GREEN BAY, Wis. – Truck drivers — the people who deliver our food, cars and clothing — have one of the most dangerous jobs in America — accounting for nearly 15 percent of U.S. work-related deaths. And that's only counting the accidents.
They are also more at risk than average Americans for a number of health problems. Obesity is rampant. Many don't bother to wear seatbelts because their stomachs get in the way. About one in four have sleep apnea. Half of them smoke.
The latest research in an upcoming report drives home those points and may help influence government regulations for truck drivers' health, which are under review. The Federal Motor Carrier Safety Administration is considering tightening its rules for conditions including diabetes and high blood pressure. And many companies are stepping up their own efforts at improving health.
"It takes a while to undo years and years and years of unhealthy behavior," said Christie Cullinan of the American Trucking Associations, which represents about 2,000 companies and suppliers. "But I think companies are having to look at this because of the skyrocketing health care costs and related workers compensation costs."
Drivers are tested every two years to maintain their licenses, which are issued by states. Waivers can be granted, but generally commercial drivers can't be licensed if they have severe high blood pressure or severe heart conditions. Other aspects of drivers' health, like weight and smoking, aren't regulated.
"They can't say, 'You can't be obese' and they can't force you to stop smoking,'" said Gerald P. Krueger, a psychologist who compiled the latest research by the Transportation Research Board. "The government shouldn't regulate that. But we've been trying to educate people to the linkage between being a healthy person and a safe driver."
Krueger said trucking companies need to do more to foster better health among their employees, whether it's to reduce health care costs or hang onto employees in an industry where turnover is high and shortages growing.
It's not clear how many companies are making efforts. The trucking associations group says it is planning a survey. The group estimates there are 1.3 million long-haul drivers nationwide.
An Associated Press spot check of companies revealed these initiatives:
_Celadon Group Inc. has stationed nurses at its main facility in Indianapolis and encourages its 3,200 drivers in the U.S. and Canada to get blood pressure and cholesterol checks. Doctors are on call if needed, and Celadon pays all expenses. The company says it's helped trim its $10 million annual health care bill.
_Melton Truck Lines Inc. replaced sodas in the Tulsa, Okla., headquarters vending machines with green tea, water and diet drinks. The company also offered a 12-week weight-loss series.
_Con-way Freight of Ann Arbor, Mich., saw annual workers compensation claims plunge 80 percent and lost work days drop 75 percent in Los Angeles after its trial of a wellness program two years ago. Now leaders of such programs are being hired at other hub offices.
_Schneider National Inc. of Green Bay, Wis., screened 10,000 of its 15,000 drivers for apnea, a disorder that interferes with breathing during sleep and can leave the sufferer groggy and exhausted. The company provided the 10 percent who had the disorder with special air masks to help them sleep.
Some drivers are responding to all the health campaigns, working out at loading stations, cooking for themselves and even walking laps around their rigs. (Thirty-two times around an 18-wheeler is a mile.)
Sammy Belvin, a driver for Oklahoma-based Melton Truck Lines, has been getting advice from a wellness coordinator with the company. He carries weights in his truck, and for meals, he eats cereal and cooks chicken breasts on an electric grill in his cab.
A driver for 23 years, Belvin says these days he's not the only one jogging around in the mornings before he drives off for the day.
Lisa Miles, an independent driver based in Fort Wayne, Ind., lifts weights in the cabin of her semi, too, while her partner driver takes the wheel. She gave up smoking three years ago and now is trying to lose 30 pounds.
"It's real easy to let your personal health be the last of your priorities," she said.
As many as half of drivers are regular smokers, compared to about one-fifth of all Americans. Many truckers are obese, and only about one in 10 get regular aerobic exercise. More details will be available in a soon-to-be-published study for the Transportation Research Board, an arm of the National Academy of Sciences. All those bad habits can fuel high blood pressure and chronic conditions like heart disease and diabetes.
Sleep apnea, which is linked to obesity, is rampant too. An industry study a few years ago found 28 percent of drivers had it; that compares with about 4 percent in the general population who have the disorder.
Government numbers say the trucking industry has the most fatalities of all occupations. The Bureau of Labor Statistics says truck drivers account for nearly 15 percent of all worker deaths in the most recent data available, from 2005. (The death rate per 100,000 is higher for other occupations.) Of those trucker deaths, 80 percent involved traffic accidents, the bureau said.
Truck drivers also report more injuries, such as sprains, than workers in any other category, according to the Occupational Safety and Health Administration. Many of them unload the goods they carry, risking back injuries.
The medical review board of the Federal Motor Carrier Safety Administration will discuss updating medical guidelines at a meeting this month, but any changes are at least a year away, officials said.
Meanwhile, the Teamsters union wants to ensure that truckers don't lose their jobs if health rules are tightened, said Lamont Byrd, director of safety and health for the union.
"We see some real changes coming down the pipe that suggests the bar may be raised," he said.
Truckers pose unique challenges when it comes to improving health, said Ilene Masser, director of such a program for faculty and staff at New York University Medical Center. They sit for long periods, are out on their own, eat a lot of fast food and most of them are men, who often need more prodding than women to make changes, she said.
Changes are worth it. About three-quarters of employers with at least 1,000 workers have a wellness program, she said. And for every dollar invested, they get about $3.14 back, including savings on health care costs and added productivity.
William Rundle is one of the drivers for Schneider National who benefited from his company's aggressive effort to treat sleep apnea.
"It's wonderful to be able to function during the day now," he said, adding that he has more energy and makes his deliveries on time. He said his company has also persuaded him to quit smoking and eat better.
In the past year he's trimmed 15 pounds from his formerly 300-pound, 5-foot-7 frame. It's difficult, he said. He wants to eat salads but they often come with hard-to-resist cheese and bacon. He wants to exercise but counts few safe places to walk close to the highway.
"You don't see very many truck drivers that look like they're in good shape. We're just like anybody else," said Rundle, 43, who lives in Woodbourne, N.Y.
For at least seven years, Schneider has worked to improve drivers' health. Twice a year, the company takes a "discomfort" survey on driving ergonomics and aches and pains. Physical therapists follow up with drivers to address problems before they become severe.
Krueger, the Transportation Research Board psychologist, said younger drivers know more about healthy behaviors because they've heard it in school. But the problem lies in convincing the drivers already on the road that they need to exercise, see a doctor regularly and eat better. He has spent decades researching occupational medicine and he's heard all sorts of excuses, especially from drivers.
"My favorite line is, 'Dr. Krueger, I get off work at 3 in the morning. You want me to go to Gold's Gym and do what?'"