A few years ago, the seeds of a new driver health reality were sown when a medically unqualified coach operator lost control of his vehicle, ran off of the highway and killed or injured many of those passengers who had trusted their lives to him. This same scenario has played out at least a few times since then, with coach or truck drivers the focus of the problem. It seems that an aging workforce, coupled with some adverse lifestyle choices, have produced, in part, a driver population that is at risk of some significant health and safety problems.

This new reality has led to some health and wellness countermeasures, including those developed by the Federal Motor Carrier Safety Administration (FMCSA). The FMCSA has created a new medical panel that evaluates driver health trends and urges changes for the agency to consider. Inside the agency, regulatory personnel have strengthened the requirements for driver health, including tighter controls on hypertension and new processes to manage driver physical qualification.

At the motor carrier level, more efforts at health and wellness have been made available to a sometimes reluctant workforce. Fleet managers have recognized that chronic shortages in the driver workforce can be in part alleviated by a healthier workforce, working more days for a longer period of time. They have also seen that a healthier workforce sustains fewer on-the-job injuries, leading to lower direct cost of worker compensation coverage, and that same healthier staff suffers fewer illnesses away from work, leading to lower health insurance premiums. In short, fleet managers have recognized that good health means good business.

But to the consternation of many managers, the passenger fleet driver workforce has often been slow to take advantage of wellness program opportunities. This failure of a formal program to "catch fire" usually leads to higher front end costs for programs but few - if any - back end savings. This is the formula for frustration, failure and program termination. Perhaps it is time to think about what it would take to make management's wellness concerns come to life in the hearts and minds of the driver staff.

Make wellness a priority

If ever there was a single reason that wellness programs fail, it would be a lack of employee motivation. While many folks are concerned about their current state of health, it is another thing entirely to move them from the status quo to a healthier lifestyle. Thousands of words have been written and spoken about the evils of excess weight, smoking, fast foods and lack of exercise, but the trends continue and your driver workforce, a microcosm of America, hears it all but is often unmoved. The son who buried his lung cancer-ridden father continues to smoke, while the daughter who assists her obese mother in and out of bed each day continues to enjoy junk food. Obviously, it will take more than an announcement of free gym memberships to get your employees out of their current, and expensive, unhealthy lifestyles.

What is to be done? There is no single "silver bullet," but experience has shown that employees do react when the employer makes wellness a priority. Purchasing a "wellness package" may work for some, but the foundations are needed first, including a few building blocks such as:

Personal leadership - When the boss speaks and then does, the message is, "I think this is important and will live by my own advice." In the same way that a radar detector on the dash of the safety director's car undoes all of his speeches against speeding, a boss who ignores his or her own advice (or that given by a paid vendor) sends a clear message: "Nice for you, not important for me." It is very clear that for this and other programs, leadership matters.

Opportunity - There are a number of ways to make wellness programs accessible to employees, be they training classes on topics such as nutrition (not everyone knows croissants are mostly made of butter!), gymnasium and shower access, or simply a walking map of safe routes or destinations in the area. Denying the opportunity to smoke is important as well. A smoke-free campus, not just a smoke-free office, can force the issue for some, and those who value a cigarette over their job might better find new employment on someone else's health insurance policy; cancer treatment isn't cheap.

Incentives - Simple efforts at creating peer group competitions and other incentives have value. Inexpensive pedometers provided to all employees with a competition for the most walking by individuals or a group is a proven winner. Challenges for limited periods work as they motivate in the short term and begin to break down poor habits, replacing them with a new awareness. As for prizes, give healthy ones, or reduce the health insurance premiums by increasing employer share for participants. The money will come back to the employer, with dividends.

Get the message out

Information is king, once an employee gets the message that health and wellness do matter and are achievable. The message needs to get out about heart disease, diabetes, weight control and other conditions that can be managed and controlled. This ends up being an employer responsibility, as trusting the message to be delivered by public service announcements may work for some, but certainly not for all. Payroll stuffers, posters, training sessions and other methods each offer a means to send out and reinforce that same message: health and wellness do matter and are achievable.

For the passenger fleet driver, a few issues have an immediately higher priority, as they affect the driver's ability to continue his or her employment. Heart disease and hypertension are at the top of the list, followed by diabetes awareness, prevention and control. Each of these conditions includes career-ending medical condition disqualifiers.

