i 

DEDICATED TO THE MEMORY OF 

PAT WALLER 

DIRECTOR EMERITA OF THE 

UNIVERSITY OF MICHIGAN TRANSPORTATION RESEARCH 

INSTITUTE 

LIFELONG ADVOCATE FOR TRUCK DRIVER 

OCCUPATIONAL SAFETY AND HEALTH 

August 15, 2003

Cover photographs courtesy of Jim West / jimwestphoto.com. 
ii

Truck Driver Occupational Safety and Health 

2003 Conference Report and Selective Literature Review*

Gregory M. Saltzman† and Michael H. Belzer‡

Revised February 8, 2007 

DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Centers for Disease Control and Prevention 

National Institute for Occupational Safety and Health 

 _____________________ 

*

The Wayne State University Truck Driver Occupational Safety and Health Conference was held April 24-25, 2003, 

at the Detroit Metro Airport Doubletree Hotel, Detroit, MI. 

†

E. Maynard Aris Professor and Chair, Department of Economics and Management, Albion College, 611 East Porter 

Street, Albion, MI 49224. Adjunct Research Scientist, Institute of Labor and Industrial Relations, University of 

Michigan. gsaltzman@albion.edu 

‡

Associate Professor of Industrial Relations, Wayne State University, Department of Interdisciplinary Studies, 

College of Liberal Arts and Sciences, Detroit, MI 48202. Adjunct Associate Research Scientist, Institute of Labor 

and Industrial Relations, University of Michigan. Michael.H.Belzer@wayne.ed
ii

Disclaimer 

Sponsorship of the Truck Driver Occupational Health Conference and these proceedings 

by the National Institute for Occupational Safety and Health (NIOSH) does not constitute 

endorsement of the views expressed or recommendations for the use of any commercial 

product, commodity, or service mentioned. The opinions and conclusions expressed in 

the presentations and report are those of the authors and not necessarily those of NIOSH. 

All conference presenters were given the opportunity to review and correct statements 

attributed to them within this report. 

Recommendations are not final statements of NIOSH policy or of any agency or 

individual involved. They are intended to be used in advancing the knowledge needed for 

improving worker safety and health. 

This document is in the public domain and may be freely copied or reprinted. 

Ordering Information 

To receive documents or other information about occupational safety and health topics, 

contact NIOSH at 

NIOSH—Publications Dissemination 

4676 Columbia Parkway 

Cincinnati, OH 45226–1998 

Telephone: 1–800–35–NIOSH (1–800–356–4674) 

Outside the U.S.: 513–533–8328 

Fax: 513–533–8573 

E-mail: niosh-publications@cdc.gov

or visit the NIOSH Web site at www.cdc.gov/niosh

DHHS (NIOSH) Publication No. 2007–120
iii

Foreword 

In 2003, NIOSH co-sponsored a conference that brought together researchers from 

around the world to discuss the safety and health of commercial truck drivers. NIOSH 

recognizes that these workers merit attention due to the difficult and dangerous nature of 

their trade. Truck drivers have an unusually high rate of occupational injury, and one of 

the highest rates of on-the-job fatality. NIOSH is actively working to improve the safety 

and health of truck drivers. Current Institute projects will increase our understanding of 

cause-specific mortality among owner-operator truck drivers, the health effects of diesel 

exhaust particles, and the influence of work organization on truck driver fatigue. 

Reducing occupational injury and illness among truck drivers is assisted by a coordinated 

effort, and this conference was an important step towards establishing a national research 

agenda. The following report and accompanying CD-ROM share the information, insight, 

and research of the professionals who participated in the conference. Together they 

provide an overview of the trucking industry, summarize the current state of knowledge 

regarding truck driver safety and health, and document the topics for future research 

suggested by the conference participants. NIOSH hopes that these proceedings will be 

valuable to researchers, industry representatives, policymakers, and the public. 

John Howard, M.D. 

Director, National Institute for 

 Occupational Safety and Health 

Centers for Disease Control and Prevention 
iv
v

Contents 

Foreword................................................................................................................ iii

Abbreviations......................................................................................................... vii

Acknowledgements................................................................................................ ix

Executive Summary............................................................................................... x

Introduction............................................................................................................ 1

Keynote: The Need for a Research Agenda on Truck Driver Occupational 

Safety and Health .............................................................................................. 3 

Introduction to Trucking: Operations, Labor Markets, 

and Occupational Safety and Health ................................................................. 6

Epidemiology, Surveillance, and Measurement .................................................... 23

Ergonomics, Job Injuries, and Exposure................................................................ 32

Labor Market, Employment Relations, and Personnel Management .................... 39

Fatigue and Truck Driver Safety and Health ......................................................... 46

Causes of Driver Fatigue and Sleep Deprivation................................................... 57

Health Consequences of Driver Work Schedules.................................................. 60

Health Consequences of Job Stress........................................................................ 62

Social and Behavioral Consequences of Employment as a Truck Driver ............. 65

Developing a Research Agenda on Truck Driver Occupational 

 Safety and Health ............................................................................................. 69

References.............................................................................................................. 81

Appendix 1: Conference Participants and Speaker Profiles .................................. 96

Appendix 2: Agenda .............................................................................................. 114

The conference also is on the web at 

http://www.ilir.umich.edu/TIBP/truckdriverOSH
vi

Tables 

Table 1. Occupational Injury/Illness of Commercial Motor Vehicle (CMV) 

 Operators, 2004........................................................................................ 1 

Table 2. Driving Maximum Hours, Old Rules .......................................................... 19 

Table 3. Working Maximum Hours, Old Rules......................................................... 19 

Table 4. Driving Maximum Hours, New Rules, Carriers Operating 

 Six Days a Week...................................................................................... 19 

Table 5. Driving Maximum Hours, New Rules Carriers Operating 

 Seven Days a Week ................................................................................. 20 

Table 6. Working Maximum Hours, New Rules Carriers Operating 

 Six Days a Week...................................................................................... 20 

Table 7. Working Maximum Hours, New Rules Carriers Operating 

 Seven Days a Week ................................................................................. 20 

Table 8. Permanent Disability Claims for Unionized LTL Carriers.......................... 34 

Table 9. French Truck Driver Work Hours ............................................................... 42 

Table 10. Research Needs: Data ................................................................................ 74 

Table 11. Research Needs: Economics and Industrial Organization......................... 75 

Table 12. Research Needs: Assessment..................................................................... 76 

Table 13. Research Needs: Interventions and Countermeasures............................... 78 

Table 14. Research Needs: Dissemination and Education......................................... 80 
vii

Abbreviations 

ATA American Trucking Associations 

BAC Blood alcohol concentration 

BLS Bureau of Labor Statistics 

BMCS Bureau of Motor Carrier Safety (predecessor to FMCSA) 

BTS Bureau of Transportation Statistics 

CDLIS Commercial Driver License Information System 

CFOI Census of Fatal Occupational Injuries 

CPSC Consumer Product Safety Commission 

DHHS U.S. Department of Health and Human Services 

DOT U.S. Department of Transportation 

EEC European Economic Community (predecessor of European Union) 

EEG Electroencephalogram 

EOBR Electronic on-board recorder 

EU European Union 

FACE Fatality Assessment and Control Evaluation 

FARS Fatality Analysis Reporting System 

FMCSA Federal Motor Carrier Safety Administration 

GH Growth hormone 

HOS Hours-of-service regulations 

IBT International Brotherhood of Teamsters 

ICC Interstate Commerce Commission (abolished 1995) 

IHD Ischemic heart disease 

INRETS French National Institute for Transport and Safety Research 

JAMA Journal of the American Medical Association 

LTCCS Large Truck Crash Causation Study 

LTL Less than truckload 

MCMIS Motor Carrier Management Information System 

NAFTA North American Free Trade Agreement 

NCHS National Center for Health Statistics 

NEISS National Electronic Injury Surveillance System 

NHAMCS National Hospital Ambulatory Medical Care Survey 

NHTSA National Highway Traffic Safety Administration 

NIOSH National Institute for Occupational Safety and Health 

NOMS National Occupational Mortality Surveillance System 

NTOF National Traumatic Occupational Fatality Surveillance System 

OOIDA Owner-Operator Independent Drivers Association 

OSA Obstructive sleep apnea 

OSHA Occupational Safety and Health Administration 

OSPAT Occupational Safety Performance Assessment Test 

PVT Psychomotor vigilance test 

REM Rapid eye movement sleep 

SENSOR Sentinel Event Notification System for Occupational Risk 

SOII Survey of Occupational Illnesses and Injuries 
viii

SWS Slow-wave sleep 

TIBP Trucking Industry Benchmarking Program 

TIFA Trucks Involved in Fatal Accidents 

TL Truckload 

UMTIP University of Michigan Trucking Industry Program 

UMTRI University of Michigan Transportation Research Institute 

VIUS Vehicle Inventory and Use Survey 

3PL Third party logistics 
ix

Acknowledgements 

The Wayne State University Truck Driver Occupational Safety and Health Conference 

was organized by Michael H. Belzer and sponsored by the National Institute for 

Occupational Safety and Health (NIOSH), the Owner-Operator Independent Drivers 

Association (OOIDA), the International Brotherhood of Teamsters (IBT), the Trucking 

Industry Program and the Trucking Industry Benchmarking Program (both partly 

sponsored by the Alfred P. Sloan Foundation as part of the Industry Centers Program), 

with in-kind resources provided by the Douglas Fraser Center for Workplace Studies in 

the College of Urban, Labor, and Metropolitan Affairs at Wayne State University. 

The authors thank the eight anonymous referees for their comments on the draft of this 

report, and thank Jan Birdsey of NIOSH for help in preparing the final version. 
x

Executive Summary

In April 2003, an international group of researchers convened in Detroit to discuss the 

occupational safety and health of commercial motor vehicle drivers. This conference was 

unusual because it focused on driver well-being, rather than general highway safety and 

transportation issues. Truck drivers merit special attention not only because of their large 

numbers—approximately 2.8 million in the U.S.—but also because they face 

extraordinary risk of on-the-job injury and death. In 2004, U.S. truck drivers were 7 times 

more likely to die on the job, and 2.5 times more likely to suffer an occupational injury or 

illness, than was the average worker. 

The meeting was sponsored by the National Institute for Occupational Safety and Health, 

the Owner-Operator Independent Drivers Association, the International Brotherhood of 

Teamsters, and the Trucking Industry Program and the Trucking Industry Benchmarking 

Program at Wayne State University. The following report provides a selective review of 

the relevant literature, summarizes the conference presentations, incorporates the 

comments made by many of the participants, and outlines some topics needing further 

research. The accompanying CD-ROM contains the conference PowerPoint 

presentations, conference handouts, supporting papers, and reports. Information in this 

Executive Summary was presented or discussed at the conference, and relevant literature 

references are provided within the report. 

Introduction to Trucking 

The first plenary session provided an overview of the trucking industry and government 

regulations. The U.S. trucking industry is essentially divided into three main segments: 

government entities, private carriers, and for-hire motor carriers. Government entities 

such as the U.S. Postal Service operate truck fleets for their own use. Private carriers 

(wholesale, service, or industrial companies) may sell transportation services to others, 

although they primarily haul their own freight. For-hire motor carriers receive all of their 

freight from shippers. The for-hire trucking industry is commonly grouped either by 

shipment size (parcel, less-than-truckload [LTL], and truckload [TL]), or by geographic 

scope (local, regional, inter-regional, national, or international) and type of commodity or 

operation. 

The structure of the U.S. trucking industry changed radically soon after deregulation in 

1980. Formerly regulated common carriers that had assumed health care and pension 

costs found it difficult to compete with new non-union TL carriers that had no pension or 

health care liabilities and little capital overhead. Trucking has shifted from being 

predominantly unionized before deregulation in 1980 to less than 15% unionized today. 

Driver wages (adjusted for inflation) have fallen 30% since 1980. 

The Federal Motor Carrier Safety Administration issued the latest hours-of-service rules 

for commercial truck drivers in 2005.1

 The new rules increase the minimum daily offduty time, yet allow drivers to spend more total time working and more time behind the 

wheel than the previous regulations. For solo drivers, the mandatory break period after a 
xi

shift has increased from 8 to 10 hours, offering greater opportunity for a driver to obtain 

restorative sleep, and all work must be completed within 14 hours of the driver’s start 

time, making it more difficult to falsify log books. However, the new rules also increase 

the maximum allowable daily driving time from 10 hours to 11 hours, and they allow 

drivers to work as much as 84 hours in a seven-day period. Drivers were previously 

limited to 70 hours of work time within any seven-day interval, but a new “restart” 

provision allocates a fresh set of work hours to a driver after 34 hours of continuous offduty time (theoretically, two sleep periods). Thus, a driver can now complete 70 hours of 

duty time early in the 5th day of the week, take 34 hours off, and work another 14 hours in 

day 7, for a total of 84 hours. 

U.S. drivers are allowed to work more hours than their counterparts do in either the 

European Union or Australia’s eastern states. While the daily work schedule allowed in 

Australia’s eastern states (14 hours of work and 12 hours driving in a 24-hour period) is 

similar to the U.S. hours of service rules, the Australian drivers are limited to 72 hours of 

working time in a seven-day period, 12 hours less than the U.S. “restart” provision 

allows. Drivers in the European Union (EU) are allowed even fewer hours; the latest EU 

rules will eventually limit all truck drivers to an average of 48 hours per week (over a 

four-month period), and a maximum of 60 hours per week. Currently, all EU drivers are 

limited to 9 hours of driving per day. 

Long working hours, irregular shift and day-off patterns, and many consecutive nights 

away from home and family can make truck driving an arduous career. The overtime pay 

provisions of the Fair Labor Standards Act, which require time-and-one-half pay for 

work hours in excess of 40 per week, do not apply to truck drivers. Drivers are often paid 

by the mile, and they are not compensated for the time they spend waiting at the docks or 

performing tasks such as loading and unloading, which make up approximately 25% of 

their total work time. The American Trucking Associations cite the combination of 

undesirable working conditions and low wages as reasons for the 121% driver turnover 

rate in the large truckload sector for 2005. 

Truck Driver Occupational Safety and Health 

Several sessions at the conference outlined existing surveillance efforts and highlighted a 

variety of safety and health topics. Participants agreed that while several existing data 

systems collect detailed information on highway crashes and on-the-job fatalities, 

significant data gaps remain, especially in the areas of fatigue, occupational stress and 

violence, and chronic disease. With new hours-of-service rules now in place, complete 

and timely data on truck driver health and safety is essential to characterize health risks, 

identify emerging problems, and assess interventions. 

Chemical and ergonomic hazards 

Truck drivers face a variety of chemical exposures. Drivers who deliver unhardened 

concrete are exposed to chromium and alkaline substances, putting them at risk for both 

allergic skin reactions and chemical burns. Drivers of gasoline tanker trucks often 

experience acute headaches, dizziness, or nausea after exposure to vapors released during 
xii

gasoline transfers. Diesel exhaust has been linked to lung cancer and allergic 

inflammation, and exposure can be substantial at loading docks and truck stops. 

Increasing the allowable working hours for drivers increases the risk that their exposures 

to hazardous substances will exceed recommended limits. 

Ergonomic risks vary widely and can include loading and unloading heavy cargo 

(beverage delivery drivers handle approximately 36,000 pounds each day), awkward 

postures, and working in tight spaces such as the drum of a ready-mix concrete truck. The 

effects of these hazards are borne out by the high number of injuries reported by drivers 

both in the U.S. and abroad. 

Fatigue and highway safety 

Many of the conference participants considered fatigue to be a critical problem for 

drivers and the trucking industry. Safe vehicle operation requires sustained vigilance, 

excellent judgment, and quick reactions, particularly during heavy traffic or poor driving 

conditions. Fatigue impairs all of these abilities, endangering not only truck drivers, but 

also other motorists who share the road with them. A common proximate cause of fatigue 

among truck drivers is partial sleep restriction, which in turn causes sleep debt and semichronic sleepiness. One study reported that drivers slept an average of only 4.78 hours 

per day, while those who worked on a steady night schedule averaged only 3.83 hours of 

sleep per day. 

Sleep restriction, in turn, stems both from medical problems such as sleep apnea and from 

employment conditions in trucking. Long work hours cut into time available for sleep, 

and work-related stress makes it hard for drivers to sleep even when time is available. 

Shift work or an irregular work schedule forces many drivers to sleep during the day, in 

opposition to natural circadian rhythms, and most team drivers probably experience this 

irregular schedule. Sleeper berths do not provide optimal sleeping conditions, and sleep 

likely is fragmented for solo drivers and team drivers alike. Some drivers find it difficult 

to sleep in a moving vehicle, especially if they do not trust the driving ability of their 

partner, or if the vehicle is making numerous stops. Likewise, solo drivers' sleep may be 

fragmented while awaiting notification of the availability of their next load. 

Even moderate levels of sleep deprivation (17-24 hours of wakefulness) can cause 

neurobehavioral impairment equivalent to a blood alcohol level (BAC) of 0.05 to 0.10. 

This is considered an unsafe level of functioning for truck drivers; commercial drivers 

may have their licenses revoked if they operate a heavy truck or haul hazardous cargo 

with a BAC of 0.04 or above. Further compounding the problem, a driver may not be 

aware of his or her level of impairment for two reasons: (1) over several days of sleep 

restriction, habituation may make sleepiness feel normal to the driver, and (2) “wake state 

instability” causes individuals with moderate sleep loss to perform optimally most of the 

time, but not reliably. Thus, while sleep-deprived individuals do not necessarily 

experience any immediate impairment of neurobehavioral function, lapses can occur 

when sustained cognitive accuracy and speed are critical. 
xiii

The inability to determine their level of impairment may explain why some drivers are 

willing to risk driving while fatigued. In the U.S., 25% of long-distance truck drivers 

reported falling asleep at the wheel in the past year, while 47% reported having fallen 

asleep at the wheel sometime during their driving career. Drivers were more likely to 

report falling asleep at the wheel if they split their off-duty periods, or if they worked a 

demanding schedule (10 or more hours of consecutive driving, or less than 8 hours of offduty time per day). Similarly, Australian truck drivers reporting 6 or fewer hours of sleep 

prior to a trip were significantly more likely report a hazardous event related to fatigue 

during that trip, such as nodding off while driving. According to conference participants, 

driver fatigue was a factor in 6% to 49% of the highway truck crashes they studied. 

