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Taxis are essential to economic growth due to the ease and comfort they offer passengers. This is evident as most cities, especially in Africa, are dominated by taxis providing door-to-door services. However, their susceptibility to road traffic accidents (RTA) raises serious concerns due to their risky driving behaviours. In contrast, studies on taxi driver involvement in RTA due to their risky driving behaviours are sparse, especially in African countries. Consequently, the study examined the relationship between risky driving behaviour and traffic accident involvement among Nigerian commercial taxi drivers using the structural equation modeling (SEM) approach. Prior to the structural model analysis, the modified driver behaviour questionnaire (DBQ) was valid. This was assessed through the measurement model, and the results showed that the composite reliability, average variance extracted, and discriminant validity were greater than 0.7, greater than 0.5, and less than 0.90, respectively. Furthermore, the structural equation modeling results show that the driving violation and driving error constructs influenced road traffic accidents among taxi drivers, while inattention error was insignificant (p > 0.05). Although driving violations and errors significantly increase the chances of RTA among taxi drivers, driving violations had a more substantial influence than driving errors. Also, the regression coefficient indicates the risky driving behaviour of commercial taxi drivers accounts for 5.2 % of the RTAs in Nigeria. This research contributed to validating the DBQ for commercial taxi drivers in Nigeria, examining the influence of their driving violations, driving errors, and inattention errors on accident involvement and that inattention error may not necessarily influence accidents, which will aid policymakers in formulating mitigative strategies for RTA reductions. Moreso, it will guide driver trainers in curriculum development for specific commercial taxi driver training.

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Objectives: Most road traffic accident (RTA) deaths occur before victim reaches a definitive trauma care facility. The aim of the study was to determine the role of commercial drivers toward providing post-crash care to RTA victims in Jodhpur, Rajasthan. Materials and Methods: This cross-sectional study assessed the role of commercial auto-rickshaw and cab drivers for providing post-crash care in urban Jodhpur during 2019-2020. Eligible participants volunteering for the study were included from taxi and auto stands in urban Jodhpur. A pre-tested questionnaire was administered by a trained interviewer. Data analysis was done using SPSS v23.0. Summary measures in terms of frequencies, means, and range are reported. Chi-square test, Fisher's Exact test, and Multivariate Logistic Regression analysis were done for statistical associations. Results: Two hundred male participants completed the study with a mean age of 37.74 (8.96) years having an average work experience as commercial drivers of more than 10 years. Over 70% of participants witnessed RTA in the past year and 52% provided care to victims. The knowledge of post-crash care was most affected by their education level (adjusted odds ratio [aOR]: 1.778, 95% confidence interval [CI]: 0.958, 3.301), whereas the intended post-crash care practices were significantly better among participants with previous training (aOR: 15.376, 95% CI: 2.149, 110.017). Conclusion: The current study establishes the role of commercial drivers as first responders at accident sites in the fast urbanizing city of Jodhpur, Rajasthan. Systematic capacity building initiatives of commercial drivers to salvage RTA victims have potential to strengthen pre-hospital trauma care continuum in non-metro districts of India experiencing high burden of accidents.

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BACKGROUND: Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality in the United States, with 20% of deaths in adults under age 65. Commercial drivers have an increased CVD incidence rate of 50% compared to 30% for the general population, yet one third of drivers will not be screened for risk factors due to a lack of insurance or primary care. With approximately 3.5 million commercial drivers nationally and correlation of CVD to increased motor vehicle accidents, fatalities, and excessive healthcare costs, addressing the care gap for this high-risk population is imperative. METHODS: An evidence-based practice (EBP) project synthesized the literature and implemented CVD risk screening for commercial drivers examined in an occupational practice setting. Using the non-laboratory Framingham CVD risk score calculator, over 90% of drivers were screened during mandated medical examinations and provided education regarding modifiable risk factors during a 2-month period. FINDINGS: Over 40% of commercial drivers were at high risk for CVD with 25% uninsured and 32% without primary care. The average CVD risk score was twice the general population's risk score, with obesity, hypertension, and smoking being the most common risk factors discussed. CONCLUSIONS/APPLICATION TO PRACTICE: Incorporating CVD risk screening and education during opportune encounters is logical, efficient, and financially prudent. The EBP change supports occupational professionals' standards, and ongoing review of CVD screening guidelines with integration into practice provides health promotion and promotes public safety for these essential workers.

