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Abstract
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OBJECTIVES: Karoshi problems (overwork-related deaths and disorders caused by cerebrovascular and cardiovascular diseases) still occur in Japan. Truck drivers, who are in one of the riskiest occupations, are reported to show an increased prevalence of hypertension, obesity, hyperlipidemia, and diabetes, which are characteristic of Karoshi. Their health problems also include excessive fatigue. This cross-sectional study aimed to examine the association between work-life factors and health disorders/excessive fatigue among Japanese truck drivers.
METHODS: We distributed a questionnaire regarding work hours, health status, lifestyle, burden of driving, and excessive fatigue to 5,410 truck drivers and collected a total of 1,947 responses, all from males. The association between work-life factors and health outcomes was evaluated by multivariable logistic regression analysis adjusted for age, drinking, and smoking status.
RESULTS: The prevalence rates of obesity, hypertension, hyperlipidemia, diabetes, cardiovascular disease, cerebrovascular disease, and excessive fatigue were 22.2%, 19.3%, 8.5%, 5.6%, 2.5%, 0.7%, and 6.0%, respectively. Significant associations were observed for long-haul trips (two days or more) with obesity (adjusted odds ratio 1.5 [95% Confidence Interval 1.1-2.1]), local and night trips with hypertension (1.5 [1.0-2.2]), early morning awakening on workdays with obesity (1.5 [1.1-2.1]), being indoor-oriented on weekends with hypertension (1.5 [1.1-2.0]); and heavy burden of driving at night with hyperlipidemia (2.0 [1.3-3.0]). The adjusted odds ratios were significant for waking after sleep onset (2.6 [1.2-5.3]) and lack of sleep satisfaction (2.7 [1.4-5.1]) on workdays, less than six hours of sleep (2.8 [1.0-7.8]) and lack of sleep satisfaction (2.8 [1.5-5.2]) on weekends, 0-3 days off per month (3.6 [1.3-10.2]), and heavy burden of driving at night (2.2 [1.0-4.8]) with excessive fatigue.
CONCLUSIONS: The present findings highlight that night and early morning work, heavy burden of night driving, and the resultant decreases in the quality and quantity of sleep may represent shared risk factors for health disorders and excessive fatigue among truck drivers. Adequate measures should be taken to limit the amount of night and early morning work, reduce the burden of night driving, and ensure days off for sleep opportunities and leisure activities, with the goal of preventing Karoshi.
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日本においてトラックドライバーは脳・心臓疾患による過労死や健康起因事故が多い職種である．また，トラックドライバーは，脳・心臓疾患のリスクである高血圧症，肥満，高脂血症，糖尿病に関連する項目の定期健診での有所見率も高い．そこで，トラックドライバーの過労死防止策の立案に向けて，職種の特徴を踏まえた労働生活条件と，脳・心臓疾患に高血圧症，肥満，高脂血症，糖尿病を含めた健康障害，疾患前としての過労状態との関連について検討した．対象と方法：全国のトラックドライバーを対象として，上記の健康障害の既往歴および過労状態を含む，基本属性，生活習慣，働き方，休み方，運転労働の負担について質問紙調査を行った．47都道府県の1,082のトラック運送事業所に5部ずつ合計5,410部を配送し，1,992部を回収した（回収率36.8％）．そのうち，女性41人および性別不明4件を除く男性1947人を解析対象とした．労働生活条件と各種健康障害との関連は多重ロジスティック回帰分析を用いて検証した．結果：解析対象トラックドライバーにおいて，肥満は22.2％，高血圧症は19.3％，高脂血症は8.5％，糖尿病は5.6％，心臓疾患は2.5％，脳血管疾患は0.7％，過労状態は6.0％に見られた．多重ロジスティック回帰分析の結果，健康障害の既往歴は，運行形態が長距離2泊以上と地場夜間早朝，勤務日の早朝覚醒有り，休日の過し方が不活発，夜間運転の重い負担と有意な関連が示された．また，過労状態は，勤務日の中途覚醒および睡眠不足感有り，休日の睡眠時間が6時間未満および睡眠不足感有り，ひと月あたりの休日数が0-3日，運転・夜間運転・作業環境の重い負担と有意な関連が示された．考察と結論：トラックドライバーにおける健康障害および過労状態と有意な関連は，夜間・早朝勤務への従事および夜間運転の負担が重いこと，また夜間・早朝勤務に付随する睡眠の量と質の低下に見られた．本研究より，過労死防止策を念頭に置いた勤務の改善点として，夜間運転の負担軽減や，十分な夜間睡眠取得および活動的に過ごすための休日配置の重要性が示唆された．
Language: ja |