Other health effects of driver work hours 

In addition to increasing the risk of being in a crash, the long and irregular work hours of 

many drivers can have other adverse health effects. Sleep debt is associated with 

impaired glucose metabolism, abnormal cortisol (stress hormone) regulation, altered 

growth hormone (GH) profiles, altered autonomic function (elevated sympathovagal 

balance), and impaired immune function. Disruptions in the endocrine system may 

contribute to health problems such as obesity, diabetes, and hypertension. Long-haul 

drivers who work many hours per day and do not have 24-hour work/rest cycles may 

suffer from desynchronized internal circadian rhythms. Working over 40 hours per week 

can double the risk of acute Helicobacter pylori infection (associated with peptic ulcers), 

even controlling for age, sex, and marital status. Irregular hours and night work raise the 

risk of being hospitalized for ischemic heart disease (IHD), and professional drivers are at 

greater risk of IHD if they work long hours. 

The demanding work schedule of truck drivers also makes it more difficult for them to 

obtain quality health care. Forty-seven percent of long-distance truck drivers surveyed 

lacked a regular health care provider. Fifty-six percent of drivers found it difficult to 

make a healthcare appointment when at home due to their work schedule, and 62% said 

they had failed to seek out needed health care when on the road working. 

Stress 

Truck drivers experience stress from many sources. Long working hours, night work, or 

spending extended periods on the road away from friends and family can isolate drivers 

and leave them too exhausted to nourish their relationships. Pressure to stay on schedule 

even when road conditions are bad or they are fatigued can strain drivers’ nerves. 

Delivering or picking up loads can be taxing – drivers are often required to wait in their 

trucks for long and unpredictable periods of time; they may be denied opportunities for 

food, water, and restroom facilities; and they may be treated disrespectfully by shipping 

and receiving personnel. Owner-operators are often under intense financial pressure, 

finding it difficult to make the required loan or lease payments on their truck due to low 

compensation rates. 
xiv

Workplace violence 

Truck drivers can be victims of either physical violence or verbal abuse. Among 300 

Australian truck drivers surveyed, 30% had been victims of verbal abuse, 21% had been 

victims of “road rage,” 10% had been threatened, and 1% had been assaulted. At freight 

forwarding yards, verbal abuse and threats were closely linked with economic pressures 

in nearly all incidents. Loading delays, drivers cutting in line, and mistakes by forklift 

drivers fueled tensions and led to the violent behaviors. U.S. beer delivery drivers are 

robbery targets, since they may carry $1,000 to $3,000 in cash by the end of the day. 

Threat of such abuse and violence can increase psychological stress and use of 

maladaptive coping mechanisms. 

Driver Compensation and Safety 

Driver compensation is inversely associated with both employee turnover and crash risk. 

Three empirical studies on the relationship between truck driver compensation and safety 

found a strong and significant relationship: more pay to the driver resulted in 

substantially fewer crashes. In a study of J.B. Hunt drivers, researchers found a 10% 

higher base mileage rate was associated with a 34% lower probability of a crash. In 

addition, a 10% increase in driver pay was associated with a 6% lower crash probability, 

giving an overall pay-rate effect of 1:4. In a cross-sectional study of 102 truckload 

carriers, researchers found that for every 10% increase in average total compensation for 

drivers, the carrier would experience a 9.2% lower crash rate. In a driver survey study, 

researchers found that drivers earning a 10% higher mileage rate had an 18.7% lower 

probability of having a crash during the reporting year, while drivers given 10% more 

paid days off had a 6.3% lower probability of having a crash during that same year. 

Higher compensation may reduce crash risk by enabling carriers to recruit and retain 

better-qualified drivers. For example, unionized LTL carriers provide good pay (typically 

$60-70,000 per year for drivers), pensions, and health insurance benefits; drivers at these 

companies tend to have long job tenure, sometimes staying at the same company for 30 to 

40 years. In addition, higher compensation might reduce the driver’s economic incentive 

to exceed legal and safe driving limits while increasing his or her desire to maintain a 

good driving record. 

Research Needs 

The conference participants cited a need for additional research on a wide variety of 

topics. Many discussions revolved around fatigue; how to measure it and compare it to 

other types of impairment such as alcohol intoxication; how to help drivers recognize 

when they become dangerously sleepy; and whether fatigue can be effectively managed 

through prescription drugs, light therapy, or changes to work organization. Fatigue was 

clearly a topic of concern, partially because this was an area of expertise for many of the 

participants, and partially because it appears to be a pervasive problem among drivers. 
xv

Other suggestions included: 

⇒ Explore the association between work characteristics and driver health 

⇒ Explore the relationship between driver compensation and safety, and 

quantify the society-wide benefit/cost ratio of increasing driver 

compensation 

⇒ Explore ways of increasing truck driver access to health services, 

including continuity of care needed for effective diagnosis and treatment 

⇒ Determine whether drivers’ health-related behavior can be improved by 

increasing their awareness of safety and health risks 

⇒ Compare the health risks and work characteristics of U.S. drivers to those 

of other countries 

⇒ Determine the relationship between sleep debt and endocrine function 

⇒ Study long-term effects of demanding work schedules and sleep debt 

In evaluating the potential health effects of the revised hours-of-service rules for 

trucking, the Federal Motor Carrier Safety Administration stated that due to lack of 

existing data on commercial truck driving, “...the Agency had to evaluate and weigh 

information from different fields and adapt it to a trucking environment.”1

 This statement 

makes it clear that more research specifically on commercial truck drivers is needed. 

Ideally, a research agenda addressing the most pressing issues will be developed in 

consultation with truck drivers, trucking companies, government agencies, and other 

interested parties. Such an agenda would provide direction to the safety and health 

community and ensure that concerns are addressed in a coordinated manner. 
xvi
1

Introduction 

Many truck drivers suffer from occupational safety and health problems. In 2004, truck 

drivers accounted for 15% of the fatal occupational injuries in the U.S. (873 of 5,764).2

Similarly, in 2004, they accounted for 8% of the nonfatal occupational injuries and 

illnesses involving days away from work (100,730 of 1,259,320),3

 even though they 

comprise only 2% of the workforce4 (see Table 1). In part, the substantial number of 

drivers dying on the job or suffering occupational injuries or illnesses involving lost work 

time reflects the large number of truck drivers in the U.S.: somewhat over 1.5 million 

drivers of heavy trucks or tractor-trailers and almost 940,000 drivers of light or delivery 

trucks in 2004, not counting self-employed drivers.4 Nevertheless, truck driving was 

among the occupations with the highest rates of fatal occupational injuries in 2004.5 

Table 1. Occupational Injury/Illness of 

Commercial Motor Vehicle (CMV) Operators, 20042,3

 Fatalities Percent Injury/illness Percent 

Total—all occupations 5,764 100% 1,259,320 100% 

Bus drivers 19 0.33% 3,330 0.26% 

Truck drivers, heavy, and 

 tractor trailer 779 13.51% 63,570 5.05% 

Truck drivers, light, and delivery 94 1.63% 37,160 2.95% 

Total truck drivers 873 15.15% 100,730 8.00% 

Total CMV drivers 892 15.48% 104,060 8.26% 

In order to focus attention on the seriousness of truck driver occupational safety and 

health problems and develop an agenda for future research, a conference on this topic 

convened on April 24-25, 2003, in Detroit, Michigan. The conference, which was 

organized and hosted by Professor Michael H. Belzer of Wayne State University, brought 

together over five dozen experts from government, universities, employers, industry 

associations, and labor from the United States, Europe, and Australia (see Appendix 1). 

This report provides a selective review of the relevant literature, summarizes the 30 

presentations at the conference, incorporates the comments made by many of the 

conference participants, and outlines some topics needing further research (see Appendix 

2 for the conference agenda, and the accompanying CD-ROM or 

http://www.ilir.umich.edu/TIBP/truckdriverOSH for the PowerPoint presentations, 

conference handouts, and supporting papers and reports). It also presents selected 

citations to the relevant scholarly literature. 

The conference was organized around research and problem areas important to 

occupational safety and health researchers and practitioners, as well as those areas of 

concern identified by experts in trucking industry and labor issues. Trucking industry 

representatives attended and participated, including those working in the union and non-
2

union sectors of the industry. The Owner-Operator Independent Drivers Association 

(OOIDA) and the International Brotherhood of Teamsters (IBT, to which we refer 

hereafter as the “Teamsters”) represented owner-drivers as well as employee drivers, 

ensuring that the research and industry communities were listening to each other. 

Professor Belzer attempted to include in the conference experts with a wide range of 

relevant specialties, but it was beyond the scope of this conference to develop a 

consensus statement of research priorities. All statements in this report not attributed to a 

conference presentation or a comment made by a conference participant are the 

responsibility of the authors of this report, Gregory M. Saltzman and Michael H. Belzer. 

The opinions expressed in this report are those of the conference participants or of 

Professors Saltzman and Belzer, and not necessarily those of the National Institute for 

Occupational Safety and Health. 
3

Keynote: The Need for a Research Agenda 

on Truck Driver Occupational Safety and Health 

Dr. Patricia F. Waller 

Director Emerita 

University of Michigan Transportation Research Institute 

Dr. Patricia F. Waller was unable to attend due to the illness that took her life on August 

15, 2003, before this conference report was complete. Her prepared remarks, which 

follow, stress the importance of a research effort on behalf of truck driver health and 

safety. As one of the first women and non-engineers involved in the Transportation 

Research Board nearly 40 years ago, she observed the lack of interest in this subject and 

began a lifelong effort to address commercial driver wellness issues. She notes the 

scarcity of good data about truck crashes when she first began to study the subject in the 

1970s. She also saw a need for further investigation into the reasons why truck drivers 

tend to develop chronic diseases such as diabetes at relatively early ages. She 

commended the conference organizer and sponsors for taking these steps to develop a 

research agenda on truck driver occupational safety and health. 

First, I want to say how delighted I am that this meeting is being held. It 

has long been needed. 

When I first became involved with heavy truck safety in the 1970s, there 

was essentially no attention paid to the driver, except to blame him when 

anything went wrong. Research on truck safety was funded either by the 

government, for purposes of regulation, or by the industry, for purposes of 

profit. The driver was essentially ignored. Yet it was the driver who was 

held responsible for meeting competing demands, often incompatible 

demands, and making the whole system work. 

There was essentially one database on truck crashes, the BMCS file. This 

file consisted of crash reports that were filed with the federal government, 

voluntarily, by the motor carriers. The validity of the information was 

more or less taken for granted. 

In the 1970s, the Federal Motor Carrier Safety Standards called for drivers 

to use available seat belts. But when I looked at truck crashes occurring in 

North Carolina, using the state crash file, and compared it with the BMCS 

crashes occurring in North Carolina, I found that the reports in the BMCS 

file said that 85 percent of the drivers were using their belts at the time of 

the crash. The North Carolina police reports found that only 15 percent of 

the truck drivers were using their belts. 

But there were much more serious problems. A study by Ken Campbell at 

University of Michigan, examining only fatal truck crashes nationwide, 

found that for trucks coming under ICC authorization, 19 percent of the 
4

fatal crashes were not in the BMCS file. For trucks not under ICC 

authorization, the proportion was 49 percent. And of course fatal crashes 

are much more likely to be reported. 

Nevertheless, the BMCS file was what was used for most truck crash 

analyses. A very few independent studies were conducted and found very 

different results. When discrepancies were brought up, the response was, 

“But we have 11 studies here (based on BMCS data) that show thus and 

so, and there are only two studies, based on independently collected data, 

showing something different.” So of course the 11 studies won out. 

Good data were very hard to come by. And there was a general attitude 

that if you did not have data showing there was a problem, that proved 

there wasn’t a problem. And almost no one was concerned about the plight 

of the driver. OOIDA was still a fledging organization working to help 

truck drivers become successful small businessmen (or women). In more 

recent years OOIDA has published major articles on health promotion 

topics focused on truck drivers. But there was still no body of literature 

examining the issue of truck driver health and well-being. 

In the late 1970s, the US DOT conducted public hearings on truck safety. 

Originally scheduled to last a day and a half, it soon became evident there 

would need to be at least one more day. Drivers came from as far away as 

Alaska for their five minutes at the microphone. They came in every size 

and shape imaginable, but they told very similar stories. They described 

being forced to take overloads, being forced to take trucks that did not 

have good brakes or were in some other way dangerous. They were forced 

to meet schedules that could not be met without violating safety 

regulations. And of course the whole issue of loading and unloading and 

hours of service led to dangerous situations. 

Meanwhile, the Bureau of Labor Statistics regularly published a list of the 

occupations that accounted for the most days lost under workers’ 

compensation for illness or injury. Truck drivers hold the top spot and 

have for some time. But these data were coming from an entirely different 

federal agency, and there was no communication or coordination with 

DOT. 

At the 1995 National Summit on Truck Safety, there was a physician who 

worked with the Teamster’s Union. He said that when he was first 

approached about serving in this capacity, he knew nothing about truck 

drivers or trucking. However, he got involved, and he was soon struck by 

the fact that truck drivers were developing chronic illnesses, such as 

diabetes, at much younger ages than was true for the general population. 

Still, there was no effort being made to delve into what was accounting for 

this phenomenon. 
5

Part of the reason for the failure to examine the truck driver’s plight was 

that there was no one really qualified to do it, that is, there was no one 

who had a real understanding of the truck driver and also had the skills 

necessary to conduct the necessary research. And of course there was no 

obvious source of funding. Truck drivers had no one championing their 

concerns, with adequate funding to investigate the problem. 

When I met Mike Belzer and learned of his background, I thought, “At 

last, here is someone who could make things happen in this area.” I want 

to express my delight that all of you consider this an important topic and 

are here to develop a research agenda. It is long overdue, but it is exciting 

to see it get under way. I will look forward to the results of this meeting. 

And thank you, Mike, for inviting me to come. 
6

Introduction to Trucking: Operations, Labor Markets, 

and Occupational Safety and Health 

The conference presentation by Dr. Stephen Burks (University of Minnesota, Morris) 

provided an overview of trucking services in the U.S. “For-hire” motor carriers –carriers 

that offer their services for sale to the market, and are understood to comprise the 

trucking industry – provide only a portion of trucking services. Private carriers (“not-forhire” retail, wholesale, service, or industrial companies that operate truck fleets primarily 

for their own use) or government (U.S. Postal Service, federal, state, and municipal 

governments) provide the rest. Private carriers have more heavy freight vehicles than forhire carriers do, but for-hire carriers account for more total miles per year. The average 

for-hire truck is used more intensively: for-hire trucks operate an average of 82,000 miles 

per year, compared to 32,000 miles per year for private trucks.*

 The for-hire trucking 

industry is commonly divided into segments either by shipment size (parcel; less-thantruckload, or LTL; and truckload, or TL, including specialized haulers), or by geographic 

scope (local, regional, inter-regional, national, or international) and type of commodity or 

operation. Different technologies and specialized production equipment are used for each 

segment. Barriers to entry are substantial in parcel, moderate in LTL, and minimal in TL, 

except among the specialized haulers, some of whom have very specialized equipment 

and customer networks. While most truck drivers appear to operate similar equipment 

and use similar general skills, many require specialized training, including dry and liquid 

bulk haulers, car haulers, operators of refrigerated trucks, dump truck drivers, and others. 

Dr. Burks did not have time in his presentation to describe the nature of these barriers to 

entry or the consequences of trucking market structure; therefore, the authors have added 

the following explanation. Economists recognize two broad classes of barriers to entry: 

institutional (regulatory) restrictions and economic barriers. Larger transportation firms 

have a competitive advantage over smaller firms if there are economies of route density 

or economies of scope. Economies of route density lower costs per unit for truckload 

firms when there are many shipments per week for a particular origin-destination pair, 

and for the less-than-truckload and packages sectors when there are many shipments per 

day between city pairs or within a local pickup and delivery network.†

 Economies of 

scope lower costs per unit when a single firm produces two outputs jointly, rather than 

having independent firms produce them separately.6

 Economies of scope can be spatial, if 

adding routes enables a firm to increase capacity utilization for the firm’s vehicles;7

 they 

 

*

 The Vehicle Inventory and Use Survey (VIUS), used here to analyze the trucking function and also used 

to provide a denominator for analyses of motor carrier safety and productivity, was terminated by Census in 

2006. 

†

 The distinction in transportation economics between economies of density (more trips per week on a 

particular route) and economies of scale (larger firm size) was made by Douglas W. Caves, Laurits R. 

Christensen, and Michael W. Tretheway, “Economies of Density versus Economies of Scale: Why Trunk 

and Local Service Airline Costs Differ,” The RAND Journal of Economics, Vol. 15, No. 4, Winter 1984, 

pp. 471-489. 
7

could also reflect cost savings if a single firm jointly produced LTL and parcel services. 

