Working Hours, Shift, and Remote Work by Industry and Occupation in U.S. Full-time Workers.

BACKGROUND: This study examines working hours, shift work, and remote work patterns by occupation and industry among U.S. full-time workers, along with the association between working and sleeping hours. METHODS: Utilizing data from 2011 to 2020 American Time Use Survey, this national household survey examines how individuals aged 15 years or older in the United States spend their time within a 24-hour period. FINDINGS: In 2011 to 2019, U.S. full-time workers averaged 8.1 hours of work and 7.8 hours spent sleep on workdays, increasing to 9.6 hours on non-workdays. Among all occupations, Emergency medical technicians and paramedics had the longest average working hours (10.4 hours). Protective services occupations had the highest percentage (41.7%) of workers reporting often working shifts other than daytime. Among all industries, truck transportation industry had the longest average working hours (9.2). Food services and drinking places industries had the highest percentage (28.6%) of workers reporting often working shifts other than daytime. Working hours showed a negative association with sleeping hours. In 2020, 34.0% of full-time workers reported remote work due to COVID-19, with the largest percentage (72.3%) occurring in business and financial operations. CONCLUSIONS: The study findings offer essential benchmarks for comparing working hours and schedules across diverse occupations and industries. These insights empower occupational health practitioners to advocate for prevention measures, addressing health concerns arising from prolonged working hours and shift work.

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.

Truck driver reported unrealistically tight delivery schedules linked to their opinions of maximum speed limits and hours-of-service rules and their compliance with these safety laws and regulations.

Objectives: The study objectives were to examine U.S. long-haul truck drivers (LHTDs)' opinions on their safety needs and to assess the associations of driver reported unrealistically tight delivery schedules with: (1) their opinions on their compensation, maximum speed limits, and Hours-of-Service (HOS) regulations, and (2) their behaviors of noncompliance with these safety laws and regulations. Methods: National Institute for Occupational Safety and Health analyzed data from its 2010 national survey of LHTD health and injury. A total of 1,265 drivers completed the survey. Logistic regression was used to examine the associations between driver reported unrealistically tight delivery schedule and their opinion on safety and unsafe driving behaviors. Results: Drivers who reported often receiving an unrealistically tight delivery schedule (an estimated 15.5% of LHTDs) were significantly more likely than drivers who reported never receiving an unrealistically tight delivery schedule to report that: (1) increasing the current maximum speed limit on interstate highways by 10 miles per hour (mph) would improve safety (odds ratio (OR) = 2.1); (2) strictly enforcing HOS rules would not improve safety (OR = 1.8); (3) they often drove 10 mph or more over the speed limit (OR = 7.5); (4) HOS regulations were often violated (OR = 10.9); (5) they often continued to drive despite fatigue, bad weather, or heavy traffic because their must delivery or pick up a load at a given time (OR = 7.5); and (6) their work was never adequately rewarded (OR = 4.5). When presented with 11 potential safety strategies, the largest percentage of LHTDs (95.4%) selected that building more truck stops/parking areas would improve truck driver safety. Conclusions: Driver reported unrealistically tight delivery schedules are associated with drivers' beliefs in safety laws/regulations and risk-taking behaviors. LHTDs see building more truck stops/rest areas as the most wanted safety need among the 11 potential safety strategies that were asked about in the survey.

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.

Occupational fatalities among driver/sales workers and truck drivers in the United States, 2003-2008.

