Yorghos Apostolopoulos

Surveying the impact of work hours and schedules on commercial motor vehicle driver sleep

Background Given the long hours on the road involving multiple and interacting work stressors (i.e., delivery pressures, irregular shifts, ergonomic hazards), commercial drivers face a plethora of health and safety risks. Researchers goal was to determine whether and to what extent long-haul trucker work schedules influence sleep duration and quality. Methods Survey and biometric data collected from male long-haul truck drivers at a major truckstop in central North Carolina over a six month period. Results Daily hours worked (mean = 11 hours, 55 minutes) and frequency of working over government-mandated daily HOS regulations (23.8% “frequently or always”) were statistically significant predictors of sleep duration. Miles driven per week (mean = 2,812.61), irregular daily hours worked (63.8%), and frequency of working over the daily hour limit (23.8% “frequently or always”) were statistically significant predictors of sleep quality. Conclusion Implications of findings suggest a comprehensive review of the regulations and operational conditions for commercial motor vehicle drivers be undertaken.

The Work Organization of Long-Haul Truck Drivers and the Association With Body Mass Index.

Objective: The aim of this study was to examine relationships between work organization features of work hours, work schedules, and job stress with body mass indexes (BMIs) of long-haul truck drivers. Methods: Face-to-face survey data were collected first, followed by collection of anthropometric measures including height and weight (n = 260). Logistic regression (backward stepwise model) was used to identify significant predictors of BMI and to analyze odds ratios. Results: Mean BMI was 33.40 kg/m2, with 64.2% obese (BMI > 30 kg/m2) and 18.4% extreme/morbidly obese (BMI > 40 kg/m2). Working more than 11 daily hours was associated with statistically significant increased odds for being extreme obese. Conclusion: Findings suggest that longer work hours (>11 hours daily) have a major influence on odds for obesity among this population. The results align with recent NIOSH calls for integrated approaches to worker health.

Health and Wellness Programs for Commercial Motor-Vehicle Drivers Organizational Assessment and New Research Directions

The workplace is an invaluable venue for health protection and promotion interventions, particularly for truck drivers due to their overreliance on their work environments, a plethora of work-related stressors, and their morbidity rates. Extant efforts of trucking companies to address driver health through worksite health and wellness programs have been inadequate, producing unsustainable results. The Driver Health and Wellness Program Survey was designed for and disseminated to 46 trucking companies to assess the current state of health and wellness programs in the trucking industry, including program participation rates and longevity, program evaluation procedures, and program activities and resources. Findings indicate that programmatic efforts in trucking companies continue to fall short, and health and wellness programs are insufficient to improve health outcomes in a sustainably positive direction. A new integrated, systems-based paradigm is proposed as a conceptual and methodological framework with the potential to meaningfully advance interventions in blue-collar work settings.

Obesity indices are predictive of elevated C-reactive protein in long-haul truck drivers.

BACKGROUND Obesity rates in long-haul truck drivers have been shown to be significantly higher than the general population. We hypothesized that commercial drivers with the highest levels of general obesity and abdominal adiposity would have higher concentrations of high sensitivity C-reactive protein (CRP), a marker of inflammation. METHODS Survey and anthropometric data were collected from 262 commercial drivers. Weight, circumference measures, and blood analysis for CRP (N = 115) were conducted and compared to National Health and Nutrition Examination Survey (NHANES) data. CRP values were non-normally distributed and logarithmically transformed for statistical analyses. RESULTS BMI, waist circumference, sagittal abdominal diameter, and CRP were significantly higher than in the general population. Anthropometric indices that included height (BMI, waist-to-height ratio, and sagittal diameter-to-height ratio), were most predictive of CRP values. CONCLUSIONS Abdominal obesity is prevalent in commercial vehicle drivers and is an important indicator of the presence of inflammation in this population. Am. J. Ind. Med. 59:665-675, 2016.

Work Strain, Social Isolation and Mental Health of Long-Haul Truckers

ABSTRACT Commercial driving is associated with myriad work strains. An ethnographic approach is used to examine how chronic, excess work strains impact the overall mental health of U.S. long-haul truckers. Social isolation and inherent difficulties of establishing and maintaining meaningful social ties during long stretches on the road are found to take a toll on drivers’ mental health. Truckers struggle with loneliness and are overstressed from work pressures and weak support systems. Therefore, commercial driving urgently needs policies designed to curb trucking’s harmful effects on driver mental health and public safety and occupational therapy programs designed to improve mental health.