In a sense, all intercity LTL firms produce a joint product: local pickup and delivery, and 

intercity truckload services, because operationally the intercity move is a truckload type 

of move. There may be economies of density8

 and economies of scope in LTL and parcel 

delivery. Stigler proposed a survivor technique to infer the existence of economies of 

scale: if firms below a certain size tend to lose market share in an unregulated market, 

then one can infer that these firms were smaller than minimum efficient scale.9

 A 

survivor-technique study found that market share of LTL firms with less than 2 million 

ton-miles of freight per year was substantially lower in 1993 (after deregulation) than in 

1975 (before deregulation), suggesting that smaller LTL firms have a competitive 

disadvantage,10 although this study did not distinguish between the impact of economies 

of density and economies of scope. Recent consolidation in LTL and parcel delivery 

provides further evidence that there may be economies of density or scope in LTL and 

parcel. 

In December of 2003, Yellow Transportation, a national LTL carrier, merged with 

Roadway Express to become by far the largest LTL company in America, and in May of 

2005, Yellow-Roadway acquired USF – a national network of regional and inter-regional 

carriers – to further consolidate its dominance in LTL. Federal Express, originally a 

package carrier, purchased Viking (a west coast regional) and American Freightways (an 

east-of-the-Rocky-Mountains interregional) to establish FedEx Freight, an LTL carrier 

with national reach. In 2005, FedEx bought Watkins Motor Lines, a trans-national LTL 

carrier, to further extend its national capacity. In 2005, United Parcel Service acquired 

Overnite, one of the nation’s largest interregional carriers, purchasing it from Union 

Pacific, which had hauled the trans-national freight on the railroad. These consolidations 

have transformed the entire LTL sector, creating an entirely new competitive 

environment. 

In contrast, the TL sector has perhaps hundreds of thousands of small firms. Consistent 

with the economic model of perfect competition, a single small TL firm has almost no 

power to influence the price of the trucking services it sells; it is at the mercy of market 

forces beyond its control. But the growth of large and sophisticated TL carriers such as 

J.B. Hunt and Schneider National suggests that some segments of TL may have 

economies of density or economies of scope. Large TL firms often develop subsidiary 

operations providing third-party logistics services (“3PLs”) to shippers and consignees in 

an effort to take advantage of economies of scope to attract freight and fill up their 

network (which gives them economies of density). It also provides additional services 

(two outputs, in economists’ parlance) in an effort to increase their firm’s value to their 

customers and giving the customer an opportunity for “one-stop shopping.” 

Market concentration in trucking is similar in the U.S. and Europe, but Dr. Dieter Plehwe 

(Social Science Research Center Berlin and, at the time of the conference, Yale 

University) stated that trucking in the European Union (EU) has experienced paradoxical 
8

change. While the package express sector has consolidated, as have some of the large 

trucking companies that span the entire EU, small- and medium-sized firms have actually 

become even smaller, fueling a growing gap between large and small firms.* 

Many TL firms consist of a single owner-operator who owns one truck, arranges for 

freight, operates under his or her own authority (hence the term “owner-operator”) and 

drives the truck. Data from the University of Michigan Trucking Industry Program 

suggest that approximately 85% of all owner-drivers lease both their truck and 

themselves to a larger motor carrier, under whose authority they operate. More recent 

data collected by the Wayne State University Trucking Industry Benchmarking Program 

suggest that this fraction may have dropped to as low as 65%, although these data may be 

biased toward more independent operators since they were collected on line from OOIDA 

members in a very sophisticated survey.13 While most of these individuals either own 

their trucks outright or obtain financing from a bank or financing company, some of them 

– many with very little personal capital – lease their trucks from a firm loosely affiliated 

with the carrier to which they are leased. This quasi-employment/debtor relationship may 

put them into debt peonage, in which they incur large financial obligations to pay for the 

capital cost of leasing or buying their truck and then find it difficult or impossible to 

generate enough revenues to meet these obligations, much less have something left over 

to pay themselves wages for their driving labor. The leasing company can declare the 

“owner”-driver in default if he or she is unable to meet the lease obligations, whereupon 

it repossesses the truck and leases it to someone else. Like the coal miners in Tennessee 

Ernie Ford’s song, “Sixteen Tons,” they owe their souls to the company store. 

Owner-operators often have had little training in financial management of business, much 

less the incredibly complex business of interstate trucking, with its maze of licensing and 

taxation regimes and intense competition. Dr. Burks characterized the situation of many 

owner-operators as a failure of rational choice; a stream of new owner-operators 

continually enters the industry, even though the average owner-operator appears to make 

less money than employee drivers, use up their business capital in a relatively short time, 

and go out of business at a high rate. John Siebert (Owner-Operator Independent Drivers 

Association) noted that the highly competitive market structure in TL shipping services 

causes productivity improvements to drive down shipping prices, rather than to raise the 

earnings of owner-operators above those of employee drivers (who do not undertake the 

risk of purchasing and maintaining capital, and operating a business).†

 Another 

 

*

 See also Plehwe, Dieter, “National Trajectories, International Competition, and Transnational Governance 

in Europe,” in G. Morgan, P. H. Kristensen, and R. Whitley (eds.), The Multinational Firm: Organizing 

across Institutional and National Boundaries (Oxford: Oxford University Press, 2001), pp. 281–305 and 

Dr. Plehwe’s conference presentation on the accompanying CD-ROM. 

†

 For a recent analysis of owner-operator cost-of-operations and earnings, see Belzer, Michael H. (2006), 

'OOIDA 2003-2004 Cost of Operations Survey: Report of Results', (Detroit, MI: Wayne State University). 

This on-line survey of 421 owner-drivers shows that owner-operators who have no employees and drive 

their own trucks earn an average net operating profit per mile of 36.4 cents, of which 6.8 cents is wages 

they pay to themselves. See www.ilir.umich.edu/TIBP. Available from the author by request. 
9

conference participant characterized many owner-operators as bogus entrepreneurs, 

saying that owner-operators who always work for the same companies are covert 

employees. Indeed, the unclear standards governing the status of what some other nations 

call “dependent owner-operators” continue to be an issue.11 Although the National Labor 

Relations Board was supposed to have clarified the matter,12 court judgments in recent 

lawsuits in California and elsewhere have found that dependent owner-operators (such as 

those driving package delivery trucks for FedEx) do not meet the tests of independence 

sufficient to distinguish them from employees. 

Dr. Michael Belzer (Wayne State University and the University of Michigan Institute of 

Labor and Industrial Relations) proposed a framework for understanding the nature of the 

economic and operational problems faced by truck drivers. His presentation was based on 

his trucking industry, truck driver, and motor carrier safety research, including research 

reported in his book, Sweatshops on Wheels.13 The structure of the trucking industry 

changed radically soon after deregulation in 1980, as formerly regulated common carriers 

“burdened” with health care and pension costs – as well as with hitherto required terminal 

overhead – failed to compete with new-entrant truckload carriers that were non-union, 

had no pension or health care liabilities, and little capital overhead.14 Trucking shifted 

from being predominantly union-represented before deregulation in 1980 to less than 

15% unionized today.15 This has caused trucking firms to compete on the basis of wage 

costs, and just as carriers have little bargaining power to influence rates, individual 

drivers have little bargaining leverage or market power to raise their wages. 

Drivers work long hours; for example, intercity drivers work an average of 65 hours per 

week, which is 5 hours more per week than legally allowed.* However, about 25% of 

their work time is unpaid. Ten percent of all over-the-road drivers work 94 hours or more 

per week. Drivers’ individual decisions to work illegally long hours contribute to their 

problem by supplying excessive labor to the marketplace in what becomes a selfperpetuating sweatshop environment. Drivers’ work schedules also are irregular, both in 

terms of days of the week worked and time of day worked, and this irregularity likely 

contributes to both safety and health problems. 

Truck drivers’ wages are low: the University of Michigan Trucking Industry Program’s 

Truck Driver Survey in 1997 found that nonunion truckload drivers earned the equivalent 

 

*

 Under regulations in effect at the time of the conference and until January 4, 2004, drivers technically 

could work to complete tasks they were performing at the time they ran out of hours, but they could not 

drive after they have worked 60 hours in a seven-day period or 70 hours in an eight-day period. The 

regulations that became effective in January 2004 have almost the same weekly limit rules except that 

drivers who use up their weekly hours can invoke the 34-hour restart provision, allowing them to work 

legally up to 84 hours per week. Regulatory enforcement, however, has been a long-standing issue because 

it is based primarily on driver self-report. Drivers historically have falsified their Records of Duty Status 

(“log books”) to exceed weekly limits, and both public and private surveys have demonstrated that the top 

25% exceed these weekly limits by 25% and the top 10% exceed them by 50% – too many hours to be 

explained by non-driving work beyond the daily limit. 
10

of a job with overtime premium pay that had a base wage of just $8.17 per hour.16 See 

also Belman and Monaco (2001).17 Current Population Survey data also indicate that 

driver earnings are low; drivers who work up to the legal limit earn about $7 per hour, 

and those who work more hours than the legal limit earn $6.20 per hour overall.18 Driver 

wages have fallen 30% in real (inflation-adjusted) terms since 1980 due to the 

elimination of barriers to entry, deregulation of prices for trucking services, the dramatic 

increase in interfirm competition, and the drastic decline of unionization in trucking.19

Drivers often live in their trucks and are away from home for extended periods. As a 

result, employee turnover is high, particularly in the truckload sector – typically 100% 

per year in the non-union truckload sector (where wages are substantially lower than in 

unionized sectors). In recent years, the average turnover rate has been steady at about 

130%. 

Labor economist John Budd has argued that employers’ demand for efficiency should be 

balanced with employees’ demand for equity and voice. He bases his argument on a 

business ethics paradigm; while he allows that people have different ethical models, he 

points out that people must have an ethical framework of some kind. The balance among 

the three objectives of the employment relationship – efficiency, equity, and voice – can 

be analyzed using the ethics of utilitarianism (based on Jeremy Bentham and John Stuart 

Mill, stressing efficiency), the ethics of liberty (based on John Locke, stressing property 

rights), the ethics of duty (based on Immanuel Kant, stressing respect for human dignity 

and the Golden Rule), the ethics of virtue (based on Aristotle, stressing moral character), 

the ethics of justice (based on John Rawls, stressing personal liberty, equal opportunity, 

and concern for the poor), and the ethics of care (based on Carol Gilligan’s notion of 

nurture).20 Businesses and citizens make their decisions based on these ethical 

frameworks. In Belzer’s view, as more trucks become sweatshops on wheels, policymakers have given too much attention to efficiency and too little attention to equity and 

voice in the supply chain. Although truckers have come to understand that low truck 

driver compensation underlies the labor supply problems the industry faces, the shipping 

community continues to take advantage of cheap freight based on low compensation and 

low trucking industry profits. 

Trucking industry competition, Dr. Belzer said, has adversely affected highway safety. 

Low wages have forced the industry to hire drivers with undesirable characteristics, 

created perverse incentives that motivate drivers to cheat on their logs and motivate 

carriers to turn a blind eye to such cheating, and this has made it difficult to retain 

experienced qualified drivers.21 The increased use of just-in-time delivery has put 

additional pressure on drivers to meet tight schedules. Dr. Belzer argued that reducing 

driver hours (especially unpaid labor time) and increasing driver compensation could 

improve highway safety. Charging shippers and consignees for delay time would reduce 

unproductive use of driver time, thereby minimizing lost production associated with 

reductions in driver work hours, and reducing drivers’ incentive to log unpaid time as 

non-work time and exceed legally prescribed hours-of-service limits. It would mitigate 
11

the problem that economists call “moral hazard,” or living on “somebody else’s money:” 

shippers would absorb the cost of delays for which they are responsible.* 

These pressures on drivers to work longer hours and run more miles for less money puts 

drivers in a no-win situation. Dr. Gregory Saltzman (Albion College and the University 

of Michigan Institute of Labor and Industrial Relations) discussed the need for federal 

regulation of truck driver work hours to keep competition within socially acceptable 

bounds. He noted that federal hours-of-service (HOS) regulations have limited work 

hours of interstate truck and bus drivers since 1938. Violations of HOS regulations, 

however, are widespread. Furthermore, long and irregular driver hours adversely affect 

highway safety and driver health. He recommended that the federal government enforce 

existing HOS regulations with electronic on-board recorders (EOBRs), similar to those 

required in the European Union, noting that EOBRs would reduce the tendency of 

trucking companies to base their competitive advantage on their willingness to violate the 

law. He also recommended that HOS regulations be amended to guarantee a weekly day 

of rest and to foster 24-hour work/rest cycles. 

In an idealized economic model, Dr. Saltzman noted, there would be no need for 

government HOS regulations. If long work hours have an adverse effect on drivers’ 

health, family life, and sense of well being, then drivers will demand higher hourly pay 

for jobs that entail long hours. Trucking companies and shippers will be willing to pay 

the cost of these compensating wage differentials only if the benefit to them of having 

drivers work long hours is large enough to justify the cost. In short, market forces reduce 

driver hours whenever the benefits from reduced hours exceed the costs. 

Dr. Saltzman added, however, that economists recognize two circumstances that would 

justify government regulation notwithstanding the above argument. First, the distribution 

of income may not be ethically acceptable. Truck drivers work longer than average hours 

and face a high risk of occupational fatality, for lower than average hourly pay. 

 

*

 The Federal Motor Carrier Safety Administration announced new Hours of Service rules on the day of 

this conference. One part of the new rules may help to solve this problem, albeit indirectly. Although many 

experts have considered this interpretation illegal, under the HOS rules existing at the time of the 

conference as they were interpreted by the Federal Highway Administration’s Office of Motor Carriers 

(FMCSA’s predecessor), drivers had been allowed to log as much time off duty during any “tour of duty” 

as they wished. Since road drivers almost always are paid only “when the wheels are turning,” they 

typically would log loading, unloading, and waiting time as “off duty.” Under the new rules, truck drivers 

“may not drive beyond the 14th hour after coming on-duty, following 10 hours off duty.” Since “breaks do 

not extend on-duty time” under the new rule, either driver productivity will decline or shippers and 

consignees will become much more efficient in the use of drivers’ time. While they may still log time off 

during their 14-hour tour-of-duty, they will not be able to extend their work day. See final rule: Department 

of Transportation, Federal Motor Carrier Safety Administration, 49 CFR Parts 385, 390, and 395, “Hours 

of Service of Drivers; Driver Rest and Sleep for Safe Operations,” Federal Register, Vol. 68, No. 81, 

Monday, April 28, 2003, pages 22456–22517. 
12

Second, market failures prevent an unregulated market for truck driver labor from 

achieving economic efficiency. Truck drivers’ long work hours creates what is known as 

an externality – a situation where some of the costs or benefits of a decision spill over to 

third parties not involved in making that decision. Long work hours for truck drivers 

endanger the safety of other highway users, and some of the damage caused by highway 

collisions is either not fully compensated or is compensated through insurance policies 

that are not fully experience-rated. As a result of this externality, an unregulated free 

market provides less than the efficient level of highway safety. Similarly, the unregulated 

market creates a health-related externality because some of the costs of unhealthy 

working conditions for drivers spill over to third parties. These third parties include 

insurance companies (because trucking companies generally are too small to have fully 

experience-rated health insurance plans), subsequent employers or taxpayers (because 

health effects may become manifest years later, when the driver is employed elsewhere or 

is covered by Medicare), and health providers (because of uncompensated care for 

current or former drivers without health insurance). 

Another class of market failures includes inadequate or asymmetric information and 

cognitive problems in processing data. The long latent period for occupational illnesses 

such as diabetes and cardiovascular disease prevents drivers from recognizing the 

importance of changing their employment conditions until much of the health damage has 

already been done. Furthermore, as Akerlof and Dickens noted, cognitive dissonance 

often causes workers to underestimate the health risks they face in the workplace, as 

allowing themselves to recognize these risks would be too stressful.22 Because of these 

information and cognitive problems, labor markets do not force trucking companies and, 

ultimately shippers, to pay drivers higher wages to compensate them fully for assuming 

health risks. Similarly, decisions by managers may be distorted when some costs are not 

explicit. Since nonunion long-haul and regional drivers typically are paid only by the 

mile, with no separate pay for non-driving work, trucking companies and shippers 

perceive driver waiting and loading time as free; they therefore fail to re-engineer 

inefficient aspects of their operations. Finally, economic theory does not assert that 

existing regulations continue to be efficient. Hours-of-service regulations designed at a 

time of regulated trucking rates and maintained in an era of strong union protection for 

drivers, high production costs for EOBRs, and limited scientific knowledge of adverse 

health and safety effects of sleep deprivation, may no longer be appropriate today. 

One potential area for future research would be to assess the impact of a small business 

training program on the safety records of owner-operators. Are owner-operators who 

understand their costs less likely to face intense financial pressures that lead them to drive 

when they should be sleeping? Another potential area for future research would be to 

determine whether the self-employed drivers in the U.S., like those in Australia, are more 

likely to have safety problems. Are self-employed drivers in the U.S. more likely to have 

nonfatal or fatal crashes? 

In response to this presentation, Dr. Michael Quinlan noted that self-employed workers in 

Australia have higher fatality rates in mining as well as in trucking because there is less 

regulation for self-employed workers and because self-employed workers are less likely 
13

to be unionized. He said that unionization of long-haul truck drivers in Australia had 

fallen dramatically as employee drivers became self-employed, even though they have a 

protected right to unionize (unlike similarly employed U.S. drivers). Dr. Quinlan reported 

that the Transport Workers Union had pushed for a bill in the Australian federal Senate to 

set a minimum compensation rate per kilometer for owner-operators in order to improve 

highway safety and protect the interests of owner-operators; but the bill seemed unlikely 

to pass soon. 