BACKGROUND: This study provides a national profile of occupational fatalities among truck drivers and driver-sales workers. METHODS: Data from the 2003-2008 Census of Fatal Occupational Injuries were used. Cases were extracted specifically for occupational subcategories included in the Driver/Sales Workers and Truck Drivers occupational category: Driver/Sales Workers, Heavy and Tractor-Trailer Truck Drivers, and Light Truck or Delivery Services Drivers. RESULTS: In 2003-2008, the group Driver/Sales Workers and Truck Drivers had 5,568 occupational fatalities, representing 17% of all occupational fatalities in the United States. The majority of these fatalities were in the subgroup Heavy and Tractor-Trailer Truck Drivers (85%) and due to transportation incidents (80%). Older and male drivers had higher fatality rates than their counterparts. CONCLUSIONS: Findings suggest a need for targeted interventions to reduce highway fatalities among heavy truck drivers. Better employment data are needed to separate the three occupational subcategories by worker characteristic and employment history for use in research and prevention efforts.

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.

The influence of stem design on critical squeaking friction with ceramic bearings.

Ceramic-on-ceramic hip joints have been reported to squeak, a phenomenon that may occur in compromised lubrication conditions. One factor related to the incidence of in vivo squeaking is the stem design. However, it has not yet been possible to relate stem design to squeaking in deteriorating lubrication conditions. The purpose of this study was to determine critical friction factors for different stem designs. A hip simulator was used to measure the friction factor of a ceramic bearing with different stem designs and gradually deteriorating lubrication represented by evaporation of a volatile fluid lubricant. The critical squeaking friction factor was measured at the onset of squeaking for each stem. Critical friction was higher for the long cobalt chrome (0.32 ± 0.02) and short titanium stems (0.39 ± 0.02) in comparison with a long titanium stem (0.29 ± 0.02). The onset of squeaking occurred at a friction factor lower than that measured for dry conditions, in which squeaking is usually investigated experimentally. The results suggest that shorter or heavier stems might limit the possibility of squeaking as lubrication deteriorates. The method developed can be used to investigate the influence of design parameters on squeaking probability.

An alternative radiographic measure for cam-type FAI in patients with idiopathic hip pain.

Femoroacetabular impingement (FAI) has been accepted as a potential cause of idiopathic hip pain and osteoarthritis. Few cases of FAI have been reported in the Chinese population. We reviewed radiographic features of patients with idiopathic hip pain to characterize FAI in the Chinese population, any alternative radiographic measures, and potential symptom association. All anteroposterior pelvic radiographs of outpatients (n = 1,128) between December 2007 and August 2008 were reviewed. The radiographic measurements, including anteroposterior alpha angle (AP-a), radial height/radius ratio (R1), and 1/2 radial height/radius ratio (R2) as well as crossover signs, were recorded on both hip joints of all patients. The differences in AP-a, R1, and R2 were compared between cam-type hips (including mixed FAI) and non-cam-type hips (including non-FAI). From the group of patients, 269 were eligible for further evaluation, including those exhibiting FAI at the site of complaint (n = 38) or without symptoms (n = 7). FAI was significantly associated with hip pain (P = 0.009). For painful hips, the frequency of FAI was higher in males than in females (P = 0.038). AP-a was significantly higher in cam-type hips than in non-cam-type hips for either gender (P < 0.001, P < 0.001). R1 was comparable between the 2 subgroups for either gender (P > 0.05, P > 0.05), whereas R2 differed significantly (P < 0.001, P < 0.001). The occurrence of FAI was underestimated in Chinese patients showing negative radiographic findings with idiopathic hip pain. In addition, R2 was used to differentiate cam-type FAI from non-cam-type FAI.

Nonfatal work-related motor vehicle injuries treated in emergency departments in the United States, 1998-2002.

