The American truck driver has long a romantic image in national folklore -- a high-paid diesel cowboy, an independent King of the Road, barreling down the freeway, country music blaring on the radio. But there's another side to the free-spirit imagery: bumper-to-bumper traffic, bad weather, nowhere to get a decent meal, and the highest roadway fatality rates of any profession.

The on-the-road lifestyle, in fact, is the crux of many a trucker's health problems, according to Scott Madar of the International Brotherhood of Teamsters' (IBT) health and safety department in Washington DC. "Drivers have few opportunities for exercise and limited choices for meals. If your only option is fast food and there's no chance for exercise, you're on the fast track for obesity, heart-disease, and other ailments."

Truckers suffer from poorly designed workspaces (their cabs), exposure to hazardous chemicals, and a work atmosphere laden with diesel fumes. More serious, among all occupations, truckers have the eighth highest incidence of fatal injuries.

According to the US Bureau of Labor Statistics, there are about 2.8 million commercial truckers in the US -- ranging from big-rig operators hauling lumber and fuel to small step-van drivers delivering newspapers and baked goods. They suffer the most fatalities of all occupations, accounting for about 12 percent of worker deaths nationwide. More than two-thirds of trucker fatalities were caused by highway crashes. In any given year, over 4,700 large trucks are involved in fatal crashes that kill close to 5,000 people, most of whom are occupants of other vehicles. In 2006, one out of every nine traffic fatalities resulted from a collision involving a large truck.

Truckers are often too tired. While deadlines are common in most professions, a trucker on a deadline has to battle snarled traffic, replace blown-out tires, and combat sleepiness from driving for hours without rest. When a big rig reaches its destination, the driver may have to unload tons of merchandise. That sort of punishment, day in and day out, can lead to extreme fatigue -- and that can lead to a dependence on stimulants to keep awake.

Drowsiness is the cause of one in three fatal commercial truck accidents, according to Dr. Alan Swartz of Johns Hopkins Sleep Disorder Center. In 2005, the Insurance Institute for Highway Safety found that 20 percent of truck drivers admitted that they fell asleep at the wheel at least once in the month preceding the interview.

In the battle against fatigue, truckers have traditionally resorted to artificial stimulants, from coffee to over-the-counter and prescription stimulants ranging from No-Doz to amphetamines and cocaine. Stimulants can cause an increased release of catecholamines, a naturally occurring chemical transmitter that increases blood pressure and heart rate, increasing the risk of hypertension, heart attacks, and strokes. And chronic insomnia often plagues drivers coming down off stimulants, making it difficult to catch up on rest.

During the 1990s, agents of the Federal Drug and Alcohol Testing program embarked on a program to aggressively monitor truckers' substance abuse levels -- and put a dent in drug use among drivers. The large distributing companies felt the heat and curbed pressure on drivers to meet impossible deadlines. But independent drivers are still under the gun. "Those who are working under unions or good companies are getting the required rest they need," says IBT's Madar. "Those who are asked to violate the service standards are driving tired."

Ergonomics -- or work design -- is another problem. Cramped in poorly designed, confining seats as they crisscross the nation's thoroughfares, truckers are plagued by neck and back injuries. Worst hit are those who make long hauls with few stops.

Indeed, long-distance drivers may sit for double the time the average American desk worker does, minus any natural breaks such as trips to the water cooler or boss's office -- let alone lunchtime walks or racquetball sessions. And while ergonomic seating is being designed for newer-model trucks, big rigs are built to last. For most companies, turning over their current fleet may take years.

Another reason for strained backs and shoulders? "After all those long hours, drivers are asked to unload their trucks," says Madar. "They don't have adequate time to stretch their back muscles and get their bodies into the flexible physical condition required to do that kind of movement, so they easily damage their backs." In fact, according to the Bureau of Labor Statistics, truckers -- in a tie with hospital workers -- top the list of occupations with the highest rates of musculoskeletal injuries.

Road-hardened and competent as they may be, truck drivers can make mistakes doing things they've done hundreds of times before. That 9-foot drop from the cab to the ground can become treacherous if you're dog tired. Muddy ground, grease leaks, and frozen puddles can lead to nasty falls. Nearly 35 percent of all drivers' workers' compensation cases stem from drivers slipping and falling. "Realistically, it's not always possible to [safely] maneuver into a cab when you're trying to hoist a package into it," Mader says.

Then there are other, less quantifiable, work hazards like depression and loneliness from being away from home so much of the time. Statistically, the divorce rate of truck drivers is far higher than the national average. "The job is stressful on the driver, but also on the spouse and children," says the IBT's Madar. "When the driver is home, he needs to get the necessary rest, so often he cannot participate in family life. During the periods the driver's on the road, the entire responsibility for the family is shifted to the spouse. Drivers I know say they don't know many truckers that can keep a marriage together." In the United States, where statistics show that married men have better health than single ones, truckers often go it alone, and their health reflects it. For no small number of drivers, the isolation of the road leads to depression.

Because truckers frequently deal with hazardous materials, they are also at risk from chemical leaks, fires, and explosions. Lung damage can result from far more commonplace activities, like fueling up at the diesel pump. Over time, exposure to diesel fumes can lead to chronic lung problems, and some researchers believe there may also be a link between diesel fumes and lung cancer. Yet because the rate of cigarette smoking is so high among truckers, it's often difficult for doctors to know the origin of a driver's lung disease.

While today, some trucking companies are offering "wellness education programs" designed to teach drivers to eat well and get the recommended amount of exercise, they're only going halfway, says Madar. "They're trying to 'educate,' but there are no gyms available for drivers, and their choice of meals is very limited."

Experts advise truckers to try to work in at least 30 minutes of exercise each day and to build up their social networks as well. Some long-haul drivers enjoy talking with other truckers by CB radio, while some are turning to cell phones. "I use different aliases and voices just to keep myself amused," said one trucker of his CB chats. "It's always something to look forward to."

-- Diana Reiss-Koncar has written for Hippocrates, Vibe, and the San Francisco Examiner, and recently received a grant from the Smithsonian to record oral histories in Mexico.

Further Resources

National Institute for Occupational Safety and Health (NIOSH)

A federal research agency that makes recommendations to help prevent job-related injuries and illness.

800/232-4636

http://www.cdc.gov/niosh

Occupational Safety and Health Administration (OSHA)

Part of the Department of Labor, OSHA develops and enforces safety and health regulations in the workplace.

800/321-6742

OSHA's Trucking Industry page:

http://www.osha.gov/SLTC/trucking_industry/hazards.html

References

First published December 13, 2000
Last updated August 27, 2008
Copyright © 2000 Consumer Health Interactive