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PURPOSE: To assess the efficacy of overnight pulse oximetry in screening male commercial drivers (CDs) for obstructive sleep apnea (OSA). METHODS: Consecutive male CDs undergoing their annual scheduled occupational health visit were enrolled from ten transportation facilities. All subjects underwent a home sleep apnea test (HSAT) to determine the Respiratory Event Index (REI). Oxygen desaturation indices (ODIs) below the 3% and 4% thresholds were computed using the built-in HSAT pulse oximeter. We then assessed the association between ODI values and the presence of OSA (defined as an REI ≥ 5 events/hour) as well as moderate to severe OSA (REI ≥ 15 events/hour). RESULTS: Of 331 CDs recruited, 278 (84%) completed the study protocol and 53 subjects were excluded due to inadequate HSAT quality. The included and excluded subjects were comparable in demographics and clinical characteristics. The included CDs had a median age of 49 years (interquartile range (IQR) = 15 years) and a median body mass index of 27 kg/m2 (IQR = 5 kg/m2). One hundred ninety-nine (72%) CDs had OSA, of which 48 (17%) were with moderate OSA and 45 (16%) with severe OSA. The ODI3 and ODI4 receiving operating characteristic curve value were 0.95 for predicting OSA and 0.98-0.96 for predicting moderate to severe OSA. CONCLUSION: Overnight oxygen oximetry may be an effective means to screen CDs for OSA.

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Background: An excellent vision is crucial in driving and many driving related injuries and fatalities have been associated with visual problems especially for commercial drivers. Visual efficiency plays an important role during driving. This study determined the knowledge and attitude of commercial drivers in Benin towards utilization of eye care services. Method: This was a cross sectional study conducted among 100 commercial drivers in Benin City metropolis. Data was collected using an interviewer administered questionnaire, among commercial drivers from 3 major parks in Benin City. Data was analyzed using SPSS version 22. Descriptive and inferential statistics was used to analyze the data. Statistical significance was set at p < 0.05. Results:The results revealedthat majorityofcommercial drivers in Benin city had knowledge of which an eye care provider is (60%), as well as knowing the eye care providers closest to them. However, 75% of them do not see it necessary to utilize the eye care services. Results of this study will help eye care professionals to better advise commercial drivers, concerning their eye health.Conclusion: Findingsrevealed that commercial drivers had a good knowledge of whom eye care providers are but a poor level of utilization of eye care services that they provide (P< 0.05). The factors affecting the poor utilization of eye care services was not statistically significant.

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Sleepiness at the wheel (SW) is recognized as an important factor contributing to road traffic accidents, since up to 30 percent of fatal accidents have been attributed to SW. Sleepiness-related motor vehicle accidents may occur both from falling asleep while driving and from behavior impairment attributable to sleepiness. SW can be caused by various sleep disorders but also by behavioral factors such as sleep deprivation, shift work and non-restorative sleep, as well as chronic disease or the treatment with drugs that negatively affect the level of vigilance. An association between obstructive sleep apnea (OSA) and motor vehicle accidents has been found, with an increasing risk in OSA patients up to sevenfold in comparison to the general population. Regular treatment with continuous positive airway pressure (CPAP) relieves excessive daytime sleepiness and reduces the crash risk. Open questions still remain about the physiological and clinical determinants of SW in OSA patients: the severity of OSA in terms of the frequency of respiratory events (apnea hypopnea index, AHI) or hypoxic load, the severity of daytime sleepiness, concomitant chronic sleep deprivation, comorbidities, the presence of depressive symptoms or chronic fatigue. Herein, we provide a review addressing the epidemiological, physiological and clinical aspects of SW, with a particular focus on the methods to recognize those patients at risk of SW.

