Occupational health disparities among U.S. long-haul truck drivers: the influence of work organization and sleep on cardiovascular and metabolic disease risk
DOI: 10.1371/journal.pone.0207322
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Summary
This study investigates occupational health disparities among U.S. long-haul truck drivers (LHTDs), specifically examining how work organization and sleep quality influence cardiovascular and metabolic disease (CMD) risk. The research is motivated by significant transformations in the trucking industry over the past four decades, which have introduced stressors such as long hours, shift work, and limited control over working conditions. These factors are hypothesized to contribute to poor physiological and psychological outcomes, yet the specific degree of CMD risk resulting from these work conditions remains unclear. The study aims to quantify disparities in CMD risk between LHTDs and the general U.S. population and to identify predictive relationships between occupational factors, sleep, and disease risk. The researchers conducted a cross-sectional study involving 260 LHTDs surveyed at a large highway truck stop in North Carolina. Data collection included interviewer-administered surveys assessing work organization (e.g., driving experience, miles driven, work hours, schedule irregularity), sleep duration and quality, and perceived stress. Additionally, blood serum samples were collected from 115 drivers after a 10-hour fast to analyze biomarkers. Cardiometabolic risk was calculated using the Framingham Global CVD Risk Score and National Institute of Diabetes and Digestive and Kidney Diseases guidelines for metabolic syndrome. These findings were compared against data from the 2011–2012 National Health and Nutrition Examination Survey (NHANES). Logistic regression models were employed to explore predictive relationships between work organization, sleep variables, and CMD risk outcomes. The results revealed statistically significant disparities between LHTDs and the general population. The truck driver sample exhibited higher mean scores for both cardiovascular risk factors (3.71 vs. 3.10; p < 0.001) and metabolic disease risk factors (4.31 vs. 3.09; p < 0.001). Drivers were less physically active, had lower HDL cholesterol, and showed greater prevalence of smoking, higher BMI, and metabolic syndrome diagnoses compared to NHANES data. Specifically, 88.9% of drivers had a BMI of 25 or greater, and 58% met criteria for metabolic syndrome. Logistic regression identified that more years of driving experience and poor sleep quality were statistically significant predictors for both cardiovascular and metabolic disease risk. Drivers reported significantly shorter sleep durations and poorer sleep quality on workdays compared to non-workdays, with 11.5% diagnosed with sleep apnea. The study concludes that elements of the occupational milieu experienced by long-haul truck drivers, particularly poor work conditions that compromise sleep quality, induce disproportionate cardiometabolic disease risk. The findings highlight an urgent need for longitudinal studies and intervention research focused on policy and systems-level changes to address these health inequities. By linking specific work organization factors and sleep disturbances to increased disease risk, the paper underscores the critical role of occupational health policies in mitigating chronic disease among this vulnerable workforce.
Provenance
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| Stage | Outcome | Tool | Model | Prompt | Attempts | Completed |
|---|---|---|---|---|---|---|
| discover | success | OpenAlex-citations | — | — | 1 | 2026-06-20 |
| archive | success | unpaywall | — | — | 2 | 2026-06-26 |
| extract | success | cached | — | — | 2 | 2026-06-26 |
| clean | success | clean | — | — | 1 | 2026-06-20 |
| chunk | success | chunk | — | — | 1 | 2026-06-20 |
| embed | success | embed | Qwen/Qwen3-Embedding-8B | — | 1 | 2026-06-20 |
| promote | success | — | — | — | 1 | 2026-06-20 |
| summarize | success | llm | qwen3.6-27b-prismaquant | summ-v5 | 1 | 2026-06-26 |
| tag | success | vector_similarity | — | — | 6 | 2026-06-20 |
| verify | success | — | — | — | 1 | 2026-06-26 |
Summary generated by qwen3.6-27b-prismaquant on 2026-06-26; verification: verified.
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- Empirical Findings: physiological data