Transportation, Warehousing, and Utilities

Burden

Obesity is a national problem and is prevalent in the transportation, warehousing and utilities (TWU) sector. Health conditions associated with obesity include metabolic disorders such as hypertension and diabetes, cardiovascular disease (CVD), and stroke [Thompson et al. 1999]. An estimated 34.2% of all TWU workers are obese [NIOSH 2013] and 6.1% have had a diagnosis of heart disease [Helmkamp et al. 2013]. 6.1 percent of TWU workers have been told they have diabetes and 21.1% have been told they have hypertension [NIOSH 2013]. The work demands and other psychological stressors of TWU workers create special challenges: tasks may be sedentary in nature, limited options may be available for where and when to eat while working or resting away from home, and sleep periods may often be less than the recommended 7-9 hours daily [Hirschkowitz et al. 2015]. Sixty-seven percent of TWU workers did not meet CDC guidelines for physical activity [Helmkamp et al. 2013], while 38.0% of TWU workers indicate less than 7 hours of sleep in a 24-hour period [CDC 2012]. Twenty-eight percent of TWU workers work more than 48 hours per week compared to 18.7% of the U.S. workforce [NIOSH 2010]. Thirty-six percent work non-standard shifts, compared to 26.6% of the U.S. workforce [NIOSH 2015]. Job insecurity may increase the odds of reporting poor health by 50%; high job demands raise the odds of having a physician-diagnosed illness by 35%, and long work hours increase mortality by almost 20% [Goh et al. 2015].

Obesity and related disorders manifest themselves in premature death and disability, increases in health care costs, lost productivity, social stigmatization, and increases risk of involvement in transportation incidents. [NIH 1998; Thompson et al. 1999; Martin et al. 2009; Anderson et al. 2012]. Obesity’s related medical factors may limit a commercial motor vehicle driver’s driving certification [Thiese et al. 2015]. Job stress is associated, in the short term, with affective reactions (e.g., irritability, anger), and, in the long term, with anxiety and depressive symptoms [Griffin et al. 2007]. Job stress also has cognitive and behavioral effects. High levels of stress can cause narrowing of attention and reduce working memory capacity, which can reduce performance accuracy. Work stressors are related to unsafe behaviors, accidents and injuries [Nahrgang et al. 2011]

Need

Research is needed to better understand the link between metabolic disorders, CVD, obesity, sleep disorders, depression, anxiety, fatigue, and stress and create interventions to mitigate negative effects. These conditions not only affect quality of life, but may also interfere with the ability to operate a vehicle safely. Previous NIOSH obesity TWU surveillance research has focused on long and short haul truck drivers, and more efficient methods to monitor obesity among other TWU workers are needed. The importance of obesity and heart disease to TWU is highlighted by the fact that individual trucking companies and insurance companies have initiated health and fitness programs based on NIOSH research findings [Baleka 2017]. High body mass index (obesity) is also a key investigatory variable called for in a recent report from the National Academy of Sciences on research needs for commercial motor driver fatigue, long-term health, and highway safety [National Academy of Sciences 2016]. Because non-standard work arrangements are understudied but increasingly prevalent, and their determinants and health and safety consequences are poorly understood, surveillance is needed. Particularly needed are models on the determinants and effects of work arrangements and efforts to improve the taxonomy of work arrangements and their characteristics. Shift work and long work hours represent complex workplace hazards. This complex hazard further requires research on many types of interventions to reduce risks. Similarly, job stress is a widespread problem in the working population and is one of the costliest risk factors to industry due to its effects on such a broad range of health, safety, productivity, social, and non-work factors.

Burden

In 2015, workers in the transportation and warehousing industry had a fatal work injuries rate of 13.8 per 100,000 workers, the second highest rate for all workers [BLS 2017]. The organization of work in the transportation, warehousing and utilities (TWU) sector exacerbates risk of work-related injuries and fatalities. The long hours of work and irregular work schedules typical of the sector often lead to chronic sleep deprivation, disruption of circadian rhythms, and poor sleep quality. Insufficient sleep is associated with a broad range of health and safety risks including, vehicle crashes and disturbances to cognition [AAA Foundation for Traffic Safety 2016; DOT 2015; FMCSA 2007]. For TWU sector workers, delivery deadlines, time pressures, long periods away from home, and pay-by-the-mile compensation can contribute to work stress and incentivize non-compliance with the U.S. Department of Transportation safety regulations that limit driving and duty hours.