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Purpose: To determine the pattern of refractive error among commercial drivers in north India. Methods: Descriptive study with convenient sampling conducted among commercial drivers of north India. Results: A total of 213 (75.8%) heavy-vehicle and 68 (24.2%) light-vehicle drivers were screened for eye diseases. Refractive error for distance was reported in 44 (15.7%; 95% CI: 11.6-20.4) drivers. Hyperopia was reported in 23 (8.2%; 95% CI: 5.2-12) drivers, followed by myopia in 15 (5.3%; 95% CI: 3-8.6) drivers and astigmatism in six (2.1%; 95% CI: 0.7-4.5) drivers. Presbyopia was reported in 157 (55.8%) drivers. Dry eye was reported in 70 (24.9%), stereo deficiency in 77 (27.4%), and color vision deficiency in 11 (3.9%) drivers. Three drivers were diagnosed with cataract, and two were referred for retina evaluation. Conclusion: Hyperopia in both eyes was the most common refractive error. Dry eye disease and color vision deficiency were also reported. Most of the drivers were not using spectacles for refractive error correction. Due to their mobile nature, drivers with cataract and retina diseases did not turn up for follow-up.

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PURPOSE: Screening commercial drivers (CDs) for obstructive sleep apnea (OSA) reduces the risk of motor vehicle accidents. We evaluated the accuracy of standard OSA questionnaires in a cohort of CDs. STUDY DESIGN AND METHODS: We enrolled consecutive male CDs at 10 discrete transportation companies during their yearly scheduled occupational health visit. The CDs had their anthropometric measures taken; completed the Berlin, STOP, STOP-BANG, OSAS-TTI, SACS, EUROSAS, and ARES questionnaires; and underwent a home sleep apnea test (HSAT) for the determination of their respiratory events index (REI). We assessed the questionnaires' ability to predict OSA (REI ≥ 5 events/h) and moderate-to-severe OSA (REI ≥ 15 events/h). RESULTS: Among 315 CDs recruited, 243 (77%) completed the study protocol, while 72 subjects were excluded for inadequate HSAT quality. The demographics and clinical data were comparable in both the included and excluded subjects. The included CDs had a median age of 50 years (interquartile range (IQR) 25-70) and a mean body mass index of 27 ± 4 kg/m2. One hundred and seventy-one subjects (71%) had OSA, and 68 (28%) had moderate-to-severe OSA. A receiver operating characteristic curve of the questionnaires were 0.51-0.71 for predicting OSA and 0.51-0.66 for moderate-to-severe OSA. The STOP-BANG questionnaire had an unsatisfactory positive predictive value, while all of the other questionnaires had an inadequate negative predictive value. CONCLUSIONS: Standard OSA questionnaires are not suited for screening among CDs. The use of the HSAT could provide an objective evaluation of for OSA in this special population.

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BACKGROUND: The World Health Organization indicates that hydration is indispensable to human life. A long-period of dehydration can result in fatigue, drowsiness and mental confusion which can result in committing serious blunders. For commercial drivers, however, these blunders can be life-threatening and their hydration cannot be overemphasized. AIM: This study was therefore undertaken to assess the water intake practices of Commercial Long-Distance drivers (CLDDs). The study was also aimed at assessing their knowledge levels on the role of water in promoting a healthy body and the consequences of dehydration. SETTING: CLDDs in Ghana who ply between Accra - Cape Coast - Takoradi or Accra - Kumasi. METHODS: A cross-sectional study which involved 256 CLDDs was conducted at six (6) commercial bus stations in Accra and Cape Coast from December 2019 to January 2020. Structured questionnaires were administered to obtain socio-demographic and water intake practices of CLDDs. SPSS was used to generate descriptive statistics based on the data collected. RESULTS: A high proportion (57.8%) of the CLDDs reported that they drunk about 2500ml-3000ml of water on a daily basis. Most (53.1%) relied on their thirst feeling to prompt them to drink water. A little over half (51.1%) consumed energy drinks believed to hydrate the body. A major barrier to drinking water regularly was to avoid frequent stop-overs to use the washroom while travelling. CONCLUSION: The findings reveal concerns about knowledge gaps with regard to the importance of water consumption and barriers to adequate drinking of water among CLDDs. Findings also suggest that many CLDDs relied on their thirst perceptions to prompt them to drink water. Health Education programmes targeting CLDDs should include conveying the importance of water intake and healthy hydration practices for optimal physical and cognitive performance.

