Fauget Company

THE RELATIONSHIP BETWEEN CHRONIC RELATED ILLNESSES AND COMMERCIAL DRIVING

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Carmen Robbertse Samantha Timm

About SMARTLearna SMARTLearna© is an SMME with head offices based in Cape Town, South Africa. The team consists of passionate professionals that hold various qualifications in Educational Psychology, Adult Education, Human Resources, and Quality & Safety. Our Expertise lies within developing, implementing , tracking and reporting on training within a compliance driven environment.

This report has been generated through the analysis of historical data collected from three sources. Names ,personal information and identification numbers have been removed for privacy purposes. Sample evidence was used for the purposes of this report with particular focus given on the role driver health, fatigue and chronic related illnesses have on incidents and accidents within a professional drivers career.

Introduction The purpose of this report is to examine and analyse information of driver health and wellness, from data stored in SMARTLearna© compliance matrix. By analysing a sample of historic data of 373 from a poll of 800 Drivers, prevalent chronic illnesses among drivers, along with their impact on cognitive ability, mental health, and driver behaviour. The data was drawn over one year (February 2022-February 2023).To strengthen the findings, the report incorporates global research articles and contribution of Dr Neill Van Tonder, an Occupational Practioner in Driver Health and Wellness. Lastly, the report includes and discusses comments made on certificates of fitness made by several Occupational Practitioners used in the sample study across Southern Africa. Research shows that Driver related jobs have an impact on physical health and as a result mental health. A lack of access to healthy food, the pressure of time-based deadlines all show to have a direct impact on cognitive distraction. One could draw on the conclusion as found in the studies that this results in an increase of incidents such as spillages, contaminations and accidents by drivers who are registered on the SMARTLearna data base. Our investigation also indicates that age, ongoing stress and health factors often result in chronic illness diagnoses of some form. We have shown that there is a relationship linking these factors to commercial driving. This is what distinguishes older drivers from long-distance with little movement, few bathroom stops, lack of access to healthy food options, irregular work patterns, in time driven operations that are considered stressful with an additional risk of exposure to dangerous substances. Thus, the very work environment of long-distance drivers has a major impact on the physical and mental health of the drivers. Their work environment predisposes them to certain risk factors associated with chronic illness. Dangerous goods drivers may face additional risks (that are not faced by other drivers) while operating a commercial vehicle such as a tanker. Some of the risk factors include: Reduced physical capabilities. Medication that may cause drowsiness. Fatigue. Stress may affect the driver’s ability to focus. Increased risk of medical emergencies

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The effects of chronic illnesses on drivers go far beyond the physical effects of the illness, and has shown to affect cognitive ability. These cognitive effects include: Medication that cause drowsiness, confusion Fatigue is caused by the chronic illness itself. This may affect their ability to stay focused and alert. Stress, a driver may be concerned about a loss of income. As well as the stress from the diagnosis of the illness. Impact on personal relationships. Chronic Illness can affect relationships with the friends, colleagues and family. Additionally, studies have shown that drivers are prone to developing depression which can in turn impact cognitive ability to focus on driving skills and possibly recall training. This could lead to an increase in incidents and higher risk to the business. A side note to employers of drivers with chronic illnesses; thanks to improvements in modern medicine, most chronic conditions are manageable. Drivers with diagnosed chronic illnesses can safely and effectively operate commercial vehicles, provided they manage their condition effectively in partnership with their medical practioner and exercise good judgement when taking medication as stipulated. This measure helps cognitive abilities and mental health. Knowing that employers accept and provide management tools to cope with chronic illness diagnosis assists with mental health and job security. Additionally, training programmes designed to focus on the management of chronic illness could prove to be an extremely useful tool for employers and drivers .

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RESEARCH The following report will look at various research articles and include observations from the medical reports previously stated. According to the Centre for Disease Control in the USA; long-distance drivers were found to be more likely to have a higher BMI and to be far less active than a majority of workers. A survey conducted found that 3 out of 4 truck drivers did not reach the recommended 30 minutes a day and five days a week recommended exercise. In addition to this, it was found that 26% of drivers were found to have hypertension, which is 2% more than the general work population. In a cross sectional study of the health of South African truck drivers (Lalla-Edward ST, et al. BMJ Open 2019;9:e032025. doi:10.1136/bmjopen-2019-032025,) it was noted that lifestyle and working conditions of commercial in particular long distance drivers predisposed them to risk factors associated with both communicable and noncommunicable diseases. The study which took place across three truck-rest stops interviewed and screened over 600 drivers, in the Free State and Gauteng, with the following results, specifically related to chronic illness: 54.9% of drivers were overweight/obese. 69% suffered from Hypertension. 8% suffered from moderate depression. 18% suffered from daytime drowsiness. 4.9% had left ventricular hypertrophy. 10% had elevated blood-sugar with 3% being insulin dependent During this study, truck stops were found to be lacking healthy environments conducive to healthy food options, clean facilities and, basic care. (Centre's for Disease Control and Prevention, 2019). It can be concluded from both studies that long-distance drivers in both South Africa and the US have higher rates of: Heart disease Diabetes Hypertension Obesity

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While similar observations have been made from the study conducted in South Africa. Berger et al. (2019) found that long driving hours among truck drivers in the US were associated with cardiovascular risk factors and mental health issues. Additionally, the US and South African study revealed that disrupted sleep patterns and limited access to healthy food at truck stops were common problems among these drivers. Of the 600 drivers in the study conducted in South Africa, it was found that 30% were on medication for hypertension and 10% had elevated blood sugar. The study also indicated that the frequency of obesity was double what is present in the general population (Indicating that there is an increased risk of chronic illnesses in long-distance drivers.) It is important to note that while the percentages in this study were small, the study only included a small portion of drivers.