Moving alcohol prevention research forward—Part I: introducing a complex systems paradigm

BACKGROUND AND AIMS The drinking environment is a complex system consisting of a number of heterogeneous, evolving and interacting components, which exhibit circular causality and emergent properties. These characteristics reduce the efficacy of commonly used research approaches, which typically do not account for the underlying dynamic complexity of alcohol consumption and the interdependent nature of diverse factors influencing misuse over time. We use alcohol misuse among college students in the United States as an example for framing our argument for a complex systems paradigm. METHODS A complex systems paradigm, grounded in socio-ecological and complex systems theories and computational modeling and simulation, is introduced. Theoretical, conceptual, methodological and analytical underpinnings of this paradigm are described in the context of college drinking prevention research. RESULTS The proposed complex systems paradigm can transcend limitations of traditional approaches, thereby fostering new directions in alcohol prevention research. By conceptualizing student alcohol misuse as a complex adaptive system, computational modeling and simulation methodologies and analytical techniques can be used. Moreover, use of participatory model-building approaches to generate simulation models can further increase stakeholder buy-in, understanding and policymaking. CONCLUSIONS A complex systems paradigm for research into alcohol misuse can provide a holistic understanding of the underlying drinking environment and its long-term trajectory, which can elucidate high-leverage preventive interventions.

Work Conditions and Health and Well-Being of Latina Hotel Housekeepers

Hotel housekeepers are exposed to a plethora of disproportionately high work-induced hazards that can lead to adverse health consequences. Latina hotel housekeepers are rendered particularly vulnerable to elevated occupational hazards and resultant health strains due to their socioeconomic status, immigration status, language barriers, and lack of access to healthcare services. The findings from the 27 interviews with Latina hotel housekeepers indicated that the interviewees were exposed to physical, chemical, and social hazards in the workplace and suffered musculoskeletal injuries. In terms of psychological wellness, the time pressure of cleaning rooms quickly and work-related stress stemming from workplace mistreatment emerged as major work-related stressors. Recommendations are made for the introduction of multilevel interventions designed to prevent work-related injuries and illnesses and to promote healthier workplaces.

Overcoming Barriers in Unhealthy Settings A Phenomenological Study of Healthy Truck Drivers

We investigated the phenomenon of sustained health-supportive behaviors among long-haul commercial truck drivers, who belong to an occupational segment with extreme health disparities. With a focus on setting-level factors, this study sought to discover ways in which individuals exhibit resiliency while immersed in endemically obesogenic environments, as well as understand setting-level barriers to engaging in health-supportive behaviors. Using a transcendental phenomenological research design, 12 long-haul truck drivers who met screening criteria were selected using purposeful maximum sampling. Seven broad themes were identified: access to health resources, barriers to health behaviors, recommended alternative settings, constituents of health behavior, motivation for health behaviors, attitude toward health behaviors, and trucking culture. We suggest applying ecological theories of health behavior and settings approaches to improve driver health. We also propose the Integrative and Dynamic Healthy Commercial Driving (IDHCD) paradigm, grounded in complexity science, as a new theoretical framework for improving driver health outcomes.

Mapping U.S. long-haul truck drivers’ multiplex networks and risk topography in inner-city neighborhoods

This article illustrates how urban inner-city trucking milieux may influence STI/BBI/HIV acquisition and transmission risks for U.S. long-haul truckers, as well as their social and risk relationships. Using mixed methods, we collected ethnoepidemiological and biological data from long-haul truck drivers and their risk contacts in inner-city trucking milieux in Atlanta, Georgia, United States. Key findings indicate that within the risk-endemic environment of distressed inner-city areas, diverse trucking risk milieux can amplify STI/BBI/HIV risk for multiplex networks of truckers. Inner-city neighborhood location, short geographic distance among risk contacts, and trucker concurrency can potentially exacerbate transmission via bridging higher-risk individuals with lower-risk populations at disparate geographic and epidemiological locations.

Moving alcohol prevention research forward—Part II: new directions grounded in community‐based system dynamics modeling

BACKGROUND AND AIMS Given the complexity of factors contributing to alcohol misuse, appropriate epistemologies and methodologies are needed to understand and intervene meaningfully. We aimed to (1) provide an overview of computational modeling methodologies, with an emphasis on system dynamics modeling; (2) explain how community-based system dynamics modeling can forge new directions in alcohol prevention research; and (3) present a primer on how to build alcohol misuse simulation models using system dynamics modeling, with an emphasis on stakeholder involvement, data sources and model validation. Throughout, we use alcohol misuse among college students in the United States as a heuristic example for demonstrating these methodologies. METHODS System dynamics modeling employs a top-down aggregate approach to understanding dynamically complex problems. Its three foundational properties-stocks, flows and feedbacks-capture non-linearity, time-delayed effects and other system characteristics. As a methodological choice, system dynamics modeling is amenable to participatory approaches; in particular, community-based system dynamics modeling has been used to build impactful models for addressing dynamically complex problems. RESULTS The process of community-based system dynamics modeling consists of numerous stages: (1) creating model boundary charts, behavior-over-time-graphs and preliminary system dynamics models using group model-building techniques; (2) model formulation; (3) model calibration; (4) model testing and validation; and (5) model simulation using learning-laboratory techniques. CONCLUSIONS Community-based system dynamics modeling can provide powerful tools for policy and intervention decisions that can result ultimately in sustainable changes in research and action in alcohol misuse prevention.