Dr. Michael Quinlan (University of New South Wales) presented information centered on 

the impact of commercial arrangements and competitive forces on occupational safety 

and health in Australian long-haul trucking. During 2000 and 2001, he prepared a report 

on this topic for the Motor Accidents Authority of New South Wales23 (document 

included on accompanying CD-ROM and available at http://www.ilir.umich.edu/TIBP/ 

truckdriverOSH). Intense competition among carriers and drivers, he said, causes 

instability and insecurity. Commercial pressures stemming from low rates adversely 

affect safety, Dr. Quinlan continued, because irresponsible and desperate carriers 

undercut responsible ones. The result is evasion of occupational safety and health 

regulations and inadequate maintenance. It is also difficult for regulators to obtain 

cooperation from drivers. Logbooks for hours are called “cheat sheets” in Australia; long 

hours, speeding, and drug use are common among drivers. In cases of serious road 

incidents, drivers are reluctant to give evidence in court that will cause them to lose their 

jobs. 

Dr. Quinlan gave particular emphasis to the role of shippers and consignees, who control 

rates, scheduling, and service because they generally are larger and more powerful than 

motor carriers, and as the source of carriers’ business have powerful market leverage. 

Shippers and consignees have little incentive to improve driver safety and health because 

the costs of driver occupational safety and health problems are borne by others. The 

subcontracting chain obscures their legal responsibility. According to Dr. Quinlan, 

lawyers inform shippers that the less they know about the operations of the motor carriers 

they hire, the less they are liable for safety violations. Dr. Quinlan cited a need to 

establish a chain of responsibility, in which “all parties to commercial arrangement for 

supplying a service or good have legal duties, not just those who carry out the actual 

task.” He noted that shipper liability laws have been enacted in Saskatchewan and 

Manitoba and that one is being considered in California. His 2001 report proposed a 

requirement that shippers and consignees (as well as drivers) sign documents attesting to 

trip routes, departure times, and arrival times to provide an evidentiary trail regarding 

driver hours. It also called for demurrage clauses (so that shippers and consignees 

minimize waiting time) and for a ban on arrival time bonuses and penalties (so that 

drivers will be under less time pressure). Dr. Quinlan argued that making shippers and 

consignees legally responsible would change health and safety outcomes by shifting 

responsibility to those who actually dominate the freight transportation process. 

Other conference participants agreed with Dr. Quinlan’s emphasis on shippers. Ms. 

Katharine Newman argued that one cannot design effective mitigation strategies for 

dangerously long driver work hours without involving shippers. One participant 
14

suggested that shippers would come to the table only when they are confronted with a 

mandate regarding the imposition of driver hours, while others emphasized the 

importance of establishing a chain of responsibility. Dr. Dieter Plehwe reported that in 

Germany, the shipper is liable for violations of regulations regarding driver work hours. 

This stops shippers from pushing prices for trucking services down to such low levels 

that HOS violations are inevitable. An implication of the conference discussion is the 

following ethical question for consumers who benefit from low shipping costs: what level 

of risk are people willing to accept in trade for cheaper goods? In the case of trucking, 

consumers share much of the truck drivers’ safety risks because the public highway is the 

truck drivers’ assembly line. 

Trucking firms have fixed costs: freight terminals, network development, and routeoptimization systems for package delivery and LTL firms; network development and 

route-optimization systems for TL firms; and the capital cost of trucks for all trucking 

firms. Intensive capital utilization reduces average costs for trucking firms. Dr. Plehwe 

commented that trucking firms need to operate their trucks intensively in order to make 

money. To accomplish this, carriers may demand that drivers run more miles and carry 

more freight. Another strategy is to have more than one driver per truck. Drivers who 

team with another driver can operate 24 hours a day, seven days a week (though not in 

Central Europe). Trucks can also operate around the clock by “slip-seating” drivers – 

rotating drivers in the same truck, either as a relay for over-the-road operations, or with 

sequential shifts for local work. Many drivers, however, do not like to share trucks with 

other drivers, and especially do not like to run team. Mr. Ron Jager, an owner-operator, 

noted that owner-operators tend to avoid co-drivers because they do not want to put their 

lives into somebody else’s hands. Mike Belzer, a former over-the-road driver, concurred 

from the perspective of an employee driver. 

Dr. Dieter Plehwe (Social Science Research Center Berlin and, at the time of the 

conference, Yale University) gave a presentation on trucking regulation in the European 

Union (EU). He noted a tension between two perspectives. There is widespread support 

for improving driver safety and health and for reducing air pollution from trucks. 

Nevertheless, free market advocates oppose economic regulation, and small motor 

carriers cannot afford increased costs for labor, fuel, and road use. 

In the 1990s, Dr. Plehwe continued, the EU gradually deregulated rail transport, but it 

rapidly deregulated trucking. Cross-border liberalization allowed more Eastern European 

truck drivers to work in Western Europe, a trend accelerated by the economic collapse of 

Eastern Europe. Yet large disparities remain within Europe in working time and 

internalization of external cost (i.e., social and environmental harmonization is slow). Dr. 

Plehwe noted that these disparities are larger among the countries of the EU than they are 

within in the U.S. and perhaps similar to those within NAFTA. 

Dr. Plehwe explained that there are two categories of EU rules. European Union 

“directives” (“soft law”) require national legislatures to adopt laws meeting EU minimum 

standards. European Union “regulations” (“hard law”) take effect immediately, without 
15

any need for action by national legislatures. In the 1990s, there was a substantial increase 

in EU regulations related to transport. 

Some of the EU transport rules were aimed at creation of a single European market. EU 

Regulation 92/881 of 1992 made it easier for EU carriers to operate across national 

borders within the EU. Regulation 93/3118 of 1993 changed cabotage rules *; it allowed 

carriers from one EU state to handle shipments whose points of origin and delivery were 

both in other EU states. After these regulations were adopted, trucking competition 

intensified within the EU, driving down shipping prices and driver wages. 

Other EU rules relate to driving time and total working time. Regulation 3820/85 of 1985 

limited drivers, including owner-operators, to an average of 9 hours of driving per day. 

Directive 93/104/EC regulating work hours for most EU workers did not apply to the 

transport sector. Employer/union negotiations in rail reached an agreement on working 

hours, but these negotiations failed in road transport. In March 2002, the European 

Parliament adopted Directive 2002/15/EC, which required national legislatures to limit 

working hours for truck drivers to an average of 48 hours per week (averaged over a 4-

month period), and a maximum of 60 hours per week. These limits will apply to 

employee drivers no later than March 2005, and to self-employed drivers no later than 

March 2009.24

Dr. Plehwe said that limits on driving time are not effectively enforced anywhere. He 

predicted, however, that enforcement will be assisted by the EU requirement of secondgeneration tachographs. These will be digital and will record more data than the driving 

hours and driving speed recorded by first-generation tachographs. 

One important topic for future research is to assess the effectiveness of the EU’s secondgeneration tachographs in improving truck driver occupational safety and health. These 

devices (called electronic on board recorders, or EOBRs, in FMCSA’s May 2000 hoursof-service proposal) can enforce limits on driving time for single-driver operations, 

though overall limits on work time might still be exceeded because the devices will not 

record waiting time or other non-driving work time. As noted in a later section, Dr. 

Patrick Hamelin reported that non-driving work time accounted for about 30% of total 

driver work time, so the inability to record non-driving work time is a major limitation. 

The effectiveness of EOBRs is further compromised in team operations where one driver 

operates the vehicle and another driver sleeps. Even with a coded and password-protected 

electronic card, two drivers may collude to use each other’s card and password to split the 

driving however they wish. Privacy concerns may prevent the adoption of a more secure 

system that uses biometrics or face recognition technology to provide electronic tracking 

and logging of truck driver activity, though a similar biometric control has been specified 

 

*

 Trans-national carriers engage in “cabotage” when they haul freight from their home country to another 

country, and then haul domestic freight (point to point pickup and delivery) on movements within that 

destination country. For example, a Bulgarian motor carrier that hauls freight into France would be 

performing cabotage if it delivered freight to Paris and picked up freight in Paris destined for Marseilles. 
16

as part of the Transportation Worker Identification Card that soon will be required in the 

U.S. by Department of Homeland Security regulations. Nevertheless, even without 

biometrics or face recognition technology, EOBRs are substantially harder to falsify than 

are the paper work logs now used in the U.S. American policy makers may be able to 

learn from EU experience with second-generation tachographs; if the European 

experience is favorable, then field trials could be conducted in the U.S. in which motor 

carriers or owner-operators are provided incentives to use EOBRs in their trucks. Dr. 

William Rogers predicted that EOBRs would have a greater impact on the TL sector than 

on the LTL sector as drivers in the TL sector are less likely to be in compliance with 

HOS regulations. 

April 2003 Revisions in U.S. Hours-of-Service Rules 

On April 24, 2003 (the first day of the conference), FMCSA announced the first 

significant changes since 1962 in hours-of-service regulations covering interstate truck 

drivers.*

 On the evening of April 24, these new HOS rules were discussed by a panel 

including Mr. David Snyder, Vice President and General Counsel for the American 

Insurance Association (who was in Washington for the FMCSA announcement and 

participated in the conference by speaker phone); Mr. Robert Rothstein, General Counsel 

for the American Moving and Storage Association; and Mr. Ron Jager, an owneroperator.†

 The new rules, which took effect on January 4, 2004, apply to truck drivers but 

not to interstate bus drivers (who remain under the old rules). Some aspects of these new 

rules are applicable to certain other drivers, while some drivers continue to be exempted 

from portions of the old and new rules. Partially exempt industrial operations include oil 

field operations, ground water well drilling operations, construction materials and 

equipment, and utility service vehicles; agricultural operations are entirely exempt insofar 

as they do not exceed a 100-mile radius of operations and operate during planting and 

harvesting seasons as determined by the states. The new rules make several changes: 

 

*

 The Circuit Court of Appeals struck down the new HOS regulations in July 2004 on the grounds that 

FMSCA “neglected to consider a statutorily mandated factor - the impact of the rule on the health of 

drivers.” See Public Citizen v. Federal Motor Carrier Safety Administration, 374 F.3d 1209 at 1216 (D.C. 

Circuit, 2004). The motor carrier industry especially did not want to return to the old regulation, having 

spent a great deal of money restructuring their operations and re-educating their employees to comply with 

the new regulation. After a period of legal and political wrangling, Congress passed a law in September 

2004, giving FMCSA one year to develop new regulations and an analysis that would comply with the 

court’s ruling. FMCSA issued a new rule in September 2005, modifying the HOS rules originally issued in 

April 2003, by requiring drivers using the sleeper berth provision to take at least 8 consecutive hours in the 

sleeper berth, with the modification effective October 1, 2005; it also issued a new analysis addressing 

health issues. See 

http://www.fmcsa.dot.gov/rules-regulations/topics/hos/hos-2005.htm, available online on June 27, 2006, 

and included on the accompanying CD-ROM and at http://www.ilir.umich.edu/TIBP/truckdriverOSH. †

 Note: this discussion is included at this point in the conference report, rather than at the conclusion of the 

first day’s report, because it pertains to the issues of regulation and operation. 
17

⇒ They allow truck drivers to drive for 11 hours in each work/rest cycle, rather than 

in the previous rule. 

⇒ They prohibit an individual from driving after the 14th hour after having come on 

duty for the current work shift (i.e. drivers cannot extend their work shift by 

taking breaks or by logging loading, unloading, or waiting time “off duty”). 

⇒ They require that each work/rest cycle include an off-duty period of 10 hours, 

rather than 8 in the previous rule. 

⇒ For team drivers, the rules allow this 10-hour off-duty period to be divided into 

two separate segments, provided that no segment is less than two hours long.*

⇒ They allow drivers who have been on duty for 60 hours within 7 consecutive days 

(for six-day-per-week operations) or 70 hours within 8 consecutive days (for 

seven-day operations) to resume work after an off-duty “restart” period of 34 

consecutive hours, rather than having to wait until the 7-day or 8-day period† is 

over. 

States will have three years to change their regulations to make them consistent with the 

new HOS rules. 

The new restart provision allows truck drivers to drive more hours per week. Under the 

new regulations, if a driver works for a company that operates six days per week, he or 

she can start at midnight on Sunday morning, and have 21-hour drive/rest cycles (11 

hours of driving and 10 hours off duty). Thus, a driver can complete 60 hours of driving 

in a period of 110 hours, rotating his or her circadian clock backward three hours per day. 

The driver’s first workweek, therefore, could last approximately 5 1⁄2 days, spanning 110 

hours. The 34-hour restart makes him or her available to drive again at midnight on 

Saturday morning with a fresh set of hours, for a theoretical maximum of 74 hours of 

driving in a seven-day period (see table 4). 

The new provisions have particular importance for long-haul firms, which typically 

operate on a seven-day week (which invokes application of the eight-day rule). Drivers 

would run out of driving time early on their sixth day of work, allowing them to drive 70 

hours in a 124-hour time span but be eligible to start fresh again as soon as 8 PM on the 

seventh day. They also would be able to drive as many as 74 hours in a seven-day period 

(see table 5). In all cases, it allows as much as a three-hour backward rotation of the 

wake-sleep cycle per day, though in practice the impact is unclear. 

 

*

 The rules effective October 1, 2005, require a single eight-hour period for sleep, plus the additional two 

hours. The rules require the driver to remain in the berth for the entire eight hours, a requirement to which 

many drivers object. 

†

 These seven- and eight-day periods constitute the truck driver’s work week and this is common parlance 

in the trucking industry (the FMCSA refers to these periods as the “week” and the “workweek” in the 

regulation), but the 74- and 84-hour maximum to which we refer in subsequent paragraphs applies to the 

seven-calendar-day week. 
18

If a driver has non-driving work duties (and most drivers do), then the reset provision 

would also allow more hours of total work per week. A driver on a 14/10 schedule (14 

hours of work, including at least 3 hours of breaks or work other than driving) and 

working for a company that operates six days per week could run out of hours early on 

the fifth day (a 100-hour time span), but end up working as many as 84 hours during a 

seven-day week (see table 6).* A driver working for a firm that operates seven days per 

week – a more likely scenario – would be permitted to complete 70 hours of work in five 

days, running out of hours after a workweek spanning 110 hours. After the restart period 

on day six, the driver could begin with fresh hours, working a full fourteen-hour day on 

day seven (see table 7). This driver also can work 84 hours in seven days, or 20% more 

possible working hours than under the previous rules. 

Tables 2–7 illustrate scenarios involving maximum working time under both old and new 

rules. For all tables, we assume that drivers take no breaks and work the maximum hours 

on all days. Realistically, the driver will take breaks and may well log waiting or nondriving labor time as off duty, extending the number of hours available during a week. 

This will not extend his or her daily hours, however, since they are limited by the 14-hour 

rule. 

Indeed, the most significant effect of this rule will be felt on a daily basis. When a driver 

starts fresh with 14 hours to work (including 11 hours of driving time), he or she may not 

drive beyond the 14th hour. This means that delays experienced en-route (either from 

traffic or from customers who force the driver to wait to load or unload), whether logged 

on-duty or off-duty, will count against his or her overall daily work time available. In 

addition, drivers might work less than the available 14 hours, log off for 10 hours, and 

then start a new work shift. This will cause the driver’s start time to vary, potentially 

rotating the driver’s circadian schedule forward or backward. Both of these real-world 

examples may significantly reduce the maximum hours estimates above. 

An important question is how the change in HOS regulations will affect productivity. 

While FMCSA estimates a 3.9% increase in long-haul productivity (primarily derived 

from the additional driving hour),25 J.B. Hunt estimates a 2.6% drop in utilization and a 

2.4% decline in on-time performance, using the 34-hour restart.26 Schneider estimates 

productivity declines up to 20%, depending freight characteristics and length of haul 

productivity enhancement on the part of shippers and consignees.27 It is important to 

distinguish between labor productivity (output per hour) and production (total output), 

however, as an increase in driver hours might raise production but cut labor productivity 

 

*

 Note that even though drivers work for carriers that operate 6 days per week, these drivers can work 7 

days per week; how a carrier not operating 7 days a week has drivers working 7 days a week is not 

explained. Although they may not exceed 60 hours of work per week, the 34-hour restart negates the effect 

of the rule because they can drive 74 hours per week and work 84 hours per week, which is a 37% increase 

in working time. While Table 4 shows the driver driving all available working hours taking a day off, this is 

arbitrary because normally driver schedules vary from this extreme with unpredictable affects on hours of 

work. Table 5 shows a driver for the same kind of carrier unambiguously working 7 days a week. 
19

Table 2. Driving Maximum Hours, Old Rules 

Day Time of day Hours Totals 

Day 1 12 am – 10 am 10 10 

Day 1 – 2 6 pm – 4 am 10 20 

Day 2 12 pm – 10 pm 10 30 

Day 3 6 am – 4 pm 10 40 

Day 4 12 am – 10 am 10 50 

Day 5 – 6* 6 pm – 4 am 10 60 

Day 6** 12 pm – 10 pm 10 70 

Day 7 OFF DUTY 0 70 

* For those on 7-day week, out of hours until midnight, start of Day 8 

** For those on 8-day week, out of hours until midnight, sart of Day 9 

Table 3. Working Maximum Hours, Old Rules 

Day Time of day Hours Totals 

Day 1 12 am – 3 pm 15 15 

Day 1 – 2 11pm – 2 pm 15 30 

Day 2 – 3 10 pm – 1 pm 15 45 

Day 3 – 4* 9 pm – 12 pm 15 60 

Day 4 – 5** 8 pm – 6 am 10 70 

Day 6 OFF DUTY 0 70 

Day 7 OFF DUTY 0 70 

* For those on 7-day week, out of hours until midnight, start of Day 8 

** For those on 8-day week, out of hours until midnight, start of Day 9 

Table 4. Driving Maximum Hours, New Rules, 

Carriers Operating Six Days a Week 

Day Time of day Hours Totals 

Day 1 12 am – 11 am 11 11 

Day 1 – 2 9 pm – 8 am 11 22 

Day 2 – 3 6 pm – 5 am 11 33 

Day 3 – 4 3 pm – 2 am 11 44 

Day 4 12 pm – 11 pm 11 55 

Day 5* 9 am – 2 pm 5 60 

Day 6* OFF DUTY 0 60 

Day 7 12 am – 11 am 11 71 

Day 7 9 pm – 12:00 am 3 74 

Drivers on seven-day log 

* 34-hour restart between 2 pm on Day 5 through 12 am, Day 7 
20

Table 5. Driving Maximum Hours, New Rules 

Carriers Operating Seven Days a Week 

Day Time of day Hours Totals 

Day 1 12 am – 11 am 11 11 

Day 1 – 2 9 pm – 8 am 11 22 

Day 2 – 3 6 pm – 5 am 11 33 

Day 3 – 4 3 pm – 2 am 11 44 

Day 4 12 pm – 11 pm 11 55 

Day 5 9 am – 8 pm 11 66 

Day 6* 6 am – 10 am 4 70 

Day 7* 8 pm – 12 am 4 74 

Drivers on eight-day log 

* 34-hour restart between 10 am on Day 6 through 8 pm, Day 7 

Table 6. Working Maximum Hours, New Rules 

Carriers Operating Six Days a Week 

Day Time of day Hours Totals 

Day 1 12 am – 2 pm 14 14 

Day 2 12 am – 2 pm 14 28 

Day 3 12 am – 2 pm 14 42 

Day 4 12 am – 2 pm 14 56 

Day 5* 12 am – 4 am 4 60 

Day 6–7* 2 pm – 4 am 14 74 

Day 7 2 pm – 12 am 10 84 

Drivers on seven-day log 

*34-hour restart from 4 am on Day 5 to 2 pm on Day 6 

 Table 7. Working Maximum Hours, New Rules 

 Carriers Operating Seven Days a Week* 

Day Time of day Hours Totals 

Day 1 12 am – 2 pm 14 14 

Day 2 12 am – 2 pm 14 28 

Day 3 12 am – 2 pm 14 42 

Day 4 12 am – 2 pm 14 56 

Day 5 12 am – 2 pm 14 70 

Day 6* OFF DUTY 0 70 

Day 7 12 am – 2 pm 14 84 

Drivers on eight-day log 

* 34-hour restart goes from 2 pm on Day 5 to 12 am on Day 7 
21

if fatigue diminishes the effectiveness of drivers. Further empirical research on the 

impact of HOS regulations on both productivity and production may be useful for policy 

makers. 

