Improving driver wellness is a no-brainer. It can help prevent high turnover rates, as well as help retain the most talented employees without having to lose them to disease or poor health. It’s never been easy to stay fit or healthy on the road, but it’s no longer possible to ignore the impact on the health of those who sit behind the wheel for a living.
Commercial truck drivers/bus drivers face many factors that create a workplace atmosphere of unhealthy habits. The sedentary job and lifestyle, decreased access to preventative health care, and easy access to poor food choices play a significant role in these unhealthy habits. It also has been linked to a higher rate of Metabolic Syndrome (MetS) and obesity in the transportation industry.
Metabolic Syndrome (MetS) includes three of the following five factors: hypertension, high blood sugar, increased waist circumference, abnormal cholesterol, and triglyceride levels.
Figure 1 presents the breakdown of the number of MetS factors the participants exhibit at the initial screening. Within our dataset there are 39% of the population with metabolic syndrome.
Individuals with Metabolic Syndrome (MetS) have an increased risk for cardio-vascular disease, diabetes, and stroke¹. The link between wellness and accidents may be less obvious — but the numbers are convincing. Obesity (>29.9 BMI) has similar health risks as seen with MetS and has also been linked to a significantly higher rate of crashes. This is prevalent in newly hired drivers. Recently hired drivers who are obese have a 50% higher chance of an accident during their first two years of employment. Obstructive sleep apnea, which is often associated with obesity, increases crash risk up to five times²,³.
Addressing health and wellness is also becoming more critical because of the aging workforce. As more workers enter their 50s and 60s, companies could see potentially devastating spikes in health care costs, lost time, and other age-related problems. The percentage of older workers is even higher in transportation than in most industries, with the Transportation Research Board estimating that up to 25% of drivers will be older than 65 by 2025.
Figure 2 presents the breakdown of the study population based on age with a medi-an age of 52 years old. This population is slightly older by comparison to the median age of the fleets this data was derived from (44 years old).
A 2016 HireRight Transportation Survey reported that 21% of drivers leave their jobs due to health issues. This statistic, as well as the aging workforce within the transportation industry, leads many transportation companies to explore and implement wellness and health promotion programs to retain younger drivers and help lengthen driver careers.
Atlas Injury Prevention Solutions recently published their fourth paper of a series looking at trends within the transportation industry. Trends related to biometric screening and coaching and how it relates to BMI and metabolic syndrome were analyzed over five years.
Recommendations based on the findings are summarized on the following page.
Metabolic Syndrome (MetS)
Most MetS factors are undetectable without a blood test. Therefore, most drivers do not know they are at risk. Diabetes, cardiovascular disease, stroke, and many cancers have been linked to MetS, and the majority of drivers do not know they have these factors. The two factors that demonstrated the greatest change between screenings in our data was low HDL and high triglycerides. Physical activity is key to maintaining a favorable HDL and triglyceride levels. When activity drops off due to starting a new career in commercial driving, it typically shows as a drop in HDL and an elevation in triglycerides.
Screening and coaching can improve a driver’s knowledge and awareness of what the factors are, what they mean, and how to make positive changes to reduce those factors. Repeated screening and coaching sessions can improve driver health by giv-ing drivers benchmarks and goals. Regular coaching will provide drivers with valuable feedback on how their health is progress-ing, and what further actions or follow up may be needed.
Currently, only 18% of transportation companies are addressing tobacco use with wellness programs. Emphasis should be placed on the development of 1) smoking cessation programs, and 2) awareness programs on the connection between all types of tobacco use and MetS conditions for drivers. Companies should be more proactive in addressing the harmful effects of tobacco associated with cardiovascular health and the development of MetS. Screening and coaching programs can help raise driver awareness of the negative effects of tobacco on their bodies. Linking the use of smoking with health factors associated with MetS can educate drivers and help decrease the need for reactive medical treatments in the future.
Retaining drivers is a significant concern within the transportation industry. Programs that can positively affect retention and driver health are paramount to maintaining a healthy and productive workforce. Bio-metric screening is a critical component for driver retention when considering the number of drivers who leave due to health concerns. Monetary benefits assist with retention but do not have an overall effect on driver health.
Programs that couple monetary benefits with increasing driver awareness of critical health concerns can significantly improve retention. Programs should focus on regular follow-up coaching on MetS factors, with particular attention paid to blood glucose levels and diabetes education.
Our research shows that today’s drivers are aware of the significant lifestyle chal-lenges that exist with behind-the-wheel employment. However, if drivers have not addressed these issues before entering the industry, they are even less prepared to meet the lifestyle challenges unique to commercial driving. Many drivers lack a detailed view of how their health is impacted. Most drivers — up to 80% — do not attend an annual preventative exam with a personal health care provider. Instead, they rely on the incomplete information they receive on a DOT examination. The DOT exam will miss many Metabolic Syndrome risk factors that would be discovered by biometric screening and preventative exams.
If health issues continue over time, driv-ers will find themselves at a crossroads in their transportation career. It will be here that they will be faced with either declining health or an ability to work safely/productively. Options they may choose:
- Actively improve their health, which would strengthen their ability to remain in the transportation industry and the organization. These drivers are more likely to seek relevant programs and utilize resources.
- Resign from the industry prematurely, recognizing an inability to manage their health risk. Drivers may be motivated to consider this option to avoid a less desira-ble, involuntary exit from the organization or DOT exam process.
- Continue the path of escalating medical costs and waning productivity toward the end of the career, potentially ending in critical illness or inability to pass a DOT examination.
Above all, maintaining good health is the best option. Somewhere between optimal health and a potential exit from the industry due to health reasons lies a state of health described as “sick, but not sick enough.” This describes health that has begun to show the risk of approaching conditions but is not yet severe enough to limit eligibility/capability to work. With the noted prevalence of obesity and metabolic syndrome factors among drivers, our data shows this is the average state of health.
Rather than taking a reactive approach to medical costs and health-related turno-ver, organizations should strongly consider investing in health awareness programs that include biometric screening or annual physical exams. Coaching and program development must be specific to the lifestyle and daily routine of the driver to be effective. This type of program will improve driver awareness and their ability to make meaningful efforts toward enhancing and maintaining a healthier lifestyle. Maintaining such a program long term allows best practices to emerge, which can be shared with peers to impact a broader portion of the fleet/company culture.
Research paper summarized by Kris Corbett, Director, Atlas Injury Prevention Solutions.
1. Wideman L., Oberlin D.J., Sönmez S., Labban J., Lemke, M.K., and Apostolopou-los Y. (2016). “Obesity indices are predictive of elevated C-reactive protein in long-haul truck drivers.” American Journal of Industrial Medicine, 59(8), 665-576.
2. Anderson, Jon E., et al. “Obesity is associated with the future risk of heavy truck crashes among newly recruited commercial drivers.” Accident Analysis & Prevention 49 (2012): 378-384.
3. Burks, Stephen V., et al. “Nonadherence with employer-mandated sleep apnea treatment and increased risk of serious truck crashes.” Sleep 39.5 (2016): 967-75.