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The World Health Organization estimates an annual toll of 1.25 million deaths from road traffic accidents (RTAs). Nigeria is said to have the highest rate of RTAs and deaths per 10,000 vehicles. Target 3.6 of Goal 3 of the United Nations Sustainable Development Goals aims for the reduction of RTA-related injuries and deaths by half. Few studies have explored the relationship of the driver’s health with crashes and severity thereof.
As part of its Shared Value and Care agenda in ensuring safety, the operator partnered with the Federal Road Safety Commission (FRSC), the National Union of Road Traffic Workers, and the National Union of Petroleum and Natural Gas Workers (NUPENG) to screen drivers in three major motor parks in two major cities in Nigeria, Port Harcourt, and Lagos, to ascertain their health status and the effects of lifestyle risk factors.
Methodology
Health studies were performed in the Ojota (Lagos), Mile 3 (Port Harcourt), and Eleme (Port Harcourt) commercial and tanker driver parks. Consent was obtained from union executives to administer questionnaires to participants. Informed consent was also obtained from participants. One union refused to grant consent for the administration of the questionnaire but consented to the use of registers. A closed-ended, interviewer-administered questionnaire was issued to consenting drivers who sought information on their demographics, commercial driving experience, history of selected chronic illnesses, hearing and eye impairment, and alcohol use.
Rapid diagnostic kits were used to screen participants for random blood sugar, cholesterol, malaria, human immunodeficiency virus, and breath analyzers for blood alcohol concentration (BAC). Participants were also screened for hypertension, visual acuity using Snellen’s chart, and body mass index (BMI).
Results
A total of 731 drivers were screened from the three motor parks, comprising 330 commercial and 401 tanker drivers. The mean age of the commercial drivers was 48.5 years, and that of the tanker drivers was 45.2 years. More tanker drivers (75%) than commercial drivers (65%) had at least a secondary level of education.
Social Behavior. Responses were received from 465 attendees regarding social behavior: 350 (73.5%) drank alcohol, 95 (19.9%) smoked cigarettes, 89 (18.7%) both consumed alcohol and smoked, and 109 (22.9%) neither consumed alcohol nor smoked cigarettes. BAC was possible in only one of the stations, where 192 were screened. Thirty-four (17.7%) had no trace of alcohol; there were trace-to-very-low alcohol levels (0.001–0.099 g/dl) in 121 (62.8%) respondents, while low-to-mild (0.01–0.04 g/dl) and moderate-to-high (greater than 0.05 g/dl) concentrations were seen in 30 (15.8%) and 7 (3.7%), respectively. The BAC test was carried out between 0800 and 1000 in the morning, around the start of the work day.
History of Existing Ailments. Response was obtained from 539 participants in two of the parks. Of the participants, 47% reported having impaired vision, 17.6% reported impaired hearing, 12.6% were known hypertensives, and 5.7% were known diabetics.
BMI. Forty percent of the drivers registered a normal BMI weight while 18% were obese. Obesity was higher (19%) among tanker drivers than commercial drivers; the difference was, however, not statistically significant. When the relationship of BMI to hypertension was analyzed, a statistically significant proportion of those who were overweight or obese had raised blood pressure.
Blood Cholesterol. Of the 172 drivers screened for blood cholesterol, 62 (35.5%) had raised levels. The percentage of raised cholesterol levels was greater in tanker drivers (45.7%) than the 6.7% measured among commercial drivers; the difference was highly statistically significant. There was no relationship between high cholesterol and raised blood pressure.
Blood Pressure. Blood pressure was measured in 622 participants, of whom 36.9% had raised blood pressure levels, defined as systolic above 140 mm/Hg or diastolic above 90 mm/Hg. Of those not known to be previously hypertensive, 3.4% had systolic blood pressure of 200 mm/Hg and higher. Among the known hypertensives, 32.8% had raised blood pressure. The percentage of commercial drivers who had raised blood pressure was 40% and 34.4% among the tanker drivers; the difference was not statistically significant.
Eye Defects. Of 471 participants screened for eye defects, 221 (46.9%) reported having poor eyesight. Of that latter group, 59 (26.9%) use glasses. Among those who used glasses, 47.5% of glasses were obtained from the hospital or the Federal Road Safety Corps (FRSC), while all others (52.5%) obtained glasses from friends, relatives, or the marketplace.
Two-thirds of 539 respondents had never had an eye test; 7.7% knew how frequently they should have an eye test. Of the 584 drivers screened for eye impariment, 498 (85.3%) experienced hyperopia. Other eye defects among respondents included conjunctivitis, glaucoma, cataracts, and myopia (Fig. 1).
Focus Group Discussions With Unions. The two unions reported that they are not involved in the emplyment of drivers but regulate activities in the various parks. Both unions had banned the sales of alcohol in the parks. Concerning eye tests, the unions stated that many of their members had not had their eyes screened. Reasons given were lack of awareness and funds. One respondent claimed he was hearing about eye tests for the first time. In probing how they obtained driving licenses without having had eye tests, the respondents said that eye tests often are not enforced by the FRSC, making it possible to obtain a license without observing due process.
The unions enforce discipline in the parks through sanctions. NUPENG reported that weekly safety talks are held between the FRSC and the drivers.
Discussion
This study sought to evaluate the social behavior and health status of drivers and compare these between commercial and tanker drivers. Evaluation of the social behavior of drivers in this study showed that they were more likely to drink alcohol (73.5%) than smoke (19.8%); those who smoked were very likely to consume alcohol (18.7%), while only about a fifth did not indulge in smoking or drinking. Among those tested for BAC, 3.7% were found to have moderate-to-significant alcohol concentrations, while 78.6% had trace-to-mild concentrations. This shows an ease of access to alcohol despite the ban on alcohol sale in the parks. The focus group discussion held with the union executives revealed that drivers have access to alcohol dispensed outside the parks.
While several reports on driver behavior have been conducted, less attention is paid to driver health. Some studies have shown that driver health could affect the severity of a crash. A large percentage of drivers in this study complained of poor vision. Two-thirds of them had never had an eye test, a prerequisite for issuance and renewal of driving licenses by the FRSC. Some drivers with impaired vision reported using eye glasses. However, over half of those obtained the glasses from unofficial or unprofessional sources, presenting the risk of using incorrect lenses.
Cardiovascular risk factors were prevalent among the drivers and were similar between tanker and commercial drivers, except for blood cholesterol level. A third of the drivers had raised blood pressure. While overweight and/or obese classifications were associated with raised blood pressure, high cholesterol was not.
A previous systematic review has shown that excess weight and obesity (risk factors to hypertention), in coexistence with other morbidities such as obstructive sleep apnea and diabetes mellitus, can increase risk of road crashes, because affected drivers were likely to sleep behind the wheel, having had insufficient sleep.
Conclusions. These observations call for stringent control of alcohol sale and use around motor parks, enforcement of FRSC laws for obtaining and renewing driving licenses, on-the-spot BAC checks on the road, and implementation of a health insurance program to improve access of drivers to routine medical checkups. These steps will greatly improve the road safety of commercial and tanker drivers and will help keep Nigeria’s roads safe.
This article, written by JPT Technology Editor Chris Carpenter, contains highlights of paper SPE 199440, “Taking Goal Zero Outside the Fence: Lifestyle and Health Influences on Tanker and Commercial Drivers’ Performance and Road Safety,” by A. Fajola, F. Oduneye, and R. Ogbimi, Shell, et al., prepared for the 2020 SPE International Conference and Exhibition on Health, Safety, Environment, and Sustainability, originally scheduled to be held in Bogota, Colombia, 28–30 July. The paper has not been peer reviewed.