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Managing health risks for bus and lorry drivers

Professional drivers will tell you that, in general, there has been a deterioration in working conditions over the past several decades in terms of traffic pollution, traffic congestion, noise pollution, and the demand to meet schedules. Bus drivers find it difficult to meet schedules which causes passenger discontent, and lorry drivers are responsible to making deliveries within tight timeframes to maintain profitability.

The result is increased stress levels, conflict with customers, and the fomenting of a more hostile work environment. Knowing the risks, though, can help us manage them, or teach others how to manage them. As a driving instructor teaching a lorry or bus driver, or a person who is learning to drive a lorry or bus, awareness of the issues is the first step in creating a plan to deal with future stress in a positive and commanding way. However, as an instructor, be sure to not present this in some kind of doomsday scenario. Not all drivers experience stress, are susceptible to illness or will even be driving in scenarios where they will be affected by any or all of the following scenarios.



Professional drivers are exposed to increasing levels of pollutants in the air. Despite EU regulations limiting emissions, and vehicles becoming generally less polluting, the sheer increase in the number of vehicles on the road, and the resulting slowing of average traffic speeds causes pollution. There’s only so much pollution that an air filter can filter out of the cab air, and that’s mostly only relevant for long-distance lorry drivers. Bus drivers have to open the door frequently, mostly in busy streets; short-haul delivery drivers are in and out of their cabs frequently during the day. Other drivers may spend much time at transport depots loading and unloading where other lorries have their engines running.

Carbon monoxide, nitrogen oxides  and sulphur dioxide as well as carcinogenic diesel particulates take a toll on health, contributing to asthma, headaches, coughs, bronchitis, sore eyes and more. They are also implicated in lung and bladder cancers.


As a professional driver your risk of being injured on the road is increased. Also, your risk of causing injury on the road to cyclists or pedestrians is increased simply due to the amount of time you spend behind the wheel. When there are time pressures, there’s the tendency to make choices that aren’t necessarily safe.

Many drivers will be driving between midnight and 8am. The likelihood of having an accident is twice that of between 8am and midnight. Driving between 3am and 6am increases the risk of falling asleep at the wheel by a factor of over 70! Some studies have shown that as many as 28% of lorry drivers have actually fallen asleep at the wheel and 60% have almost fallen asleep.

Evidence of illness

Accumulated epidemiological evidence and occupational health surveys have time and again indicated that lorry and bus drivers have elevated risks for gastrointestinal disorders, musculoskeletal disorders, cancers, fatigue, and noise issues.


Drivers are constantly breathing polycyclic aromatic hydrocarbons (PAHs) and volatile organic chemicals (VOCs) are given off from plastic and other materials in the cab, especially when the vehicle is new.  Some of these particulates (particularly ones from diesel engines) are implicated in bladder and lung cancers which are more prevalent in drivers.

Gastrointestinal illness

Dietary factors contributing to driver illness are the tendency for drivers to eat while on the run, and make poor choices, such as meals high in fat and refined carbohydrates and low in fresh vegetables and fruit. Dehydration is a major contributor to many illnesses including headaches and gastrointestinal problems such as peptic ulcers. A study in Denmark showed that bus drivers were twice as likely to have peptic ulcers than the general population. Drivers are also more likely to be smokers.

Stress and fatigue

Stress factors are numerous. Drivers tend to be away from home more, do longer hours, have awkward shifts, and be on the receiving end of negative feedback from the public and customers, even for things that are outside their control, for example if a bus is late to a stop through no fault of the driver. Insomnia can be debilitating and common, especially when shifts are rotated rapidly before the body has time to adjust.

Fatigue reduces a driver’s ability to react quickly. Drivers have incessant pressure to stay on schedule and will often miss meal breaks and rest stops to make up time. This can cause other bladder issues such as incontinence and kidney stones, as well as contribute to impotence and other issues.

Musculoskeletal issues

In some studies, over 50% of drivers suffer from lower back pain. The exposure to vibration and overall posture were identified as the primary reason for this. For local drivers, lifting large items can cause back and arm problems.

Other drivers can suffer lower leg, ankle and foot pain due to the constant pressure of the foot on the accelerator in a fairly static position.


Low frequency noise also creates fatigue and, if loud enough, can eventually damage hearing. It’s recommended that noise levels are kept below 70dBA, although many trucks and buses will be above this. This paper on noise, vibration and air quality makes for interesting reading.

What can be done to minimise the risks?

At a very basic level there are three easily controllable activities that drivers can take to minimise their risks, plus some conditions that drivers can ask for or insist on from their workplace.

Nutrition and hydration

Talk to a nutritionist or dietician so that they can make a plan that is specific for your requirements. Ensure that the diet is full of as many healthy fresh vegetables and fruit as possible, augmented by complex carbohydrates (e.g. wholemeal bread rather than white bread), seeds, nuts and quality protein. Keep hydration levels up and don’t mistake feelings of thirst for feelings of hunger.


Even 10 minutes a day of exercise will make a huge difference. Sitting in one period for a long period of time fatigues the body as well as weakening it. Back muscles become weak and therefore cannot support the body, while other muscles in the shoulders and neck can become overused or stiff. Exercises that focus on strengthening muscles will reduce pain. A personal trainer or physiotherapist will be able to design you a routine that you can fit into your schedule.

Sleep and relaxation

Humans are designed to need 7-9 hours of sleep each night, generally to a fairly regular schedule. Shift work is not good for our body clock and forces our adrenal glands to work overtime to keep us awake. Relaxation can be helped with other therapies and activities such as sports, reading, massage or meditation. Talk to a sleep clinic if you are having problems with insomnia.

Work conditions

  • Drivers can assist management to make rotating schedules and routes that are realistic, productive, save fuel, and take into consideration a driver’s health and family contact, etc
  • Drivers can work with other drivers and management to promote healthier lifestyles and exercise
  • Bus drivers should have access to toilet facilities and should be rotated through areas that are less congested some days to minimise exposure to pollution.
  • Truck cabs can be fitted with technology that recognises drowsiness, and drivers can be trained to recognise signs of fatigue

Darren has owned several companies in the automotive, advertising and education industries. He has run driving theory educational websites since 2010.

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Posted in Advice, Driving Instructors, Heavy Vehicle, Passenger Vehicle
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