David Snyder praised certain aspects of FMCSA’s new HOS rules. He said that they 

followed the findings of sleep science by moving closer to 24-hour work/rest cycles (21 

hours if driving time is maximized under the new rules, compared with the 18-hour 

work/rest cycles allowed under the 1962 amendments to the HOS rules), even if he would 

have preferred that they move farther in that direction. He supported the increase in offduty periods to at least 10 hours in each work/rest cycle. Nevertheless, Mr. Snyder was 

disappointed that the new HOS rules did not address enforcement with EOBRs and that 

the 34-hour restart period allows drivers to work more hours per week than the old rules 

do. He also said that the new rules are no simpler than the old rules and thus, no easier to 

administer. 

Mr. Rothstein reported that FMCSA had not run a field test of the new HOS rules prior to 

announcing them. He said it would have been preferable to have run such a field test to 

determine the effects of the new rules on driver sleep and operational requirements of 

motor carriers. Nevertheless, Mr. Rothstein generally supported the new rules. 

Mr. Rothstein pointed out that the new HOS rules were simpler than the HOS proposal 

that FMCSA put forth in May 2000, which had different rules for each of five classes of 

drivers. He was pleased that the new rules did not require EOBRs. He said that the 

industry objected to the cost of EOBRs. He also noted that the American Trucking 

Associations had expressed concern that EOBRs would put truck owners and drivers at a 

disadvantage in crash litigation where a truck and a car collide; the truck’s speed and the 

number of hours the truck driver had been driving would be recorded by an EOBR, but 

comparable information about the car would not be available.* Finally, Mr. Rothstein 

supported the provision in the new rules allowing the 10-hour off-duty period, if taken in 

the sleeper berth, to be broken into two separate segments. 

Dr. Ann Williamson disagreed with Mr. Rothstein on the latter point. She argued that 

breaking the 10-hour off-duty period into two segments would reduce the amount of 

sleep that drivers get.†

 Dr. Williamson also expressed disappointment that the new HOS 

rules do not address the time of day that drivers work, because nighttime driving is more 

dangerous. 

Mr. Jager noted that brokers with whom owner-operators often deal typically have more 

power than individual owner-operators. Mr. John Siebert of OOIDA concurred, noting 

that brokers frequently ask more trucks to come than the number of available loads. Mr. 

 

*

 John Siebert, of OOIDA, later agreed with Mr. Rothstein. He said that owner-operators were very 

independent minded and therefore opposed EOBRs as intrusive. 

†

 In the amended rules issued in September of 2005, the sleeper team provision was changed to require at 

least one break of at least eight hours. 
22

Snyder noted that the amendments to HOS regulations proposed by FMCSA on April 24, 

2003 put no new liability on brokers. They do not expand the chain of responsibility. 

Drivers continue to have sole legal responsibility for HOS violations even if the broker 

tenders them a load with unreasonably little time for delivery. 

Dr. Drew Dawson expressed concern that the new HOS rules could result in drivers 

getting less sleep than the old rules did because the 34-hour restart period allows them to 

work more hours per week. Dr. Orfeu Buxton expressed concern about the three-hour 

backward rotation permissible under the new rules if a driver’s work/rest cycle consisted 

of 11 hours of driving and 10 hours of rest. Sleep would then be expected to occur on a 

regular basis at a circadian phase unfavorable to good-quality, restorative sleep, Dr. 

Buxton said. 

Mr. Scott Madar of the Teamsters said that younger drivers might like the new HOS rules 

because they can make more money, but older drivers might not because the 34-hour 

restart period may mean less time off at the end of the week. 

FMCSA’s May 2000 HOS proposal, one conference participant noted, was very widely 

disliked. The April 2003 HOS amendments, in contrast, have some supporters, even 

though others are disappointed. Many conference participants, however, agreed that an 

important goal for research was to make future HOS regulations more science-based. 
23

Epidemiology, Surveillance, and Measurement 

Several speakers at the April 2003 conference addressed issues of epidemiology, 

surveillance, and measurement. Transportation safety analysts traditionally have focused 

on highway crash data, driver fatigue, work hours, and driving speeds. Epidemiologists 

have taken a broader view, considering not only crash injuries, but also disease frequency 

and the relationship between risk factors and disease. Accurate measurement is essential 

to identification of driver occupational safety and health problems and assessment of the 

effectiveness of interventions to address these problems. A good surveillance system also 

includes development of standard metrics for evaluation. 

Dr. Roger Rosa (National Institute for Occupational Safety and Health [NIOSH]) started 

the discussion of surveillance and measurement by defining surveillance as systematic 

data collection over a period of years—tracking, rather than taking a single snapshot. Dr. 

Rosa’s remarks are summarized well by his conference report (also included on the 

accompanying CD-ROM and at http://www.ilir.umich.edu/TIBP/truckdriverOSH): 

Research on work-related sleep loss, sleepiness, or fatigue suggests that 

these factors may increase the risk of operational errors contributing to 

traumatic injuries or catastrophic incidents. In addition, chronic sleep loss, 

circadian rhythm disruption, or fatigue from demanding work schedules 

may contribute to stress-related health problems. Tracking these 

relationships and estimating their frequency of occurrence in the U.S. 

working population, however, has been difficult. Currently, there is little 

or no information in existing occupational safety and health surveillance 

systems to link injuries or illnesses with fatigued or sleep-deprived 

workers. Establishing those links requires the development of reliable 

indicators of sleep loss and fatigue risk that can be recorded systematically 

and efficiently, either through existing surveillance systems, or by 

establishing new forms of surveillance. Successful tracking of fatiguerelated cases would help focus injury and illness prevention efforts. 

Laboratory studies of sleep loss and field studies of demanding work 

schedules point to some sleep loss and fatigue risk-factor indicators that 

might be developed for use in surveillance systems. Among the 

possibilities are: extended hours awake, reduced sleep, disrupted sleep, 

number of hours worked (e.g., long shifts, overtime), number of 

consecutive days worked, night or rotating shifts, unpredictable work 

times and on-call scheduling, high workloads, high environmental 

demands (e.g., heat, noise), reduced job efficiency, operational errors and 

critical incidents, degraded mood and feelings, physiological changes, and 

home and family demands. The extent to which any of these potential 

indicators can be integrated in surveillance systems depends on how easily 

and reliably they can be quantified, how frequently they might occur in a 

work situation, and how much they contribute to risk. 
24

Several Federal surveillance systems and programs have been established 

to track work-related injuries, illnesses, deaths, and emerging conditions. 

There are two major systems for tracking fatal injuries: the National 

Traumatic Occupational Fatality Surveillance System (NTOF), maintained 

by NIOSH, and the newer Census of Fatal Occupational Injuries (CFOI), 

maintained by the U.S. Bureau of Labor Statistics (BLS). The NTOF has 

no indicators that might be associated with sleep loss or fatigue. The CFOI 

records the time of day and day of week of fatal injury. Some minimal 

information on night work as a contributing factor might be developed 

from those data. NIOSH also maintains the National Occupational 

Mortality Surveillance System (NOMS) to examine work-related deaths 

from illness. This system compiles data from death certificates obtained 

from the CDC National Center for Health Statistics (NCHS). There are no 

sleep loss or fatigue indicators in the NOMS. 

Nonfatal illness and injuries rates are estimated in the Survey of 

Occupational Illnesses and Injuries (SOII), maintained by the BLS. SOII 

data are obtained from standardized injury or illness reports (OSHA 200 

logs) submitted by private industry employers. Currently, there are no 

fatigue indicators in the SOII. An upcoming revision of the OSHA logs, 

however, will require employers to record the time of injury and the time 

the injured individual started work. Some indication of fatigue from 

consecutive hours worked might be inferred from those data. 

Other more specialized surveillance programs could be modified to obtain 

information on sleep loss and fatigue. For example, the National 

Electronic Injury Surveillance System (NEISS), maintained by the 

Consumer Product Safety Commission (CPSC), and the National Hospital 

Ambulatory Medical Care Survey (NHAMCS), maintained by NCHS, 

monitor emergency department visits and already collect some workrelated information. The CPSC developed NEISS to monitor injuries 

involving consumer products and to serve as a source for follow-up 

investigation of selected product-related injuries. NIOSH has an 

agreement with CPSC to collect work-related injury data in a sample of 69 

hospitals in NEISS. Currently, there is little information on fatigue in the 

NEISS, but it may be possible to design follow-up investigations of 

selected cases to determine whether sleep loss or fatigue were contributing 

factors to the injury. 

The Sentinel Event Notification System for Occupational Risk (SENSOR) 

is another specialized program using State-based collaborative agreements 

with NIOSH to target selected work-related conditions for prevention 

activities. Targeted conditions have included acute pesticide poisoning, 

asthma, carpal tunnel syndrome, lead poisoning, noise-induced hearing 

loss, amputations, silicosis, and youth occupational injury. Cases are 

identified through several sources, such as physician reporting, death 
25

certificates, hospital discharge data, and workers’ compensation records. 

Examples of prevention activities used in SENSOR programs are 

information dissemination, education, worksite consultation, and referral 

to enforcement agencies. Currently, no information on sleep loss or 

fatigue is available from SENSOR programs, but the case-based SENSOR 

model might be developed in the future to characterize fatigue-related 

cases and devise prevention programs. 

Another case-based collaboration between the States and NIOSH, the 

Fatality Assessment and Control Evaluation (FACE) program, conducts 

State censuses of fatal occupational injuries and investigates selected 

injury types, populations, or working conditions. Some fatalities 

specifically investigated by FACE include: youth under 18 years of age, 

fire fighters, highway/street construction work zones, and machine-related 

injuries. Recommendations for prevention activities are based on in-depth 

investigations of FACE cases and series of cases of a similar type. No 

information on fatigue can be obtained from current case series, but the 

FACE approach might be useful in future efforts. 

In summary, some specialized surveillance programs allowing follow-up 

or detailed case-based investigations (e.g., NEISS, SENSOR, FACE) hold 

promise for the development of convenient sleep loss or fatigue indicators 

that, with a sufficient number of cases, would allow better characterization 

of fatigue as a contributing factor to work-related injury or illness. 

Prevention programs to reduce fatigue, such as design of better work 

schedules, or re-organization of job tasks or workload, could then be 

targeted toward those occupations or worksites where surveillance has 

identified the highest risk. Continuing surveillance could then be used to 

monitor the progress of prevention programs. 

In her presentation, Ms. Katharine Newman (U.S. Department of Labor Bureau of Labor 

Statistics [BLS]) said that the Census of Fatal Occupational Injuries (CFOI) reports 

comprehensive information on deaths due to on-the-job injuries. The Annual Survey of 

Occupational Injuries and Illnesses provides a sample of data based on OSHA 200 logs 

(records required by the Occupational Safety and Health Administration [OSHA]). For 

cases involving days away from work, the Annual Survey collects data on occupation, the 

number of days away from work, the nature and source of the injury or illness, the part of 

the body affected, and the event or exposure. For example, a truck driver may sprain 

(nature of disabling condition) his or her back (part of body affected) while lifting (event 

or exposure) a container (source directly producing disability). 

Ms. Newman noted that the incidence of workplace illnesses and injuries causing lost 

workdays has been declining since 1990 for the labor force as a whole. Still, only a few 

occupations, such as construction laborers and farm workers, have higher rates of 

occupational fatalities than truck drivers. In 2001, truck drivers accounted for over 8% of 

nonfatal occupational injuries and illnesses in the U.S. but less than 3% of employment. 
26

Highway collisions cause about two-thirds of truck driver fatalities but only about 13% of 

nonfatal driver injuries involving days away from work. About half of the driver injuries 

involving lost workdays are sprains, often caused by overexertion such as lifting heavy 

objects. Many truck drivers injured or killed on the job do not work in the transportation 

industry; rather, they drive trucks for industrial or retail companies. Furthermore, 28% of 

driver injuries or illnesses involving days away from work involved drivers with less than 

one year of tenure with their current employer. This suggests that the high turnover 

prevalent in the trucking industry may be an independent contributor to truck driver 

occupational safety and health problems. 

Dr. Ralph Craft (U.S. Department of Transportation Federal Motor Carrier Safety 

Administration [FMCSA]) reported on truck crash data available from the Department of 

Transportation. The National Highway Traffic Safety Administration (NHTSA) of the 

U.S. Department of Transportation runs the Fatality Analysis Reporting System (FARS), 

which has limited information based on police reports. The University of Michigan 

Transportation Research Institute (UMTRI) compiles Trucks Involved in Fatal Accidents 

(TIFA) for the FMCSA; it supplements FARS with interviews, providing a richer data 

set. Both FARS and TIFA are ongoing surveillance efforts. Another rich data set is the 

Large Truck Crash Causation Study (LTCCS), a one-time data collection effort currently 

in progress. LTCCS will provide data on truck crashes causing an injury or fatality 

involving trucks weighing at least 10,000 pounds. Dr. Craft reported that LTCCS obtains 

data on the reasons for the crash, including: 

• Driver errors (decision errors, performance errors, or nonperformance errors—as 

when a driver dies of a heart attack and then the truck hits somebody else) 

• Driver fatigue 

• Illegal drug use 

• Alcohol use 

• Prescription drug use 

• Prior health history of the driver 

• Driver illnesses 

• Relations with motor carriers and work related pressure 

• Problems with the roadway 

An important empirical question is the extent to which driver fatigue causes highway 

crashes. Different studies yield different answers, depending on such factors as the 

measures of fatigue used and the nature of reporting. According to Dr. Craft, LTCCS 

suggests that 26% of heavy truck crashes resulting in an injury or fatality were due to 

environmental conditions such as ice on the roadway; 25% were due to prescription 

medicines, alcohol, or illegal drugs; and only 6% were due to driver fatigue. Australian 

data presented by Dr. Ann Williamson later in the conference, however, suggested that 

fatigue was involved in 49% of heavy truck crashes. A European report, based on the 

contributions of Drs. Torbjorn Akerstedt, Catherine Garo, Patrick Hamelin, Nick 

McDonald, and Freek van Ouwerkerk, said that fatigue was a significant factor in 

approximately 20% of commercial truck and bus crashes.28 Without a “fatigue-alyzer” it 

always will be very difficult to determine the boundary beyond which fatigue becomes a 
27

safety hazard; arguably, since fatigue, sleepiness, and attentiveness are factors with 

continuous gradations, what limit do we want to establish for legal driving (as we do with 

alcohol) and how do we develop metrics and test drivers? Collecting additional highquality data about driver fatigue could help resolve uncertainty about the causes of truck 

crashes. 

Dr. Margaret (“Meg”) Sweeney (U.S. Department of Transportation, Bureau of 

Transportation Statistics [BTS]) discussed data sources available from BTS. Motor 

Carrier Financial and Operating Statistics include data on income, tonnage, mileage, 

employees, and transportation equipment on Class I and Class II for-hire intercity 

contract and common motor carriers.* While this rich data set is available only for these 

relatively large carriers, the carriers are identified by name and DOT number, and data in 

this set can be linked to other data sets that identify the carrier. The Commodity Flow 

Survey reports data on five million shipments per year, including the origin, destination, 

and commodity shipped. The BTS Omnibus Survey is a monthly household survey with 

rotating questions on issues such as satisfaction with safety standards for large trucks. 

The BTS also has data on border crossings. 