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PURPOSE: Obstructive sleep apnea (OSA) is a critical occupational health concern, but is often undiagnosed in the general population and commercial drivers. The STOP-Bang questionnaire is a simple, reliable tool to screen for OSA, which could improve public health in a cost-effective manner. The objective of this systematic review and meta-analysis is to assess the validity of the STOP-Bang questionnaire to detect OSA in these key populations. METHODS: We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, PsycINFO, Journals @ Ovid, Web of Science, Scopus, and CINAHL for relevant articles from 2008 to March 2020. The quality of studies was appraised using Cochrane Methods criteria. To calculate pooled predictive parameters, we created 2 × 2 contingency tables and performed random-effects meta-analyses. RESULTS: Of 3871 citations, five studies that evaluated STOP-Bang in the general population (n = 8585) and two in commercial drivers (n = 185) were included. In the general population, prevalence of all OSA (AHI ≥ 5), moderate-to-severe OSA (AHI ≥ 15), and severe OSA (AHI ≥ 30) was 57.6%, 21.3%, and 7.8% respectively. In commercial drivers, the prevalence of moderate-to-severe OSA was 37.3%. The trends of high sensitivity and negative predictive value of a STOP-Bang score ≥ 3 illustrates that the questionnaire helps detect and rule out clinically significant OSA in the general population and commercial drivers. CONCLUSION: This meta-analysis demonstrates that the STOP-Bang questionnaire is a valid and effective screening tool for OSA in the general population and commercial drivers. TRIAL REGISTRATION: PROSPERO No. CRD42020200379; 08/22/2020.

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INTRODUCTION: U.S. commercial drivers are entrenched in a stressogenic profession, and exposures to endemic chronic stressors shape drivers' behavioral and psychosocial responses and induce profound health and safety disparities. To gain a complete understanding of how the COVID-19 pandemic will affect commercial driver stress, health, and safety over time, and to mitigate these impacts, research and prevention efforts must be grounded in theoretical perspectives that contextualize these impacts within the chronic stressors already endemic to profession, the historical and ongoing forces that have induced them, and the potentially reinforcing nature of the resulting afflictions. METHODS: Extant literature reveals how an array of macro-level changes has shaped downstream trucking industry policies, resulting in stressogenic work organization and workplace characteristics. Emerging evidence suggests that the COVID-19 pandemic exacerbates existing stressors and introduces novel stressors, with potentially exacerbatory impacts on health and safety disparities. RESULTS: As COVID-19 exerts an array of multi-level stressors on commercial drivers, syndemic frameworks can provide the appropriate theoretical lens to guide research and prevention. Syndemic frameworks can provide the grounding to allow foregoing commercial driver COVID-19 research to transcend the limitations of prevailing research frameworks by contextualizing COVID-19 stressors holistically within the complex system of endemic chronic stressors and interrelated health and safety afflictions. Syndemic-informed prevention efforts can then be implemented that simultaneously tackle multiple afflictions and the macro-level forces that result in the emergence of commercial drivers' health and safety disparities over time. CONCLUSIONS: The impacts of the COVID-19 pandemic on commercial drivers cannot be adequately understood or acted upon in isolation from the endemic chronic stressors and interrelated health and safety disparities that characterize the profession. Instead, commercial driver COVID-19 research and prevention needs syndemic frameworks to holistically understand the impacts of COVID-19 on commercial driver stress, health, and safety, and to identify high-leverage preventive actions.

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Purpose. This study aimed to determine the impacts of rest breaks and stretching exercises on lower back pain (LBP) in commercial truck drivers. Methods. This quasi-experiment was carried out on 92 truck drivers suffering from chronic LBP. Subjects were categorized into three groups (stretching exercises and rest breaks, rest breaks only and reference). Pain severity and related disability were measured at the beginning of the survey and after 6 and 12 weeks. The latter was assessed using the Oswestry low back pain disability questionnaire (OLBPDQ) and the Roland Morris questionnaire (RMQ). Results. At the end of the intervention, the mean pain scores in the three groups were 2.72 ± 1.44, 4.11 ± 0.86 and 4.90 ± 1.31 respectively (p < 0.001). The OLBPDQ scores in group 1 (stretches and resting time breaks) were significantly lower than those in group 2 (rest break) (p = 0.009). The RMQ scores showed a significant reduction in group 1 compared with the other two groups (p = 0.001). Drivers in group 2 improved more significantly than those in group 3 regarding visual analog scale pain score (p = 0.049), OLBPDQ score (p = 0.024) and RMQ score (p = 0.011). Conclusion. This study provided converging results that supplementary exercises during break periods consistently help to minimize LBP and disability.