BACKGROUND: Current data on nonfatal work-related motor vehicle injuries are limited and fragmented, often excluding government workers, self-employed workers, and workers on small farms. This study seeks to bridge the present data gap by providing a national profile of nonfatal work-related motor vehicle injuries across all industries and occupations. METHODS: Study subjects were people who suffered nonfatal work-related motor vehicle injuries and were treated in a hospital emergency department in the United States. Subjects were identified from a stratified probability sample of emergency departments. National estimates and rates were computed. RESULTS: From 1998 to 2002, the average annual rate of nonfatal work-related motor vehicle injuries was 7 injuries per 10,000 full-time equivalents. The rate was three times higher in men than in women. The rates were higher in workers 15-19 years of age and in workers 70 years or older. Justice, public order, and safety workers had the largest number of injuries, and taxicab service employees had the highest injury rate of all industries. Truck drivers had the largest number of injuries, and police and detectives, public service employees had the highest injury rate of all occupations. CONCLUSION: Future efforts need to develop and enhance the use of surveillance information at the federal and state level for work-related nonfatal motor vehicle injuries. Prevention efforts need to address occupational motor vehicle safety for both commercial truck/bus drivers and workers who are not commercial drivers but who drive light motor vehicles on the job.

Potential work-related exposures to bloodborne pathogens by industry and occupation in the United States Part II: A telephone interview study.

BACKGROUND: The companion surveillance portion of this study [Chen and Jenkins, 2007] reported the frequency and rate of potential work-related exposures to bloodborne pathogens (BBP) treated in emergency departments (EDs) by industry and occupation, but it lacks details on the circumstances of the exposure and other relevant issues such as BBP safety training, use of personal protective equipment (PPE) or safety needles, or reasons for seeking treatment in a hospital ED. METHODS: Telephone interviews were conducted with workers who had been treated in EDs for potential work-related exposures to BBP in 2000-2002. Respondents were drawn from the National Electronic Injury Surveillance System. RESULTS: Of the 593 interviews, 382 were from hospitals, 51 were from emergency medical service/firefighting (EMS/FF), 86 were from non-hospital healthcare settings (e.g., nursing homes, doctors' offices, home healthcare providers, etc.), 22 were from law enforcement (including police and correctional facilities), and 52 were from other non-healthcare settings (i.e., schools, hotels, and restaurants). Needlestick/sharps injuries were the primary source of exposure in hospitals and non-hospital healthcare settings. Skin and mucous membrane was the primary route of exposure in EMS/FF. Human bites accounted for a significant portion of the exposures in law enforcement and other non-healthcare settings. In general, workers from non-hospital settings were less likely to use PPE, to have BBP safety training, to be aware of the BBP standards and exposure treatment procedures, and to report or seek treatment for a work-related exposure compared to hospital workers. CONCLUSIONS: This study suggests that each industry group has unique needs that should be addressed.

Potential work-related bloodborne pathogen exposures by industry and occupation in the United States part I: an emergency department-based surveillance study.

BACKGROUND: Since the early 1990s, researchers have attempted to assess the magnitude of potential work-related bloodborne pathogen (BBP) exposures in the U.S. The only data-derived estimate of 385,000 needlestick and other sharps injuries per year was reported in 2004. The estimate was derived from a convenience sample and did not include exposures outside of hospitals. This study seeks to understand the magnitude and distribution of the exposures across all industries and occupations. METHODS: Data were from the 1998 to 2000 National Electronic Injury Surveillance System (NEISS), a stratified probability-based sample of U.S. hospital emergency departments (EDs). NEISS covers all industries and occupations. National estimates of exposures and exposure rates (the number of exposures/1,000 full-time equivalents (FTE)) were computed. RESULTS: An estimated 78,100 potential work-related exposures to BBP were treated in hospital EDs annually in the U.S. While hospitals accounted for 75% of all these exposures, 11 other industries had a substantial number of exposures. While registered nurses accounted for 36% of all exposures, 13 other occupations had a substantial number of exposures. Hospitals had the highest exposure rate of 11.3/1,000 FTE, followed by nursing homes (2.8), and residential care facilities without nursing (1.9). Registered nurses had the highest exposure rate of 15.3/1,000 FTE, followed by clinical laboratory technologists and technicians (13.9), and physicians (7.1). CONCLUSIONS: While this study begins to more completely describe the problem of potential BBP exposure in the workplace, it is but a first step in further understanding the complex issues surrounding workplace BBP exposures.