Dr. Brenda Lantz (Upper Great Plains Transportation Institute) reported on a study she 

conducted with Michael Blevins of FMCSA regarding commercial vehicle driver traffic 

convictions. The purpose of their study was to help identify motor carriers with a high 

risk for safety problems. They combined two data sources, drawing stratified random 

samples from each: driving convictions for about 65,000 commercial drivers, based on 

the Commercial Driver License Information System (CDLIS); and vehicle inspection and 

crash reports for about 14,000 carriers, based on the Motor Carrier Management 

Information System (MCMIS). By linking these two data sources, they found that driver 

conviction data serve as an indicator for carriers with safety problems. Specifically, 

carriers with higher rates of driver traffic convictions were also more likely to have (1) 

vehicles placed out of service as a result of roadside safety inspections, (2) high rates of 

crashes per power unit and crashes per driver, and (3) poor scores on the Motor Carrier 

Safety Status Measurement System (SafeStat). 

Stephanie Pratt (NIOSH) compared the two primary sources of occupational fatality data 

on truck drivers: CFOI and FARS. The two data sets provide similar counts of the 

number of truck driver fatalities. According to CFOI, there were 7,228 occupational 

fatalities among truck drivers between 1992 and 2000, of which 4,834 (67%) were due to 

highway crashes. Contact with objects or equipment, assaults or other violent acts, 

harmful substances or environments, or falls caused about 20% of occupational fatalities 

for drivers. 

Ms. Pratt, however, noted that CFOI and FARS differ in several respects. First, the two 

systems have different data structures. CFOI records are person-based, with a record for 

 

*

 Unfortunately, this data set, which has been used widely for many decades in support of scholarship on 

issues ranging from motor carrier safety to productivity, was terminated in 2005. 
28

each worker who died but no information on injured persons unless it is included in the 

case narrative. FARS has accident-level, vehicle-level, and person-level records, with 

information on other involved persons and vehicles. On the other hand, CFOI provides 

more detailed occupational and industry data on the decedent than does FARS, which 

allows researchers to identify high-risk groups of workers and develop interventions 

directed to these workers and their employers. CFOI also uses multiple sources to 

ascertain a work relationship for a fatality, whereas FARS relies primarily on death 

certificates. Finally, CFOI and FARS use truck classification schemes that are not 

directly comparable. The data structure and the availability of occupation and industry 

data affect the way researchers frame their analysis of the data, while the differences in 

truck classification and ascertainment of work relationship undoubtedly influence 

comparability and case counts. Ms. Pratt considers CFOI and FARS complementary data 

sets, both of which should be considered by researchers. 

Several points related to these issues were raised by other conference participants: 

• It is difficult to get data that reports the number of hours a driver has been 

working at the time of the crash, as well as the hours of awake time and hours of 

work and sleep over the previous seven days. 

• Employers now use OSHA 300 logs, which provide information on the time of 

day of a crash and the start of the driver’s work shift. It would be desirable to 

obtain more data, but it is difficult to get even a single additional item included in 

reporting forms. 

• Data on work hours are not kept in machine-readable form. It would be very 

useful to have data not just on the work shift in which a crash occurred, but also 

on cumulative fatigue from the week preceding a crash. 

• Dr. June Fisher noted that medical exams are required for transportation workers. 

The Federal Aviation Administration requires that physicians doing these exams 

for aviation workers be certified. These medical exams may have other relevant 

information. 

• Dr. Ann Williamson emphasized the need to develop validated and sensitive 

fatigue measures. 

• The lack of objective measures of driver fatigue (comparable to a breathalyzer for 

alcohol intoxication) makes it difficult to determine whether fatigue played a role 

in a crash. Fatigue is a continuum with varying effects under different 

circumstances. 

• Dr. Michael Quinlan noted that there are no workers’ compensation data for many 

self-employed truck drivers, who may not be covered by workers’ compensation. 

Employed drivers who are covered also may not file claims because filing claims 

may endanger their future employment. 

• Dr. Dieter Plehwe pointed out that fatality rates in trucking were falling in the EU. 

The development of more systematic data on morbidity and life expectancy for truck 

drivers is an important area for future research. Several studies have shown that less 

privileged groups tend to die younger and have more health problems than more 

privileged groups. A study of French men found that managers had longer life expectancy 
29

and longer disability-free life expectancy than did manual workers.29 A U.S. study found 

that age-adjusted death rates were higher for low income and poorly educated persons 

than for those with more income and education and that the socio-economic disparity in 

death rates increased between 1960 and 1986.30 Socioeconomic differences in mortality 

rates in the U.S. stem from a variety of causes, including behavioral risk factors 

(smoking, heavy drinking, obesity, and lack of physical activity), access to medical care, 

exposure to occupational hazards, and stress related to having a lower position in the 

social hierarchy.31,32 The Whitehall II study of British civil servants found that employees 

reporting a low level of control over their jobs had more sickness absences from work33

and higher risks of developing coronary heart disease;34 both the Whitehall II study and a 

study of French civil servants found that employees lower in the hierarchy were more 

likely to report that their health was poor.35 

At the conference, Mr. John Siebert of OOIDA reported that owner-operator truck drivers 

had short life expectancies. Data on active OOIDA members who had died suggest that 

the average age of death for OOIDA members is only 55.7 years. While this sample is not 

random and is biased toward those actively in the work force and under special pressures 

encountered by owner-operators, at face value Mr. Siebert considered these numbers 

alarming. Using OOIDA member data, he reported that 49.5% of OOIDA members were 

obese, compared to only 31% of the overall U.S. population. Only 12.7% of OOIDA 

members were normal weight, compared to 36% of the overall U.S. population. 

Mr. Siebert also reported that 13 out of 430 recent OOIDA deaths (3%) were from 

suicide.*

 Suicides among owner-operators may stem partly from intense financial 

pressures: Dr Burks said that owner-operators frequently miscalculate their costs and 

consume their capital (the rational choice failure discussed above). Dr. Quinlan said at 

the conference that there was a high suicide rate among Australian drivers. Records of the 

Transport Workers Union of Australia Superannuation Fund (mainly for employee 

drivers) for the period from July 1995 to July 1998 found that suicides accounted for 10% 

of recorded deaths, more than three times the Australian average. Most of the Australian 

drivers committing suicide, Dr. Quinlan reported, had suffered a breakdown in their 

marriage or relationship in the past six months and were under severe financial 

pressure.23

Mr. Siebert reported (based on a Teamster source) that union drivers had a life 

expectancy of 63, about seven years longer than the 55.7 for OOIDA members. These 

numbers merit further investigation. First, are they accurate? Second, if they are accurate, 

 

*

 For comparative purposes, the percentage of deaths among all males in the U.S. in 2002 caused by suicide 

were as follows: age 25 to 34, 14.4%; age 35-44, 9.2%; age 45-54, 4.5%; and age 55-64, 1.9%. See 

National Vital Statistics Reports, Vol. 53, No. 17, March 7, 2005, Table 1, page 16, available online on July 

10, 2006 at http://www.cdc.gov/nchs/data/nvsr/nvsr53/nvsr53_17.pdf. Using figures in this table, it can be 

calculated that 4.9% of all deaths in 2002 among U.S. males aged 25 to 64 were caused by suicide. The 

percent of all deaths caused by suicide was half as high among females as among males, but the majority of 

truck drivers are male. 
30

why do Teamster drivers tend to live longer than OOIDA drivers? Are the differences in 

life expectancy caused by differences in working conditions and financial stress between 

union drivers and owner-operators? Alternatively, do pre-employment differences 

between union and nonunion drivers explain the apparent discrepancy between these two 

groups? Third, how do life expectancy figures for other drivers (those belonging to 

neither the Teamsters nor OOIDA) compare to those for Teamster or OOIDA members? 

This discussion also suggests several possible research topics that were not explicitly 

addressed at the conference. Life expectancy, morbidity, and disability data specific to 

truck drivers but more broadly representative than data for members of OOIDA or the 

Transport Workers Union of Australia are sparse. It would be especially useful to have 

not only standardized mortality ratios for truck drivers, but also a measure similar to the 

one used in a recent study of uranium miners: years of potential life lost per year 

employed in that occupation.36 Employment as a driver may also reduce future earnings 

potential by making the driver unfit for work. It would be instructive to determine if 

persons employed as drivers were systematically more likely than other blue-collar 

workers to become disabled or to retire early due to health reasons. Do drivers face a 

disproportionate risk of having very low incomes in their fifties and early sixties? 

Another important area for future research is to replicate with American data the foreign 

epidemiological studies concerning the incidence of disease among truck drivers. Drs. 

Saltzman and Belzer summarized some of these foreign studies as follows:37

Clearly, drivers disproportionately suffer from certain health problems, 

many with delayed onset. An epidemiological study of over 450,000 

Canadian men found that truck drivers faced higher risk of death than 

other men did from colon cancer, laryngeal cancer, lung cancer, diabetes, 

ischemic heart disease, non-alcohol cirrhosis, and motor vehicle 

accidents.38 A Danish study found that a group of 14,225 truck drivers had 

higher mortality over a ten-year period from lung cancer and multiple 

myeloma than did a group of 43,024 unskilled male laborers in other 

occupations.39 An analysis of virtually all admissions to Danish hospitals 

over several years found that, compared to the male working age 

population, both truck and bus drivers had especially high agestandardized hospital admission ratios for lung cancer, ischemic heart 

disease, cerebrovascular disease, chronic obstructive pulmonary disease, 

and prolapsed cervical or lumbar discs; and truck but not bus drivers had 

especially high admission ratios for back injuries.40

Certainly, the obvious sources of occupational fatalities and injuries such as highway 

crashes and back sprains from lifting heavy objects merit the attention that they have 

received in data collection programs such as CFOI. However, the more subtle linkages 

between employment conditions for drivers and health problems such as diabetes and 

cardiovascular disease—linkages that are not always recognized because of long latent 

periods and the simultaneous presence of non-occupational causes—require more 

attention from future research because they take a heavy toll in morbidity and mortality. 
31

For policy purposes, it would be very useful to combine epidemiological and economic 

analysis, helping researchers estimate of the dollar cost of morbidity and premature 

mortality associated with employment conditions for truck drivers. 
32

Ergonomics, Job Injuries, and Exposure 

Truck drivers face a variety of problems related to ergonomics, job injuries, and 

exposure. For example, those who drive gasoline tanker trucks often experience acute 

headaches, dizziness, or nausea after exposure to gasoline vapors during loading and 

unloading.41 Long work hours intensify hazards of truck drivers’ exposure to harmful 

substances or conditions, particularly since “occupational exposure limits are almost 

invariably calculated on the basis of an 8 hour day, 5 day week.”42

At the conference, Drs. Eric Garshick and Thomas Smith (Harvard University) presented 

work they are doing with Dr. Francine Laden (also of Harvard) on the health effects of 

exposure to diesel exhaust. According to Dr. Garshick, 40 previous studies indicate that 

truck drivers and others likely to have diesel exposure have a 20% to 50% elevated risk 

of lung cancer. Furthermore, diesel exposure may be associated with chronic respiratory 

diseases such as asthma, respiratory symptoms such as wheezing, reduction in pulmonary 

function, and allergic inflammation. They cited a recent study reporting that residence 

near a roadway in the Netherlands (where diesel engines are more common than they are 

in the U.S.) was associated with excess mortality from cardiopulmonary causes.43

The current Garshick-Smith-Laden project studies over 60,000 unionized LTL trucking 

industry workers working for four large carriers in 1985: ABF Freight System, 

Consolidated Freightways (now out of business), Roadway Express, and Yellow Freight 

System (which bought Roadway in July 2003). Using work history data from the 

employers and death information from the Central States Pension Fund and the National 

Death Index, they are examining the relationship between mortality and the intensity and 

duration of exposure to sources of diesel exhaust and other sources of particulates. Based 

on data from a questionnaire sent to a sample of 10,000 workers, they are adjusting for 

differences in smoking rates by job title and work location. Their industrial hygiene 

sampling team visited many freight terminals to measure the exposure to diesel particles 

for various emission sources (engine type, fuel, maintenance), job title (long haul driver, 

pickup and delivery driver, dock worker, hostler,* mechanic, or other), work settings 

(vehicle cab, freight dock, shop, or other), terminal characteristics (size, location), and air 

pollution background levels. The Garshick-Smith-Laden study has several advantages 

over some previous studies of diesel exposure and lung cancer risk: a large cohort with 

computerized job history information extending over most of each worker’s lifetime, and 

extensive sampling to provide estimates of the composition and intensity of exposure. 

Their project currently is funded through 2006. 

Detailed work histories are important because exposure varies according to job and work 

location within the trucking industry. For example, diesel engines became common in 

long haul trucks during the 1950s and 1960s, but they did not become common in pickup 

 

*

 A hostler (also known as a “yard jockey”) often uses a specially configured tractor to move trailers in and 

out of freight docks and park them in the yard. 
33

and delivery trucks until the 1970s and 1980s. Forklifts used in freight terminals used 

diesel fuel in the 1980s but now use propane or liquefied petroleum gas.*

 The yard 

hostler’s entire shift is spent in a specialized hostler tractor, working around the yard, 

where there may be a large number of diesel tractor units starting (a smoky phase of 

operation) and operating. In smaller companies or terminals, hostlers may also use old 

road or city tractors that no longer are roadworthy, further exposing themselves to 

environmental hazards. He or she may also be responsible for hooking up truck-trailer 

combinations for road or city drivers, who then operate the truck-trailer combination on 

the highway. Location is important because many freight terminals are located in 

industrial areas with industrial air pollution, in addition to truck exhaust. Dr. Smith 

reported, however, that driver exposure depends more on emissions from vehicles in front 

of the driver’s truck (which are especially intense during acceleration and deceleration) 

than on emissions from the driver’s own truck. 

The presentations by Drs. Garshick and Smith suggest some possible areas for future 

research that were not discussed at the conference. Can routine truck inspections readily 

detect diesel emission problems that can be fixed inexpensively by such measures as 

cleaning or replacing the injectors and sealing off leaky gaskets that leak exhaust into the 

truck cab? Is it cost effective to reduce diesel exhaust exposure by installing filters in the 

heater and air conditioner air intake systems of vehicles such as pickup and delivery 

trucks, urban buses, and taxis that are driven for extended periods in congested urban 

areas? 

Dr. William Rogers (Motor Freight Carriers Association) presented his analysis of 

workers’ compensation claims experience in unionized LTL carriers. He noted that 

unionized LTL carriers provide good pay (typically $60-70,000 per year for drivers), plus 

pensions and excellent health insurance. The union contract protects employees from 

management abuse. As a result, employees of unionized LTL carriers have long job 

tenure—often 30 to 40 year careers in one company. Dr. Rogers pointed out that many 

union LTL drivers have driven one million miles or more without an accident. He said it 

would be useful to study not only safety errors, but also the roots of success for those 

workers with no accidents during lengthy careers. 

Dr. Rogers presented data on the incidence of workers’ compensation claims. Workers 

with fewer than two years of job tenure account for 22% of workers’ compensation 

claims for drivers and 24% of workers’ compensation claims for other employees. 

Workers aged 35 or younger account for 24% of workers’ compensation claims but only 

15% of the workforce. Older workers probably are less likely to be injured because they 

know what they are doing, Dr. Rogers continued, but they take longer to recover if they 

are injured. 

 

*

 Dr. Smith noted that Mexican freight docks generally do not have forklifts; they still load freight 

manually. 
34

Dr. Rogers said that injury rates among dock workers and yard workers have been 

reduced by technological change. Now, most LTL freight is shrink-wrapped and 

palletized so that it can be handled with forklifts. This arrangement reduces the incidence 

of finger injuries and lifting injuries. Still, dock and yard workers are over-represented 

among workers’ compensation claimants: they account for 35% of all claims but only 

18% of the work force. 

Dr. Rogers presented statistics on permanent disability claims, usually the most 

expensive workers’ compensation cases. Approximately 10% of all 1999 claims resulted 

in a permanent disability, and these claims accounted for 44% of all claim costs. 

Payments for permanent disability claims were not evenly distributed among 

occupational groups, as shown below: 

Table 8. Permanent Disability Claims for Unionized LTL Carriers 

Occupational group 

Percent of work force 

in unionized LTL 

carriers 

Percent of payments for 

permanent disability claims for 

unionized LTL carriers 

City drivers 41 35 

Road drivers 23 32 

Dock workers 15 15 

Yard workers 3 11 

Office workers 14 4 

Mechanics 4 3 

Road drivers and, especially, yard workers accounted for a disproportionate part of share 

of permanent disability payments. Workers aged 51 to 55 also accounted for a 

disproportionate share of permanent disability payments: they were 18% of the work 

force but accounted for 28% of payments. Workers with less than one year of tenure were 

another high-risk group: they had 9.2% of disability claims even though they probably 

comprise about 1% of the Motor Freight Carriers Association workforce. 

Dr. Rogers reported that back sprains or strains, upper body sprains or strains, and knee 

disorders were the three most prevalent types of injuries, accounting together for about 

41% of workers’ compensation claims and about 44% of claims costs. He noted that 

average claim cost was about three times higher in cases where an attorney represents the 

workers’ compensation claimant than in cases where the claimant is not represented by 

an attorney. 

Dr. Rogers’ findings suggest a number of potential topics for research. Are workers’ 

compensation statistics on occupational injuries and illnesses consistent with other data 

sources, such as BLS’s Annual Survey of Occupational Injuries and Illnesses? What 
35

changes can be made in freight yards to reduce the high rate of permanent disability 

among yard workers? To what extent does the higher claims cost for workers’ 

compensation cases with attorney representation stem from attorneys selectively agreeing 

to represent clients who have a strong case and large potential claims? To what extent 

does the mere involvement of an attorney affect the outcome? Do attorneys win larger 

settlements than the claimants would have received without attorney representation, or 

are attorneys involved in cases more likely to have larger settlements? 

