obesity, smoking, high cholesterol, no physical activity, 6 or fewer hours of sleep per 24-hr period. CONCLUSION: Survey findings suggest a need for targeted interventions and continued surveillance for long-haul truck drivers.

Occupational exposures to respirable crystalline silica during hydraulic fracturing.

This report describes a previously uncharacterized occupational health hazard: work crew exposures to respirable crystalline silica during hydraulic fracturing. Hydraulic fracturing involves high pressure injection of large volumes of water and sand, and smaller quantities of well treatment chemicals, into a gas or oil well to fracture shale or other rock formations, allowing more efficient recovery of hydrocarbons from a petroleum-bearing reservoir. Crystalline silica ("frac sand") is commonly used as a proppant to hold open cracks and fissures created by hydraulic pressure. Each stage of the process requires hundreds of thousands of pounds of quartz-containing sand; millions of pounds may be needed for all zones of a well. Mechanical handling of frac sand creates respirable crystalline silica dust, a potential exposure hazard for workers. Researchers at the National Institute for Occupational Safety and Health collected 111 personal breathing zone samples at 11 sites in five states to evaluate worker exposures to respirable crystalline silica during hydraulic fracturing. At each of the 11 sites, full-shift samples exceeded occupational health criteria (e.g., the Occupational Safety and Health Administration calculated permissible exposure limit, the NIOSH recommended exposure limit, or the ACGIH threshold limit value), in some cases, by 10 or more times the occupational health criteria. Based on these evaluations, an occupational health hazard was determined to exist for workplace exposures to crystalline silica. Seven points of dust generation were identified, including sand handling machinery and dust generated from the work site itself. Recommendations to control exposures include product substitution (when feasible), engineering controls or modifications to sand handling machinery, administrative controls, and use of personal protective equipment. To our knowledge, this represents the first systematic study of work crew exposures to crystalline silica during hydraulic fracturing. Companies that conduct hydraulic fracturing using silica sand should evaluate their operations to determine the potential for worker exposure to respirable crystalline silica and implement controls as necessary to protect workers.

Environmental risk factors and work-related lower respiratory symptoms in 80 office buildings: an exploratory analysis of NIOSH data.

BACKGROUND: We evaluated relationships between lower respiratory symptoms and risk factors for microbiological contamination in office buildings. METHODS: The National Institute for Occupational Safety and Health collected data from 80 office buildings during standardized indoor environmental health hazard evaluations. Present analyses included lower respiratory symptom-based outcome definitions and risk factors for potential microbiologic contamination. Multivariate logistic regression models for selected outcomes identified key risk factors. RESULTS: Adjusted odds ratios (95% confidence intervals) for "at least three of four work-related lower respiratory symptoms" were, for debris in ventilation air intake, 2.0 (1.0-3.9), and for poor drainage in air-conditioning drip pans, 2.6 (1.3-5.2). Adjusted associations with risk factors were consistently stronger for outcomes requiring both multiple symptoms and improvement away from work, and somewhat stronger among diagnosed asthmatics. CONCLUSIONS: Moisture and debris in ventilation systems, possibly by supporting microbiologic growth, may increase adverse respiratory effects, particularly among asthmatics. Data from more representative buildings are needed to confirm these findings.

Hearing protector use in noise-exposed workers: a retrospective look at 1983.

Although hearing protectors have been available for more than 60 years, little field surveillance has been done to assess their appropriate wear in noisy occupational environments. This study examined historical field survey data to determine whether workers use hearing protection when exposed to loud noise. Data from the 1981-83 NIOSH National Occupational Exposure Survey were analyzed to determine whether workers in noise greater than or equal to 85 dBA were using hearing protection. The study also looked at the effect of company personal protective equipment (PPE) policies on hearing protector compliance. This study found that, in 1981-83, an estimated 4.1 million industrial workers were exposed to noise greater than or equal to 85 dBA. Of these, 41% were wearing some form of hearing protection. This percentage varied from 79% of workers exposed in SIC 76 (Miscellaneous Repair Service) to less than 1% in Communications (SIC 48), Wholesale Trade Nondurable Goods (SIC 51), and Automotive Dealers & Service Stations (SIC 55). Whether an establishment had a written policy on wearing PPE seemed to make no difference, because there appeared to be no tie between the percentage of workers wearing of hearing protection and presence of a PPE policy.