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OBJECTIVE: The study assessed driver, vehicular and road-related factors associated with road crashes (RC) in the Kintampo North Municipality. DESIGN: Cross-sectional study. SETTING: Kintampo North Municipality. DATA SOURCE: Demographics, vehicular and road usage information on registered drivers at Ghana Private Road and Transport Union (GPRTU) and Progressive Transport Owners Association (PROTOA) in Kintampo North Municipality. MAIN OUTCOME: involvement in road crashes and related factors. RESULT: A total of 227 drivers were approached for this study. None of them declined participation. They were all males. Most were between 28-37 years (30%). The proportion of drivers that reported RC ever involvement in at least one RC was 55.5% (95% CI: 8.0%, 62.1%). In the bivariate analysis, drink and drive changed lane without signalling, ever bribed police officer, drove beyond the maximum speed limit, paid a bribe at DVLA for driving license, violation of traffic signals were found to be associated with RC involvement (p<0.05). Drivers who violated traffic signals had 2.84 odds of being involved in road crashes compared to those who did not [aOR; 2.84 (95%CI:1.06,7.63)]. CONCLUSION: The proportion of drivers ever involved in road crashes was high. The major factor that is associated with RC involvement was a violation of the traffic light signals. Continuous driver education and enforcement of road traffic regulations by the appropriate authorities could curb the road crash menace in the Municipality. FUNDING: The authors funded this work.

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Sleep disorders in commercial drivers are common and treatable. Left unidentified, they lead to a host of adverse consequences, including daytime sleepiness, adverse health effects, economic costs, and public safety risks owing to sleepiness-related crashes. The best studied of these is obstructive sleep apnea, which is common and identifiable among commercial drivers. This article provides an overview of screening, and specific approaches to screen for and manage obstructive sleep apnea in commercial drivers with the goal of reducing the risk of vehicular crashes.

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BACKGROUND: First aid assistance is one of the important life-saving skills. According to World Health Organization, over 50 million people are injured or disabled and over 1.2 million people die following Road Traffic Accident (RTA) every year. Providing the basic care until emergency medical services arrive is the essence of first aid, which will prevent a number of RTA-related mortality and morbidity. AIM: To assess the knowledge, attitude, and practice regarding first aid among the commercial vehicle drivers operating in and from Haldwani. METHOD: This was a cross-sectional study conducted among the commercial drivers operating in and from Haldwani Block of Uttarakhand, from November 2018 to January 2019. Participants were selected using consecutive sampling technique. The questionnaire used for data collection was semistructured and pretested. RESULTS: All participants were male with the mean age (standard deviation) of 40.4 (8.7) years. Overall 96.4% and 81.7% had heard about first aid and the "Good Samaritan" law. Among participants, 96% knew that first aid should be provided immediately and 90.5% were willing to be trained in first aid. First aid kit was available in 84.9% of the vehicles. In total, 211 (91%) participants had attended RTA victim/s in the past, and 192 (91%) of them provided assistance to RTA victims. CONCLUSIONS: Although the study showed a positive attitude toward giving first aid to RTA victims, the knowledge and practice of first aid was not universal.

