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原文传递 Risk Factors for Crashes in a Retrospective Cohort Study of Commercial Truck Drivers.

题名：	Risk Factors for Crashes in a Retrospective Cohort Study of Commercial Truck Drivers.
作者：	Thiese, M. S.
关键词：	Truck drivers, Trucking, Transportation industry, Motor vehicles, Body Mass Index (BMI), Cross sectional studies, Medical screening, Obesity, Occupational accidents, Accident statistics
摘要：	Commercial drivers, mostly truck drivers, are involved in over 333,000 crashes causing more than 100,000 injuries and 3,500 fatalities in the US annually and are a leading cause of workplace deaths. The presence of multiple concomitant health conditions are thought to increase crash risk, however this relationship has never been evaluated. The objectives of this research were to 1) assess relationships between BMI and comorbid conditions within a large sample of truck drivers, 2) assess relationships and trends over time in individual conditions and multiple conditions among a large sample of independent, non-overlapping truck drivers using a repeated cross-sectional study design and 3) quantify relationships between CDME elements and crash outcomes. Federally-mandated, commercial driver medical examinations were conducted on 95,567 commercial drivers between January 1, 2005 and October 31, 2012. Specific medical conditions that have been identified by the Federal Motor Carrier Safety Administration's Medical Review Board as those believed to increase risk of crash were examined for trends by the year of the examination. Of 13 conditions evaluated, eight increased significantly in prevalence from 2005 to 2012. Most drivers were obese (53.3%, BMI >30.0 kg/m2) and more than a quarter were morbidly obese (26.6%, BMI >35.0 kg/m2). After adjustment for age and gender, obese drivers were statistically significantly less likely to be certified for the full 2 year period and significantly more likely to report many factors including heart disease, hypertension, diabetes mellitus, nervous disorders, sleep disorders, and chronic low back pain. The prevalence of multiple conditions also increased, with prevalence odds ratios as high as 7.39 (95% Confidence Interval=3.92, 13.98) for having 4 or more conditions in 2012 as compared to 2005. There are statistically significant increased risk for crashes, including preventable crashes with injuries with higher counts of multiple conditions. BMI is strongly related to many factors that have been associated with increased crash risk and increasing numbers of disorders that limit driving certification. Individual and multiple conditions thought to be associated with increased crash risk were also found to have significantly increased between 2005 and 2012. There may be a causal relationship between counts of multiple concomitant conditions and crash risk, particularly for more severe crashes with injuries. This relationship remains even after adjustment for possible confounding factors.
报告类型：	科技报告