Of late, the FMCSA medical review board has begun raising the issue of the links between fatigue, weight and sleep apnea. Sleep apnea has always been a disqualifier, but with more attention focused on it, more drivers than ever will feel the pressure to deal with this condition. Of course, at least a few of the solutions for all of these conditions are linked with weight control and diet. What drivers (and others) ought to know:

  • Obesity is an epidemic
  • Diet is a major factor in obesity
  • Sleep apnea is often weight related
  • Elevated blood pressure is often weight related
  • Diabetes thrives in a weight challenged individual


Medical disqualifiers                

According to the Center for Disease Control (CDC), obesity is a major health issue. The condition and its related illnesses are the second-largest cause of death in the U.S., after heart disease. Obesity is defined as having a Body Mass Index (BMI) in excess of 30; calculate BMI by using a table found by searching the Internet for "BMI", or use the formula:

Overweight employees are at greatest personal risk to good health. Excess weight, then, is the target of much wellness activity and expense. Employers are well advised to focus on education and motivation, and be aware that changes to lifestyle and entering an exercise program may be a source of concern, even embarrassment to many.

Diet and a lack of exercise seem to be at the heart of the obesity problem. While it is hard to separate the two as a health and wellness issue, diet seems to be a major problem for individuals working odd hours or finding themselves in locations with few options for meals. Control of the external circumstances is difficult as best, but the driver can begin to manage the problem by assuring that some healthier food options are within arm's reach - a lunch or snack packed at home saves both money and calories. Some fast foods are packed with calories and fats, and can create weight and hypertension concerns. Even fast food restaurants offer healthy (or least healthier) options, but those have to be choices made every day, every meal.

Sleep apnea is an obstructive condition that affects the breathing of those afflicted while they are asleep. While sleep apnea can affect anyone, a high BMI is, according to the FMCSA's Medical Advisory Board, an indicator of possible sleep apnea, and the board has recommended further testing of such individuals.

Why the concern? Sleep apnea is disruptive to sleep and victims are seldom well rested. Instead, they can potentially fall asleep in the midst of an activity and show signs of fatigue as a matter of routine. Clearly these are threats to safety. In addition, because of the nature of the affliction, stress on other body systems and parts, such as the heart, is the norm, leading to a greater possibility of medical complications. Treatments for sleep apnea are available.

Elevated blood pressure is an indication of problems in the circulatory system, with the potential for heart disease or stroke as possible results of unmanaged hypertension (high blood pressure). The FMCSA has established a strong protocol for limits on hypertensive drivers, and demands more frequent evaluation of those so affected. Blood pressure issues are often the result of multiple causes, some of which the driver has the opportunity to manage: hypertension is associated with some genetic factors, but also results from obesity, lack of exercise, an overuse of salt or simply aging. Regardless of the source of the condition, drivers must bring their blood pressure down to controlled levels through exercise, medication or both, or ultimately be denied physical qualification to drive.

Diabetes is another medical condition that can disqualify a driver. This disease is one that affects the body's ability to change carbohydrates and sugars into energy. While the specific cause for the onset of diabetes is a mystery, certain factors place a person at higher risk of contracting diabetes. These risk factors include a family history of diabetes, obesity, poor diet and physical inactivity. Once again, obesity, diet and lack of exercise are implicated in the challenge to remaining healthy and well.

Medical Starting Point

 For every individual in every wellness program, a medical evaluation before getting started is an absolute must. Predicting the future for any particular person is not often easy, except to say that among any group of employees, there will be one or two who simply must exercise extreme caution before entering into any lifestyle, diet or exercise programs. Medical evaluations at the outset offer what appears to be the best hope of sorting out these at risk individuals from the group.

A physical examination, more extensive than the basic DOT medical evaluation would seem to be in order, as well as periodic re-evaluations of the individual's continuing health and program progress. Having a medical professional squarely in the midst of an employee health and wellness program helps to assure progress, continuing oversight and preventing damage where before there was none.  

Jack Burkert is Director of Safety and Security Programs for the Trailways Transportation System. Jack may be reached at jackburkert@verizon.net