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INTRODUCTION: Visual impairment is recognized as a public health problem worldwide. People and generally drivers do not often go for routine medical or eye examination based on varied reasons. This study assessed health care seeking behaviour for visual dysfunction among motor vehicle drivers in Osun state, Southwest Nigeria. METHODS: This was a comparative cross-sectional study among 120 male commercial and 120 government drivers, selected using multi-stage sampling technique in Osogbo, Osun State. Data on knowledge, attitude and health seeking behavior of drivers for visual dysfunction and barriers for not seeking medical treatment was collected using a pre-tested semi-structured questionnaire. Questions on awareness about visual functions and attitude of the respondents concerning visual problems were scored. Two sample independent t-test was used to elicit association between mean age/knowledge of government and commercial drivers and health seeking behavior for visual dysfunction. RESULTS: The mean age of government and commercial drivers was 44.53years ± 8.51 and 38.52years ± 8.60 respectively. The mean knowledge (p<0.001) and attitude (p=0.001) differences of government and commercial drivers were associated with health seeking behavior for visual dysfunction. Of the 120 government drivers, 24 (20.0%) were aware of their current visual problems. Of the 24, government drivers, 10 (47.6%) visited the hospital for treatment. Busy workplace schedule (n = 5, 20.8%) and lack of awareness of visual defects ((n= 3, 12.5%) by commercial drivers were identified barriers for not seeking medical treatment for visual dysfunction. CONCLUSION: Knowledge and attitude towards visual dysfunction were higher among the government drivers compared to commercial counterparts. Government drivers had better health seeking behavior for visual dysfunction as compared to their commercial counterparts. We recommended routine eye medical check-up for early detection of visual dysfunction in motor vehicle drivers.

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BACKGROUND: A study was conducted in 2013 on the lack of accurate statistics on the environmental and family factors behind the use of drugs by drivers of public transport. MATERIALS AND METHODS: Overall, 1176 drivers of buses, mini-buses, vans, all kinds of trucks, and cars were randomly selected proportionately according to the type of vehicles. The capture-recapture sampling method was used to determine the prevalence rate of drug use among commercial drivers. Trained experts collected data regarding the environmental and family factors behind the use of addictive drugs. Urinalysis was performed by the Rapid Test method (ACON, San Diego, USA). To providing descriptive and analytical statistics the Kruskal-Wallis and Mantel-Haenszel methods, logistic regression, and Chi-square tests were used. RESULTS: The mean age of the drivers was 39.9 ± 9.7 years. The results of the experiment were positive in 14.1% of the drivers. A significant difference observed between addicted and nonaddicted drivers related to cold and heat (P < 0.001) and lack of facilities (P = 0.006) as the most influencing factors. The most important environmental factor was family poverty (P < 0.001), followed by marital status and its problems (P = 0.002), a large number of children (P = 0.006), and family disputes (P = 0.012). A family history of addiction was 2.5 times more among addicted drivers. CONCLUSION: Prevalence of addiction was 14.1%. Among the environmental factors, cold and heat, lack of facilities, family factors, and a family history of addiction greatly influenced addiction.

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Assessing fitness to drive in applicants with a historical or current substance use disorder presents a specific clinical challenge. The Australian guidelines require evidence of remission and absence of cognitive change when considering applications for re-licensing driver or individuals applying to reengage in safety-sensitive work. This paper reviews some of the clinical and biochemical indicators that determine whether a particular person is in 'remission' and meets the criteria for return to driving or other safety-sensitive occupation. It provides an overview of the challenges in establishing an evidence-based approach to determining fitness for safety critical activities. There is no internationally accepted definition of 'remission'. Review of the literature and examination of assessment protocols from other national jurisdictions are available for alcohol and the more important drugs of interest in road safety. Assessing fitness to drive when there is a history of substance misuse and/or substance use disorders is a complex issue that requires assessment of biomarkers, clinical findings and clinical assessment before the person returns to driving. We propose that hair testing provides a reliable and reproducible way to demonstrate remission and provide cost-effective monitoring. Standardised psychological tests could provide a reproducible assessment of the cognitive effects of drug use and suitability to resume driving. We recommend that AustRoads amend the national guidelines to reflect an evidence-based approach to assessing fitness to drive after conviction for offences related to alcohol and drug use.

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Long-haul truck drivers are significantly affected by musculoskeletal injuries with incidence rates 3.5 times higher than the national average. Yet, little is known about injuries that affect long-haul trucks drivers. In 2010, interviewers collected data from 1,265 long-haul truck drivers at 32 truck stops across the United States. These surveys were analyzed to describe all self-reported musculoskeletal injuries. Injuries to the arm (26.3%) and back (21.1%) were the two areas most reported in the survey. Musculoskeletal injuries were most often caused by falls (38.9%) and contact with an object or equipment (33.7%) resulting most commonly in sprains/strains (60%). This large scale survey highlights the significance of musculoskeletal injuries in long-haul truck drivers and suggests the need to develop interventions to prevent injuries and improve recovery once injuries occur.

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