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DATA COLLECTION AND FINDINGS

Research in this paper indicates a prevalence in chronic diseases among professional drivers. In the next section, we analyse data from SMARTLearna© Matrix which records chronic illness and medical fitness reports for compliance for over 900 commercial drivers. For purposes of this study a sample of three hundred and seventy three drivers (373) were used with in-depth analysis of the relationship chronic illness has on incidents where remedial training was completed and recorded in the Matrix. The study indicates the relationship between unmanaged chronic illness which may have contributed to fatigue and cognitive distraction subsequently resulting in incidents. It is important to note that the study excludes consequent management that may have led to dismissal over the same period as SMARTLearna©, has no access to these records. Results indicate that: 25.74% of drivers reported some chronic illnesses. 20.11% of drivers had undergone remedial training over the same period.

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The below table indicates results analysed from the sample used in for purposes of this report 16% of drivers in the sample indicate no remedial training and no specified chronic illness, 9% of drivers in the sample indicated remedial training and had chronic illness. 75% of drivers in the sample indicated no chronic illness and no remedial training.

It is important to note that a small percentage of medical fitness certificates examined did not divulge chronic illness due to patient confidentiality. We discuss this in more detail in the following section and provide reasons given.

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INTREPRETATION OF DATA.

Upon examining the sample data, it can be inferred that drivers tend to develop chronic illnesses as they age. The data also reveals that chronic illnesses are more prevalent in Drivers age 40+. As such drivers who were identified from the sample drawn as having a chronic illness during their medical assessments were over the age of 40,It was found uncommon that Drivers under the age of 40 years to have chronic illnesses. The table below reflects this data.

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It is this that often distinguishes younger drivers from older drivers. This trend can be attributed to the working conditions and years of experience of drivers, specifically their work environment such as the truck cab. It also speaks to their lack of exercise and healthy eating options. Analysis indicates that hypertension is the most frequently reported chronic illness among drivers in the sample data, followed by diabetes. Further investigation into medical fitness certificates, provided some evidence that there may be a link between hypertension , diabetes and sleep apnoea. It is not clear, exactly what the correlation there is, and more data is needed to further anaylse this relationship. This correlation however seems to reflect that sleep schedules are irregular. In addition there is a correlation between remedial training and chronic Illness, see table below:

It is worth mentioning that the category of chronic illnesses listed as unspecified is due to privacy laws in South Africa, resulting in a number of chronic Illnesses being listed by Occupational Practioners as unspecified. Despite this information being kept confidential the effects of the work environment on the health of a driver are remain undisputed. Majority of drivers who had a chronic illness listed had the occupation of ‘tanker driver’. These drivers generally work under more stressful circumstances and require more focus on the task at hand. Related illness such as hypertension which can can be attributed to the additional risks associated with transporting petroleum products and a lack of designated safe stopping areas in South Africa also been identified on page five (5) of this report are contributing factors, to driver health and fatigue. Drivers who work nightshift have also shown to be at higher risk of developing sleep disorders such as Sleep Apnoea associated with irregular sleep patterns. www.smartlernamatrix.com

Pressure associated with time based deliveries and delays have shown to be a contributing factors , resulting in drivers taking in fewer stops and reduction in rest periods. A noteworthy observation made from data received is that the tanker drivers who have a chronic illness listed are more prevalent in coastal regions, this could be because fuel refineries with access to harbours and fuel deliveries are prevalent along the coast of South Africa. This provides clarity of the impact of irregular work schedules and long-distance travel requirements. It can be also be deduced from comments made by various Occupational Practioners that these drivers may not have their chronic illnesses under control. This could result in two of the risk factors mentioned earlier: reduced physical capabilities and increased risk of medical emergencies. Additional information provides insight into the standard of medical fitness reports, provided by Occupational Practioners such as comments detailing the exam provided, provided, mental health observations that could predict signs of early onset of depression and the layout of the fitness certificate. Our investigation indicates that only a handful of Occupational Practioners test for Sleep Apnoea as a norm whilst others request this to be identified as an optional extra. A comparison made between various medical fitness reports, revealed providers based along the coast provided more detail and insight into drivers under their care, while still maintaining patient – doctor confidentiality.

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Additionally the same Occupational Practioners provided individual eye tests, drug tests and medical tests providing significant information regarding sleep apnoea test results. From comments observed in notes provided by these Occupational Practioners drivers within coastal lying regions appeared to have optimal control over their chronic illness and were thoroughly supported by their OC, in partnership with General Practioners and Local Clinics. Comprehensive reporting of Drivers with intermediate to high risk of sleep apnoea was reported as a intermediate to high risk to the business and with further testing as a fitness requirement. Drivers who indicated lower risk were provided with additional tools for managing risk related to Sleep Apnoea. A note worthy observation made of fitness certificates provided by inland Occupational Practioners point to a lack of detail, neatness (more than 80% were handwritten) and no indication of discussions held with drivers. Lastly, it can be observed that drivers identified with chronic illnesses listed had remedial training on their file. 15.29% of Drivers