A preliminary study on the barriers and facilitators to improving the health, safety, and well-being of aging heavy vehicle drivers.

INTRODUCTION: Managers from road freight transportation organizations were interviewed on barriers and facilitators to implementation of occupational health, safety, and well-being interventions for aging heavy vehicle drivers. As aging drivers are more likely to be seriously injured or die in a work-related incident than younger drivers, it is important to recognize strengths and weaknesses throughout the system to identify intervention that addresses their specific needs. METHOD: A Systems Theoretic Accident Model and Processes (STAMP) control structure was constructed to chart the controllers, controls, and feedback channels in the system to identify gaps in health, safety, and well-being intervention in the system. The STAMP control structure also charted the barriers and facilitators within levels across the system. Eleven managers were recruited into the study representing a range of road freight transportation organizations throughout Australia. RESULTS: Interview data revealed that barriers and facilitators existed at most levels of the system. Facilitators included advice from external agencies, support from upper management, modern technology, and regular social communication with drivers. Barriers were a lack of guidance on aging issues, operational conflicts with health and safety objectives, and the drivers' fear of disclosing health information associated with their driving role. In regards to formalized intervention in place to support aging heavy vehicle drivers, the system is reliant on fitness to drive medical assessments based on age and jurisdiction. CONCLUSIONS: As there was generally a lack of senior direction cited from the upper levels of the system on aging issues, there was much variation across the study on how aging risks are managed in the workplace for heavy vehicle drivers. PRACTICAL APPLICATIONS: This study recommends that managers across the road freight transportation industry receive formalized aging-awareness health and safety training in how to manage work-related driving hazards for aging heavy vehicle drivers.

Examining Coroners' Recommendations for Health and Safety Management of Ageing Heavy Vehicle Drivers: A STAMP Analysis.

Recommendations were analysed from coronial cases involving ageing heavy vehicle drivers (≥55 years) and mapped onto a Systems Theoretic Accident Model and Processes (STAMP) control structure to identify the controllers and control actions influential in the heavy vehicle industry with regard to health and safety. A National Coronial Information System (NCIS) database search revealed 38 coroners' recommendations arising from 14 unique cases of ageing driver involvement. There were no ageing themes identified in the analysis of coroners' findings and recommendations. An examination of the STAMP control structure identified that the highest concentration of recommendations was in the level of regulation, the second most senior level of control, although safety constraints were advised for all five levels of the system. In regard to identifying themes of control flaws in the recommendations, the study found that "unidentified hazards" were the most common type of safety failure in the analysis of cases of ageing drivers, concentrated at the regulatory level, which indicates that additional risk identification methods by upper levels of control are needed. Therefore, a recommendation arising from the current study is that additional controls in safety intervention are necessitated in the upper and middle levels of the road freight transportation system; in particular, formalising health and safety education for organisational managers, with a focus on identifying ageing issues, would fill a gap in the system for managing ageing heavy vehicle drivers. In conclusion, this study has found that improving the health and safety of ageing heavy vehicle drivers necessitates additional safety constraints with a focus on formalised safety education for organisational managers, in addition to a means to detect emerging and unforeseen hazards in the road freight transportation industry.

Pre-injury health status of truck drivers with a workers' compensation claim.

Truck drivers are a vulnerable population due to the high number of workplace injuries and fatalities predominant in their occupation. In Australia, the road freight transportation industry has been identified as a national priority area in terms of creating preventative measures to improve the health and safety of its workers. With an environment conducive to poor nutritional food choices and unhealthy lifestyle behaviours, many barriers exist to creating a safe and healthy workforce. Thus, the current study aimed to describe the pre-injury hospital-recorded health conditions and health service use of truck drivers with a worker's injury compensation claim/s when compared to workers in other industries. Data was obtained from a compensation claims database and linked with hospital admissions data recorded five years prior to the injury claim. Health and lifestyle behaviour data for the occupational code of truck drivers was compared to other occupational drivers, as well as to all other occupations. Analysis was conducted via logistic regression. The results found that when compared to other occupational drivers, truck drivers were significantly more likely to have a hospital-recorded diagnosis of diabetes and/or hypertension, as well as being significantly more likely to have a hospital record of tobacco use and/or alcohol misuse/abuse. The findings show that there is a need to review and revise existing health strategies to promote the health and wellbeing of truck drivers, especially given their challenging work environment.

Cancer patient and clinician acceptability and feasibility of a supportive care screening and referral process.

BACKGROUND: Incorporating supportive care into routine cancer care is an increasing priority for the multi-disciplinary team with growing evidence of its importance to patient-centred care. How to design and deliver a process which is appropriate for patients, clinicians and health services in rural areas needs further investigation. OBJECTIVE: To (i) examine the patient and clinician acceptability and feasibility of incorporating a supportive care screening and referral process into routine cancer care in a rural setting, and (ii) explore any potential influences of patient variables on the acceptability of the process. METHODS: A total of 154 cancer patients and 36 cancer clinicians across two rural areas of Victoria, Australia participated. During treatment visits, patients and clinicians participated in a supportive care process involving screening, discussion of problems, and provision of information and referrals. Structured questionnaires with open and closed questions were used to measure patient and clinician acceptability and feasibility. RESULTS: Patients and clinicians found the supportive care process highly acceptable. Screening identified relevant patient problems (90%) and problems that may not have otherwise been identified (83%). The patient-clinician discussion helped patients realize help was available (87%) and enhanced clinician-patient rapport (72%). Patients received useful referrals to services (76%). Feasibility issues included timing of screening for newly diagnosed patients, privacy in discussing problems, clinician time and availability of referral options. No patient demographic or disease factors influenced acceptability or feasibility. CONCLUSIONS: Patients and clinicians reported high acceptability for the supportive care process, although mechanisms for incorporating the process into health care need to be further developed.