In the discussion, Dr. Burks said that small carriers in California face very high workers’ 

compensation premiums because of their high injury rates. They may face premiums of 

$33 for every $100 in payroll. According to Dr. Belzer, however, part of this additional 

cost may stem from unusually generous legal provisions in California that not only 

provide incentives for lawyers to take these cases, but also allow claimants to shop for 

doctors and treatments as well. Research that controls for these effects clearly is needed. 

Dr. James McGlothlin (Purdue University) presented research he conducted with 

master’s student Patrick Sheets: an ergonomic and cardiovascular stress evaluation of 

beverage deliverymen. They generally are men because one needs great shoulder strength 

to deliver beverages. They are paid based on how much soda and beer they deliver. 

Dr. McGlothlin said that beverage delivery drivers rarely work these jobs into their 

fifties. Beverage delivery work can put excess strain on their cardiovascular system due 

to physical demands of loading and unloading, long workdays, awkward postures, and 

high work rates (fast-paced, intensive work). Beverage delivery drivers also face robbery 

hazards. Beverage delivery is mostly a cash-and-carry operation, especially for deliveries 

in economically distressed areas where stores do not have good credit and must pay in 

cash. A beer delivery driver may have $1,000 to $3,000 in cash by the end of the day, 

making the driver a robbery target. Beverage delivery drivers face traffic hazards as well, 

particularly when parked on a busy street while unloading. In winter, frozen bottles can 

become like hand grenades, exploding when handled and sending glass shards into the 

driver’s face. In 2000, the number of lost workdays due to injury or illness per 100 

workers was about three times as high for beverage delivery drivers as it was for all 

workers in private industry. 

Dr. McGlothlin analyzed driver heart rates to determine which specific beverage delivery 

activities were most physically demanding and to determine if ergonomic redesigns could 

reduce cardiovascular stress. He studied nine subjects for a four-month period, recording 

their heart rate and videotaping them throughout the workday. On average, they handled 

about 36,000 pounds of beverages per day. Dr. McGlothlin said that working at more 

than 40% of a person’s maximum heart rate for a sustained period of time leads to 

fatigue, and he found that unloading beverages from delivery trucks raises the driver’s 

heart rate substantially. Increases in heart rates generally occurred during overhead work, 

handling of beverage containers below the waist, and pushing or pulling two-wheel hand 

trucks up inclines or stairs. 
36

Dr. McGlothlin considered several changes that could reduce strain on beverage delivery 

drivers. One is to use plastic bottles instead of glass, as plastic weighs less. He noted, 

however, that beverage companies prefer to force plastic bottle suppliers to compete with 

glass bottle suppliers in order to keep bottle prices down. Ergonomic changes to the 

delivery truck could also be made, such as: 

• Pull-out step-on platforms for unloading beverages (which reduce the distance 

that the driver must reach to obtain the beverage containers and allow the driver to 

place the containers on the platform for subsequent placement onto the hand 

truck) 

• Proper tire pressure on hand trucks (facilitated by placing an air compressor next 

to the end of the row where drivers obtain hand trucks) 

• Exterior grab handles by all bays 

• Three-position drop shelf holes for all bays 

• A wider step platform on the housing step bar 

• New rollers in all bay door slats, and lubricated doors 

• Air-cushioned driver’s seat 

He found that, for six of the nine subjects, these ergonomic interventions reduced the 

percent of the time that their heart rates exceeded 50% of their maximum heart rate; two 

of the remaining three subjects never exceeded 50% either before or after the 

interventions. A potential future research project might replicate the McGlothlin study of 

beverage delivery drivers with other groups of truck drivers, particularly in LTL and 

package delivery. 

Dr. Michael McCann (Center to Protect Workers’ Rights) gave a presentation on 

occupational hazards of ready-mixed concrete truck drivers. A more detailed report on 

this subject, submitted to Dr. McCann by Nancy Clark, Jonathan Dropkin, and Lee 

Kaplan of the Mount Sinai-Irving J. Selikoff Center for Occupational and Environmental 

Medicine in New York City, is included on the accompanying CD-ROM and at 

http://www.ilir.umich.edu/TIBP/truckdriverOSH. The Clark et al. report stated that readymixed concrete truck drivers have several job duties, including loading and mixing 

concrete at the plant, delivering the concrete to the construction site before it sets, and 

cleaning the mixer drum. The industry had a higher rate of OSHA-recordable nonfatal 

occupational injuries and illnesses than construction as a whole. Clark et al. analyzed 

OSHA 200 log forms for 23 ready-mixed concrete plants between 1997 and 1999, finding 

that sprains and strains accounted for 62% of lost-time cases. Other problems included 

bruises, eye injuries from particles, cuts, hearing loss, fractures, and amputations. 

Based on their site visits and their review of previous research, Clark et al. listed several 

occupational hazards faced by ready-mixed concrete truck drivers. Slips, trips, and falls 

accounted for about half of the injuries, according to a 1986 study. They wrote that 

“hazards include slippery surfaces, unsure footing, damaged ladders and walkways, and 

unsure hand- and footholds during climbing and descending truck cab and equipment.” 44

Drivers can be struck by or pinched by equipment or materials. They face ergonomic risk 

factors such as: 
37

whole body vibration from driving the trucks, awkward and fixed postures 

(for instance, while hosing down the inside of the truck and holding the 

driving wheel of an empty truck over bumpy roads), forceful muscular 

activities (for instance, lifting heavy chutes, frequently lifting chutes, and 

activating a drum when discharging concrete), extremes in temperature 

(hot and cold), and repetitive twisting of the back and neck (for instance, 

when delivering concrete or looking out the back of a truck). 45

Ready-mix operations are noisy. Drivers’ noise exposure exceeded the NIOSH 

recommendation of no more than 85 dB averaged over eight hours. When cleaning the 

drum every few months, the drivers or contract workers must work within a confined 

space in which they are exposed to noise and silica dust. During loading and unloading, 

they may be exposed to irritating chemicals. They may be burned by hot surfaces, face 

eye injuries from flying particles, and face rollover hazards “while driving or unloading 

on unstable, uneven or steep ground at delivery sites.”46

Clark et al. recommended a number of measures to prevent occupational injuries and 

illnesses among ready-mixed concrete truck drivers. These included safety and health 

training for workers and managers, active participation of workers and unions in 

identifying and controlling hazards, redesigning equipment to reduce falling hazards, 

having machine guards and lockout/tagout, better seats to reduce exposure to vibration, 

and special confined-space programs for cleaning out mixer drums. 

Some of the hazards that Clark et al. identified for ready-mixed concrete truck drivers 

also affect other drivers and merit further research. Many drivers face extended exposure 

to highway noise, which can lead to hearing loss,47 a problem exacerbated when drivers 

sleep in their trucks while their partners drive and thus lack recovery time between 

exposures.48 Can changes in cab and sleeper berth design reduce noise exposure? Many 

drivers are exposed to whole body vibration,49 which can lead to low back pain.50,51,52

Can changes in seat or sleeper berth design reduce exposure to vibration? 

A number of other exposure hazards were raised by conference participants. Dr. Michael 

Quinlan said that there was a need for more research on occupational violence in 

trucking. In 2001, Dr. Quinlan and his colleague Claire Mayhew surveyed 300 Australian 

drivers about this and other topics. About three in ten drivers reported being subjected to 

verbal abuse, somewhat fewer than one in ten reported being threatened, and 1% reported 

being assaulted. At freight forwarding yards, verbal abuse and threats were closely linked 

with economic pressures in nearly all incidents. Loading delays, drivers cutting in line, 

and mistakes by forklift drivers fueled tensions, which led to the violent behaviors. Other 

occupational safety and health problems that drivers reported in the Mayhew-Quinlan 

survey include crashes (14% in the past year and 24% in the past five years), acute 

injuries (over 25% in the past year, mostly minor), chronic injuries (over 50%, mostly 

back), and hearing loss (22%). Dr. Quinlan’s presentation at the conference also reviewed 

the literature on driver occupational safety and health problems, noting studies of 

vibration, back, and spinal injuries; hazardous substance exposure; and crashes. 
38

Dr. Stephen Burks commented on the higher injury rate for less experienced workers. 

Many drivers quit after only a few months, so that trucking has many inexperienced 

workers. He called for more research on how to reduce driver turnover, as reduced 

turnover would improve safety. He said that there were pockets of high injury rates in 

trucking, such as in plate glass transport that merited further study. 

These comments raised additional important subjects for future research. Can more 

intensive training and supervision reduce the injury rate among inexperienced drivers, 

dockworkers, and yard workers? How can work be redesigned to reduce the negative 

health and safety consequences of current work methods? How can trucking companies 

establish a “corporate culture” that values safety? 
39

Labor Market, Employment Relations, and Personnel 

Management 

Dr. Daniel Rodriguez (University of North Carolina-Chapel Hill) presented the results of 

a study he conducted with Dr. Michael H. Belzer (then of the University of Michigan and 

now at Wayne State University) and Dr. Stanley A. Sedo (University of Michigan) 

concerning the relationship between driver pay and highway safety. Traditional 

approaches to safety emphasize human factors, load characteristics, vehicle 

characteristics and maintenance, and environmental conditions. Belzer, Rodriguez, and 

Sedo considered whether safety depends on economic factors such as form of driver pay 

(hourly pay rather than mileage or percentage of revenue, both of which are 

“piecework”), the level of driver pay, and the impact of product market competition in 

trucking on the human capital of truck drivers. 

They did three empirical studies. First, they analyzed data for the period from 1995 to 

1998 on more than 11,000 drivers working for J.B. Hunt, the second largest truckload 

carrier in the U.S. Hunt raised driver wages an average of 38% early in 1997 in an effort 

to reduce high turnover and improve safety and reliability. Second, they studied data for a 

cross-section of 102 truckload carriers in 1998. Third, they used data from a 1997-98 

survey that included 247 mileage-paid employee drivers working in the for-hire trucking 

industry. 

In all three studies, they found that higher truck driver pay was associated with a lower 

rate of crashes. In the J.B. Hunt study they found that, starting from the mean mileage 

rate of 34 cents per mile, a 10% higher base mileage rate was associated with a 34% 

lower probability of a crash. In addition, a 10% increase in driver pay was associated 

with a 6% lower crash probability, giving an overall pay-rate effect of 1:4. In the crosssectional study of 102 truckload carriers, they found that – at the mean – for every 10% 

more in average total compensation for drivers, the carrier would experience a 9.2% 

lower crash rate. In the driver survey study, they found that drivers earning a 10% higher 

mileage rate would have an 18.7% lower probability of having a crash during the 

reporting year, while drivers having 10% more paid days off would have a 6.3% lower 

probability of having had a crash during that same year. They gave two possible 

explanations for this effect of pay on driver performance. First, higher compensation 

allows carriers to recruit and retain better-qualified drivers (a human capital effect). 

Second, higher compensation may have provided an efficiency wage incentive for drivers 

to drive safely, lest they lose a job that pays better than their alternative wage. 

Dr. Rodriguez and his colleagues also examined the impact of pay rates on the number of 

hours that drivers wished to work. Based on the driver survey data, co-author Stanley 

Sedo found a classic backward-bending labor supply curve. When the pay rate was very 

low, an increase in the pay rate made drivers want to work longer hours because the pay 

increase raised the implicit price of leisure (the substitution effect). When the pay rate 

was high, however, an increase in the pay rate made drivers want to work shorter hours 

because they could now afford to buy more of all normal goods, including leisure (the 

income effect). The income effect becomes dominant—i.e., higher pay begins to reduce 
40

rather than increase the number of hours that drivers wish to work—when the mileage 

rate paid to drivers increases above 31.4¢ per mile. In order to align the drivers’ 

economic preferences with public safety policy preferences, and reduce the number of 

hours drivers want to work per week to 60 (the legal maximum work hours for truck 

drivers since 1938), the mileage rate might be raised to 37.8¢ per mile. Their driver 

survey, however, showed that the average mileage rate for drivers with three years 

experience was only 28.6¢ per mile, which helps explain why many drivers work more 

than the legal maximum set by HOS regulations.21, 53, 54

While Belzer, Rodriguez, and Sedo demonstrated that truck driver compensation is a 

powerful predictor of both driver and motor carrier safety, limitations in the data 

prevented them from determining whether the value of this safety improvement exceeded 

the costs. The Trucking Industry Benchmarking Program, developed and directed by Dr. 

Belzer, was designed to link driver characteristics and motor carrier operations to safety 

performance, allowing a much more accurate weighing of factors operating 

simultaneously in the industrial environment. With information that allows researchers to 

weigh relative effects of various carrier-level safety measures, the predictors of safety 

performance will be much better understood (See http://www.ilir.umich.edu/TIBP). 

Further research is needed, however, to show the value of safety return for every dollar 

spent on increased driver wages. Does safety pay? If it does not, will consumers and 

government policy-makers be comfortable paying for the marginal cost of an additional 

safety margin? 

Dr. Ian Savage (Northwestern University) presented his research on the economics of 

transport safety. He compared FMCSA to a policing organization because of its emphasis 

on activities such as roadside inspections to catch unsafe trucks. He argued that safety 

fears expressed at the time of trucking deregulation were overblown. Although there had 

been fears of “killer trucks” at the time of deregulation, the rate of fatal truck crashes per 

mile driven has actually fallen since then. Nevertheless, safety advocates – and 

particularly families of victims – call for further improvements in truck safety. 

Dr. Savage asserted that there is no universal answer to whether shippers prefer high 

safety at a high price, or low safety at a low price. Safety is expensive to provide. 

Although shippers prefer more safety to less, their willingness to pay depends on the 

reduction in expected harm. Electronics shippers have a delicate product for which 

shipping costs are a small fraction of the final price; they therefore want safety and will 

pay for it. Gravel haulers, in contrast, have a product that is not damaged if the truck is in 

a collision, and shipping costs are a substantial fraction of the final price. They care more 

about low shipping cost than they do about safety. 

In order to justify government safety regulation, Dr. Savage continued, one must identify 

a market failure. Imperfect information is a problem: insurance carriers need to tailor 

rates to the risk of the trucking company, but they often say it is too costly to assess the 

risk of individual carriers. Similarly, if customers for trucking services are poorly 

informed, then unsafe carriers may be able to charge high prices, pretending to be safe 

firms. Dr. Savage therefore argued it is appropriate for government to inform shippers 
41

about the safety records of different carriers. He also said that it is appropriate to require 

a minimum level of safety because of externalities. He noted that the government does 

this by setting minimum standards for safety inputs, using these as an approximation for 

the minimum acceptable safety output level. But if shippers have different tastes for 

safety, Dr, Savage concluded, it is appropriate to have variation among carriers in safety 

levels—and the prices that they charge for their services. 

Combining Dr. Savage’s point about differing customer preferences regarding the 

tradeoff between safety and shipping cost and Belzer et al.’s finding that higher wages at 

J.B. Hunt reduced crash rates, it would be instructive to examine changes in J.B. Hunt’s 

customer mix after they raised wages. Was Hunt able to attract safety-conscious shippers, 

for whom high standards of transportation quality are important? Indeed, that was an 

important part of their strategic decision to become a quality operator. In addition, since 

the damages produced by the crash of a gravel-hauler may equal or exceed those 

produced by an electronics hauler (to use Dr. Savage’s example), how do markets 

compensate those who are harmed by the crash? In other words, if the gravel-hauler has 

less insurance coverage than the electronics hauler (consistent with the lower price 

charged to haul the goods), will the public bear a larger fraction of the cost of a gravelhauler’s crash than that of an electronics hauler? Will the gravel customer’s lower taste 

for safety become a market externality – a cost borne by the public? 

Dr. Belzer noted in the discussion that the LTL sector has the best safety record in 

trucking, and produce trucks (whose drivers have among the lowest pay rates) have the 

worst. Dr. Burks added that, when prices for trucking services were regulated, the 

Interstate Commerce Commission used to require that there be a detention charge, which 

provided additional compensation to carriers in the event of undue delays at the location 

of the shipper or consignee or delays in when the truck was permitted to enter the 

shipper’s or consignee’s premises. This requirement, Dr. Burks said, was bargained away 

after deregulation, and shipping contracts now typically do not include detention clauses. 

Drs. Belzer and Quinlan argued that restoring detention charges would reduce safety 

risks, particularly if drivers were paid for this time and therefore logged it as on-duty 

time. 

Dr. Michael Quinlan’s second conference presentation addressed more broadly the 

occupational safety and health issues prevalent in developed countries generally and 

Europe and Australia specifically. He briefly mentioned additional factors that affect 

truck safety, including: 

⇒ Time pressure from elaborate supply chains and just-in-time inventory systems 

⇒ Truck size, design, maintenance, and performance 

⇒ Driver characteristics, selection, training, and behavior 

⇒ Highway and bridge design and maintenance 

⇒ Traffic levels 

⇒ Behavior of other road users 

⇒ Ineffective regulatory regimes 
42

All of these contribute to health and safety concerns for truck drivers in these countries. 

Despite the progress made for other occupations, truck drivers lag behind in indices of 

health and safety. He placed special emphasis on economic forces compelling fierce 

competition in trucking – forces responsible for inferior health and safety outcomes for 

truck drivers in these countries. 

Dr. Patrick Hamelin (National Research Institute for Transport Safety in France 

[INRETS]) gave a wide-ranging presentation on trucking in Europe. He said that longdistance truck drivers experience extreme working conditions, almost like running a 

marathon. As Dr. Hamelin noted in a newsletter article55 (included in the accompanying 

CD-ROM and at http://www.ilir.umich.edu/TIBP/truckdriverOSH), drivers frequently 

face obstacles to staying on schedule: traffic jams, bad weather conditions, customs 

delays at borders, and queues for loading bays or forklifts. Often, Dr. Hamelin wrote, 

drivers make up for these delays by working during scheduled rest periods. Improved 

communications, meanwhile, have allowed employers to track the locations of their 

trucks, resulting in a decrease in driver autonomy. 

