Unravelling the Complexity of Irregular Shiftwork, Fatigue and Sleep Health for Commercial Drivers and the Associated Implications for Roadway Safety.

Fatigue can be a significant problem for commercial motor vehicle (CMV) drivers. The lifestyle of a long-haul CMV driver may include long and irregular work hours, inconsistent sleep schedules, poor eating and exercise habits, and mental and physical stress, all contributors to fatigue. Shiftwork is associated with lacking, restricted, and poor-quality sleep and variations in circadian rhythms, all shown to negatively affect driving performance through impaired in judgment and coordination, longer reaction times, and cognitive impairment. Overweight and obesity may be as high as 90% in CMV drivers, and are associated with prevalent comorbidities, including obstructive sleep apnea, hypertension, and cardiovascular and metabolic disorders. As cognitive and motor processing declines with fatigue, driver performance decreases, and the risk of errors, near crashes, and crashes increases. Tools and assessments to determine and quantify the nature, severity, and impact of fatigue and sleep disorders across a variety of environments and populations have been developed and should be critically examined before being employed with CMV drivers. Strategies to mitigate fatigue in CMV operations include addressing the numerous personal, health, and work factors contributing to fatigue and sleepiness. Further research is needed across these areas to better understand implications for roadway safety.

Challenges in Conducting Empirical Epidemiological Research with Truck and Bus Drivers in Diverse Settings in North America.

Over 6.5 million commercial vehicle drivers were operating a large truck or bus in the United States in 2020. This career often has high stress and long working hours, with few opportunities for physical activity. Previous research has linked these factors to adverse health conditions. Adverse health conditions affect not only the professional drivers' wellbeing but potentially also commercial motor vehicle (CMV) operators' safe driving ability and public safety for others sharing the roadway. The prevalence of health conditions with high impact on roadway safety in North American CMV drivers necessitates empirical epidemiological research to better understand and improve driver health. The paper presents four challenges in conducting epidemiological research with truck and bus drivers in North America and potential resolutions identified in past and current research. These challenges include (1) the correlation between driving performance, driving experience, and driver demographic factors; (2) the impact of medical treatment status on the relationship between health conditions and driver risk; (3) capturing accurate data in self-report data collection methods; and (4) reaching the CMV population for research. These challenges are common and influential in epidemiological research of this population, as drivers face severe health issues, health-related federal regulations, and the impact of vehicle operation on the safety of themselves and others using the roadways.