The relationship between the work organization of long-haul truck drivers and body mass index (BMI), waist circumference, and cardio-metabolic disease risk

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Barry Adam Hege (Creator)
The University of North Carolina at Greensboro (UNCG )
Web Site:
Michael Perko

Abstract: Globalization of markets, technological advances, deregulation of industries, and declines in union membership have all contributed to changes in working conditions beginning in the early 1980s. As a result, American workers are working longer hours to meet the demands of their employers, schedules requiring increased night and rotating shifts, and higher levels of stress from the workplace. These workplace factors serve as physiological, psychological, and behavioral mechanisms for poor health outcomes, increased safety risks, and ultimately shorter life expectancy. Discrepancies in work organization features are considered a major contributor to occupational health disparities for populations such as long-haul truck drivers. Long-haul truck drivers’ work organization is characterized by long work hours, irregular and rotating work schedules, and high job stress. Their work organization is substantially influenced by public policy from the U.S. Department of Transportation concerning Hours of Service (HOS), which legally allows up to 14 hours of work per day (11 of driving time), corporate operations and policies focused on profit and increasing productivity, and the competitive nature of the industry. As a result, drivers experience time pressures due to tight-running delivery schedules imposed by dispatchers who function as their immediate supervisor and have little control over the conditions influencing their work. Meanwhile, epidemiological research has revealed that the work environment is responsible for many of the poor health outcomes experienced by this occupational population. Not surprisingly, it is a population classified as one of the highest-risk occupations, having higher morbidity rates, and a decreased life expectancy when compared to the general population. A recent survey supported by the National Institute of Occupational Safety and Health (NIOSH) found that nearly 70 percent of U.S. long haul truck drivers are obese. This is more than double the rate of American workers according to the 2010 National Health Interview Survey, which presents further risks for cardio-metabolic conditions (hypertension, diabetes, cardiovascular disease). In the aforementioned survey of U.S. truck drivers, heart disease prevalence was actually less than the general population according to 2010 NHIS data (4.4 % vs. 6.7 %), but drivers had a higher prevalence of hypertension (26.3 % vs. 24.1%) and more than double the prevalence rate of diabetes (14.4 % to 6.8%). The causes of obesity are complex and multilevel and linked to numerous safety and health risks, while individual level behavior strategies have had little impact on long-haul truck drivers at the population level. Recent research has suggested that work conditions experienced by long-haul truck drivers deserve further attention in terms of their contribution to the high obesity prevalence among long-haul truck drivers. Therefore, it is critical to further understand how the work environment experienced by long-haul truck drivers serves as a mechanism for exacerbating the already ‘obesogenic’ environment in terms of individual level behavior mechanisms. As such, the aims of this study are to examine the relationships between the features of work organization such as work hours, irregular scheduling practices, and job stress and general obesity, abdominal obesity, and cardio-metabolic disease risk among a sample of 260 U.S. long-haul truck drivers. Specific understanding of these interactions may help to inform both prevention programming in long-haul trucking companies and public policy enacted at the federal level in relation to the industry. From this sample, the mean BMI was 33.40, 63.7 percent were obese, and 18.3 were characterized as extreme obese (a BMI of 40 or greater). The mean waist circumference was 114.77 cm and 76.0 percent were abdominally obese, or had a waist circumference of 102 cm or greater. When combining BMI and waist circumference measures, 80.0 percent of the sample was at high, very high, or extremely high risk of cardio-metabolic disease risk according to NIH’s classification system. Findings from this study suggest that working long hours may be the most critical work organization feature to long-haul truckers for general obesity. Specifically, working more than 11 and up to 14 hours daily was associated with increased odds for being overweight, obese, and most concerning extreme obese. These associations persisted after adjustments for other job stressors, driver age, and years of experience. A low level of supervisor support was associated with higher odds for abdominal obesity. With a BMI of 40 or greater being a significant problem among this sample, the longer working hours were associated with increased odds of an extremely high risk for cardio-metabolic disease. Daily working hours and supervisor support were both statistically significant predictors of cardio-metabolic disease risk. As such, the findings from this study support recent calls at the national level for integrated approaches to address long-haul truck driver health, including the monitoring of federal policy concerning the Hours of Service (HOS) regulations as well as organizational and scheduling practices incorporated by trucking companies.

Additional Information

Language: English
Date: 2015
Long-haul truck drivers, Obesity, Occupational health disparities, Work organization
Truck drivers $x Health and hygiene
Truck driving $x Physiological aspects
Hours of labor $x Health aspects
Job stress $x Health aspects
Industrial hygiene
Obesity $x Risk factors
Coronary heart disease $x Risk factors

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