Previous research suggests that stimulant use is an important problem for U.S. truck drivers. Couper et al. [2002] reported that 9.5% of truck drivers in Oregon and Washington State tested positive for central nervous system stimulants such as amphetamine, cocaine, and pseudoephedrine. Use during driving has been shown to multiply the risk of a fatal crash by 3 to 4.5 [Elvik 2013]. Results for a cross-sectional intercept study showed the prevalence of at-risk drinking (five or more drinks in one day) was significantly higher for male long-haul drivers, during break periods from work [Birdsey et al. 2015]. It has been reported that engaging in even one or two days of at-risk drinking per year increases the prevalence of alcohol abuse and alcohol dependence [Dawson et. al. 2005] causing problems such as failure to fulfill expectations at work or home, increased physical hazards, legal problems, social/interpersonal problems, or an inability to control drinking behavior [Maisto et. al. 2003].

Need

The Institute of Medicine [IOM 2006] calls poor sleep health, shift work, and long work hours a critical unmet public health problem, because of the societal requirements of a 24/7 clock. Scientific evidence on the topic of sleep health, shift work, and long work hours has mounted in recent decades, but information has not been adequately disseminated or implemented in the TWU sector. Despite the quite extensive body of research showing the links between stress and health and safety outcomes, there have been few studies to identify workplace psychosocial and work organization risk factors by sector and fewer studies of interventions to address these risk factors. There is a critical need to develop effective tools that organizations can use to assess sources of job stress and develop interventions to address these risk factors. Research is needed to develop effective administrative controls for managers and workers to improve sleep and reduce workplace stress. In addition, research is needed to determine effective interventions that reduce workplace injuries and fatalities correlated to fatigue, stress, and stimulants used by workers to personally mitigate these effects. This complex hazard requires research on many types of interventions to reduce risks: testing various work scheduling patterns; manipulating light exposure, pharmacology agents, and diet regimes; work organization strategies and efforts to change workplace cultures; workplace interventions including policies, fatigue risk management systems, and education programs; mathematical models to predict risks; and studies of the impact of broader public policy measures (for example, impact of hours of service rules).

Burden

Interactions between vehicles and machines have been beneficial to the employer and worker by reducing work load, repetitive tasks, and increasing production capabilities. The International Federation of Robotics reports sharp increases in sales and is projecting that a new type of robot, collaborative robots that work alongside and in conjunction with human workers, will have a market breakthrough in the next several years [IFR 2016]. Wearable robotics, such as exoskeletons to reduce physical loads on workers, are being marketed [Lowe et al. 2016]. Vehicles increasingly have automated safety features, and fully autonomous vehicles, including commercial trucks and transit vehicles, are currently being piloted on U.S. roadways. Projections on when autonomous vehicles will be commonplace vary, but some project this could be within the next decade [Kessler 2017]). As robotics and automation integrate into the transportation, warehousing and utilities (TWU) sector, workers are being tasked with working with these complex systems. Examples of these systems in TWU include: air traffic management, unmanned aviation systems, positive train control systems, motor vehicle dashboards, autonomous vehicles, ship control systems, automated warehousing, wearable robotic exoskeletons, and use of drones in warehousing and utilities [Volpe 2012; Banker 2016; Schneider and Demi 2017]. Introduction of these highly automated systems has the potential to improve safety in many areas including reducing vehicle crashes, but there are increased risks with highly automated systems. These systems are highly complicated and more emphasis needs to be placed on operator training and maintenance [Moniz and Krings 2016] Changes in the roles and responsibilities of the operator introduce increased risk of operator errors especially in the context of unforeseen or atypical events. In the past introductions of new technologies occurred at a slow pace; the current faster pace of technology introduction increases the potential for unforeseen hazards being introduced in the workplace.

Need

Current Injury statistics illustrate the need for continued research on the human/machine interface for machines used in today’s workplace, and this research will need to be expanded to address future machines and vehicles. Researchers can begin to mitigate these hazards, and reduce injuries and fatalities, through hazard identification strategies and hazard mitigation methods, human factors analysis, educational programs on human factors engineering elements for system design for engineers, and integration of human factors engineering principles in technical engineering and design standards [Leva et al. 2016; Murashov et al. 2016]. Surveillance research is needed to better understand the relationship between injuries and stress, robotics and exoskeletons among TWU workers and the interplay with fatigue and psychosocial stress of displacement robotics, exoskeletons, and autonomous vehicles. Intervention studies are needed to assess effectiveness of autonomous vehicle interventions to reduce injuries associated with monotonous and repetitive tasks.