Dr. Hamelin conducted directly comparable surveys of French truck drivers in 1983, 

1993, and 1999. Drivers, he reported, work longer than average hours and earn less than 

other blue-collar workers do, per hour worked. Dr. Hamelin presented the following data 

on weekly work hours for French truck drivers in 1999: 

Table 9. French Truck Driver Work Hours 

Employee Group Average Hours 

Worked Per Week 

Drivers returning home each night and: 

 Employed by private carriers 

 Employed for-hire carriers 

 Owner-operators 

43.2 

47.2 

52.9 

Drivers away from home 1-3 nights per week 

and employed by for-hire carriers 53.8 

Drivers away from home 4+ nights per week 

and employed by for-hire carriers 56.1 

Between 1983 and 1993, average work hours declined for drivers employed by private 

carriers, though this was partly offset by a shift in truck driver employment from private 

carriers (where hours were shortest) to for-hire carriers. Between 1993 and 1999, the 

number of French drivers getting sleep breaks of at least 9 hours increased while the 

average weekly work hours for employee drivers decreased. Work hours increased 

between 1993 and 1999, however, for owner-operators who returned home each night. 

Another development was an increase in “slip seating” (having multiple drivers use the 

same truck to increase the intensity of capital utilization and to keep the truck moving 

around the clock, which shortens delivery cycles). 
43

Dr. Hamelin noted that tensions related to driver workloads led French truck drivers to 

strike in 1992. Transport prices fell following deregulation, leading to pressure on drivers 

to increase their workload. The pressure on drivers became a double bind in 1992, when a 

new demerit point system increased the risk that drivers could lose their commercial 

driver’s licenses for driving excessive distances, driving at excessive speeds, or 

overloading. French truck drivers reacted with a spontaneous strike, stopping their trucks 

in the middle of roads and snarling traffic for 12 days. As a result of the ensuing 

negotiations, the 1992 regulations were revised to emphasize instead better training to 

qualify for a commercial driver’s license. 

Dr. Hamelin reported that European Economic Community (EEC) Regulation 3820/85 

(adopted in 1985) limits truck drivers to an average of 45 and a maximum of 56 hours of 

driving per week. He noted, however, that this regulation allows them to have 

substantially longer total work hours because about 30% of long-distance driver time is 

spent in activities such as loading, unloading, waiting, vehicle maintenance, and running 

to find forwarding agents (a figure very similar to that found by the University of 

Michigan Trucking Industry Program’s Truck Driver Survey, and by Martin Labbe’s 

survey on behalf of the Truckload Carriers Association). The “average” rule allows them 

to work a total of about 65 hours per week, while the “maximum” rule allows them to 

work around 80 hours per week. 

A new EU directive limits total work time for drivers to 48 hours per week. If, however, 

they continue driving an average of 45 hours per week, then Dr. Hamelin’s data show 

that their total work hours will almost surely exceed 48—unless there are very big 

changes in transport organization and working conditions. Even if the proportion of longdistance driver work time spent on non-driving activities were reduced from 30% to 20%, 

45 hours per week of driving would imply 56 hours per week of total work. Dr. Hamelin 

thinks it would be difficult to reduce non-driving work to less than 20%, on average, of 

total work time for long-distance drivers. 

The differences between EU and U.S. rules for truck driver hours might make it useful to 

compare European and American accident and occupational illness rates for truck drivers, 

as well as life expectancies. Illness and life expectancy reflect the cumulative effects of 

many years of experience, including prior years in which work hours for European truck 

drivers were not as different from those of American drivers as they are today. Accident 

rates, however, may respond quickly to changes in work hours, so that comparing the 

“fixed effect” change in accident rates in the EU before and after the new EU directive on 

driver work hours to the change in accident rates in the U.S. during the same time span 

might provide an estimate of the impact of driver hour regulations on trucking safety. 

Dr. Gerald Krueger (Wexford Group International) prepared a conference presentation 

(which he was unable to deliver in person) concerning driver wellness training programs 

that he conducts for truck drivers and trucking company managers. Dr. Krueger also 

prepared a handout (included on the accompanying CD-ROM and at 

http://www.ilir.umich.edu/TIBP/truckdriverOSH) about a driver alertness-training 

program sponsored by FMCSA and the American Trucking Associations (ATA). Since 
44

1996, Dr. Krueger has repeatedly conducted a train-the-trainer driver alertness course for 

trucking industry trainers, safety managers, and drivers. The course notes the hazards of 

driving while fatigued, presents relevant findings from sleep research, and identifies what 

he argues are proven fatigue countermeasures. 

In the discussion, Dr. Burks noted the differences among driver training providers. There 

were cutbacks in federal government support for commercial driving training schools 

after scandals arose involving some for-profit training schools. Dr. Burks argued that 

third-party for-profit driver training schools might not have a strong incentive to do a 

good job. He suggested that it may be better to have commercial driver training 

conducted by large trucking firms (e.g., Schneider National) that internalize costs, or else 

have a six-month certificate program for commercial drivers at community colleges. Dr. 

Belzer commented that it costs $3,000 to $7,000 per driver to hire a truckload driver. The 

100% annual turnover typical in the TL sector thus is an economic problem. 

Dr. Rogers said that, subsequent to the period that Drs. Belzer, Rodriguez, and Sedo 

studied, J.B. Hunt cut the mileage rate that they had raised in 1997. The low 

unemployment rate during the late 1990s and 2000 made it difficult for trucking 

companies to recruit and retain qualified labor unless they raised wages. The higher 

unemployment rate since 2000, however, reduced the pressure on carriers to raise wages 

and has reduced wages at some carriers. 

The U.S. market for truck driver labor may soon be affected by an important 

development not addressed in the conference presentations: an influx of Mexican 

trucking firms into the U.S. market for trucking services. Cabotage rules first established 

by the U.S. Immigration and Naturalization Service and now enforced by U.S. 

Immigration and Customs Enforcement limit Canadian and Mexican drivers and carriers 

to shipments whose origin or destination is in Canada or Mexico; they may not handle 

shipments between two points in the U.S. While Canadian trucks have been allowed to 

travel throughout the U.S. on this basis, the same privilege has not been accorded 

Mexican trucks and drivers. In February 2001, an arbitration panel established under the 

provisions of the North American Free Trade Agreement (NAFTA) ordered the U.S. to 

allow Mexican trucks to operate throughout the U.S., and not just in a twenty-mile strip 

along the border. The U.S. DOT prepared to implement the policy ordered by the 

arbitrators, rather than exercise the option provided by NAFTA to keep Mexican trucks 

out and provide Mexico with compensation.56 The opening of the border was delayed by 

a federal Circuit Court ruling that DOT had failed to conduct a legally required 

environmental analysis,57 but the U.S. Supreme Court reversed this ruling in June 2004.58

The opening was delayed further by a January 2005 report by the DOT Inspector General 

recommending that U.S. officials conduct safety inspections of Mexican trucks before 

they enter the U.S.59 Still, it seems likely that Mexican drivers soon will be able to handle 

many shipments now handled by U.S. drivers. Competition from the large potential pool 

of low-wage Mexican drivers working throughout the United States will tend to drive 

down wages and other forms of compensation in the U.S. labor market for truck drivers. 

If the research by Belzer et al. is true, this may be accompanied by a substantial increase 

in truck crashes and other incidents. 
45

Dr. Hamelin noted that international economic integration could have similar effects in 

Europe. Trucking costs are substantially lower for Hungarian and Polish firms than for 

Western European firms because of lower pay and social security costs. 

In summary, it is appropriate to take a systems approach, considering the simultaneous 

use of several approaches: training drivers how to drive safely and manage their fatigue, 

having enough truck stops along the highway, having reasonable schedules and pay 

systems, and having equity in pay between U.S. and Mexican drivers. The most 

systematic approach to safety and health might involve making an intense effort to 

incorporate into the market for trucking services all relevant costs and benefits, including 

those that now are often ignored by decision makers because they entail externalities 

affecting third parties.*

 

*

 The Transportation Research Board Committee on Trucking Industry Research has been working with 

other committees for many years to get these issues on policy makers’ “radar screens.” See presentations 

from several Annual Meetings at 

http://www.ugpti.org/trb/. 
46

Fatigue and Truck Driver Safety and Health 

A substantial scholarly literature demonstrates the adverse impact of fatigue on job 

performance. A review by Folkard and Tucker reported that the risk of accidents and 

injuries was approximately 30% higher for night shift workers than for day shift 

workers.60 Productivity in manufacturing, they reported, was about 5% lower at night.*

They also found that the risk of accidents and injuries during the 12th hour of a work shift 

was more than double the risk during the first 8 hours. Tucker, Folkard, and McDonald 

examined the impact of rest breaks on risk.61 They analyzed three years of records for a 

car assembly plant in which workers had a fifteen-minute break after each two hours of 

continuous work. The risk of accidents and injuries was more than twice as high for the 

period from 90 to 120 minutes since the last break as it was for the period from 0 to 30 

minutes since the last break. Folkard and Lombardi argued that models of fatigue and 

performance must reflect several risk factors for accidents and injuries: night work, an 

increase in the number of successive night shifts, an increase in the number of hours on 

duty, and an increase in the number of minutes since the last work break. They proposed 

a risk index adjusted for these factors as a way of assessing the risk of different work 

schedules.62

Some studies have addressed the issue of recovery from physical and mental fatigue and 

how this affects performance. Dinges et al. found that restriction of sleep to four or five 

hours per night causes significant deterioration in reaction time performance within three 

nights; and after a week of partial sleep deprivation, it takes two full nights of sleep for 

reaction time performance to recover.63 Such partial sleep deprivation is a regular fact of 

life for most truck drivers. Folkard and Akerstedt, analyzing the impact of fatigue on 

accident risk, stated “sleeps that occur at abnormal times of day may be less restorative 

than those at night, even if the sleep duration is the same.”64

The literature shows that the adverse impact of fatigue on performance applies to 

commercial drivers, too; see Freund for a review of the literature related to HOS 

regulation, including the impact of fatigue on driver performance.65 Hamelin found that 

accident risk for truck drivers depended on both time of day and work span duration. For 

drivers with work shifts of less than 11 hours, the accident risk rate was 175% higher 

from 8 PM to 7 AM than from 8 AM to 7 PM (1.85 vs. 0.74); and for drivers with work 

shifts of 11 hours or more, the accident risk rate was 76% higher from 8 PM to 7 AM 

than from 8 AM to 7 PM (2.37 vs. 1.35).66 A consensus statement by Akerstedt, Cziesler, 

 

*

 In factory settings, part of the difference between day shift and night shift outcomes may stem from 

differences in worker experience rather than differences between day and night. High seniority workers 

usually get first preference for shifts and may prefer the day shift, leaving the night shift populated by less 

senior, less experienced workers who may be more prone to mishaps. In trucking, however, much of the 

over-the-road hauling in LTL (historically some of the best-paying work) is night work, and drivers with 

seniority tend to bid the road at least as often as the city. The seniority effect thus may bias estimates of the 

impact of night work per se on mishaps, but the bias is likely to be much smaller in studies based on 

trucking data than those based on factory data. 
47

Dinges, and Horne (endorsed by 17 other experts) addressed accidents and sleepiness.67

They stated that (1) fatal sleep-related highway crashes are especially frequent between 

midnight and 6 AM, (2) official statistics may understate the importance of fatigue in 

transportation accidents, and (3) countermeasures are needed to prevent fatigue from 

causing accidents. Stoohs et al. reported that sleep-disordered breathing among long-haul 

truck drivers doubles their accident rate.68 Folkard stated that circadian rhythms, rather 

than different driving conditions at night, were probably the cause of the peak in road 

transport accidents at 3 AM.69 Arnold et al. surveyed Australian truck drivers, finding 

that those who reported sleeping 6 hours or fewer prior to their current trip were 

significantly more likely to report hazardous events related to fatigue during that trip, 

such as nodding off while driving.70 McCartt et al. surveyed U.S. long-distance truck 

drivers; 25% reported falling asleep at the wheel in the past year, and 47% reported 

having fallen asleep at the wheel sometime during their driving career.71 Drivers 

especially likely to report falling asleep at the wheel included those with demanding work 

schedules (driving more than 10 consecutive hours per day, driving many hours per 

week, and taking fewer than 8 hours per day off duty), and those with split off-duty 

periods (and hence, fewer hours in the longest sleep period). Consistent with McCartt’s 

findings, Dr. Hamelin reported at the conference that over half of the truck drivers he has 

surveyed have dropped off at the wheel at some time during their careers. 

Numerous other studies found that driver fatigue and reduced driver alertness cause 

highway collisions and near misses. Among them are articles by Lyznicki et al.,

72

Dement,73 Barach et al.,

74 Summala and Mikkola,75 Hakkanen and Summala,76 Philip et 

al.,

77 Feyer,78 Horne and Reyner,79 and Horne and Reyner.80 

Dr. Kathryn Reid of Northwestern University made a conference presentation comparing 

the effects of fatigue and alcohol on highway safety, extending the work presented in the 

paper she co-authored with Drew Dawson.81 Dr. Reid argues that we need an easily 

grasped index of impairment. Comparing fatigue to alcohol intoxication, Dr. Reid argued, 

makes the consequences of fatigue clear to the public and to policy makers. Impairment 

due to fatigue can be assessed with neurobehavioral lab tests (OSPAT or PVT); driving 

simulators for cars, trucks, or trains; or measures of actual job performance (e.g., 

observed performance driving a truck, number of accidents, or productivity). If 

experimental subjects have been awake for 23 hours, then their performance on 

psychomotor skills deteriorates to the equivalent of 0.10% blood alcohol concentration 

(BAC). *

Dr. Reid noted that the amount of deterioration in performance caused by fatigue depends 

on the nature of the task. Being awake 23 hours causes more deterioration than 0.10% 

BAC does on grammatical reasoning speed, but less than 0.10% BAC does on 

 

*

 Care should be taken whenever making the comparison between alcohol and fatigue 

because they have different sources and progressions. Over time, intoxication subsides, 

but fatigue increases. 
48

grammatical reading accuracy. Dr. Reid said we need more research about which tasks 

are most impaired by fatigue. She said that job performance deteriorates greatly in the 

first three days working on a night shift. After that, people adapt; but they still do not 

perform as well as on the day shift.82

Based on both her own research and on other studies that she reviewed, Reid concluded 

in her presentation (see the accompanying CD-ROM or 

http://www.ilir.umich.edu/TIBP/truckdriverOSH) that “performance is significantly 

impaired with moderate levels of fatigue (17-24 hours of wakefulness), equivalent to the 

performance seen at legally prescribed blood alcohol levels (0.05 – 0.1% BAC). The type 

of task and how fatigue is accrued are important in influencing the degree of 

impairment.”83, 84, 85, 86, 87, 88, 89 “Combining alcohol and fatigue increases the level of 

impairment.” 

Dr. Reid thought that many years of research would be needed to develop a good measure 

of fatigue. There is no simple marker of fatigue comparable to the breathalyzer test for 

alcohol intoxication. Laboratory studies can measure the impact of fatigue on various 

performance tasks, but laboratory performance may differ from on-the-job performance 

as a truck driver. It is therefore important to conduct both simulator studies and studies of 

actual job tasks. Also, it is difficult to determine the exact effect of a change in reaction 

time on the probability of a highway crash. The consequences of fatigue depend on the 

circumstances; falling asleep while driving is far more dangerous than falling asleep 

waiting at the loading dock while stationary. Finally, she saw a need for further studies of 

recovery from sleep loss, particularly in cases where sleep duration varies from night to 

night. 

Dr. Hans van Dongen (University of Pennsylvania at the time of the conference; now at 

Washington State University) presented work he completed with colleagues regarding 

chronic sleep loss and wake state instability. His summary (included on the 

accompanying CD-ROM and at http://www.ilir.umich.edu/TIBP/truckdriverOSH) was as 

follows: 

Chronic sleep loss is common in today’s 24/7 society, of which 

transportation operations are an integral part. Recent laboratory 

experiments have demonstrated that chronic sleep loss can lead to 

cumulative deficits in key aspects of neurobehavioral performance: 

sustained attention, working memory, and cognitive throughput.90,91 These 

deficits are substantial: after 14 days with sleep restricted to 4 hours per 

day, average impairment levels are equivalent to those observed after two 

nights of total sleep deprivation.90 This indicates that people do not easily 

adapt to the adverse effects of chronic sleep restriction. Self-reported 

sleepiness does not appear to track the cumulative performance deficits 

resulting from chronic sleep loss, however. While research subjects in a 

partial sleep deprivation study reported feeling somewhat sleepier during 

the first days of sleep restriction, their sleepiness levels did not further 

increase across subsequent days.90 This suggests that people may feel they 
49

have adapted to chronic sleep loss even when their performance deficits 

continue to increase, resulting in misperception of performance capability. 

The discrepancy between objectively measured deficits from chronic sleep 

loss and subjective experiences of sleepiness might be explained by the 

nature of the performance impairment resulting from sleep loss. This is not 

just a gradual reduction of the various aspects of neurobehavioral function 

(e.g., cognitive slowing, diminished accuracy), but rather a rapidly 

fluctuating mixture of normal performance with acute lapses in 

performance. This “wake state instability”92 causes people with moderate 

sleep loss to perform optimally most of the time—but not always and not 

reliably. Thus, while sleep-deprived individuals may not experience any 

immediate impairment of neurobehavioral function, critical lapses may 

occur in circumstances requiring sustained cognitive accuracy and speed. 

The phenomenon of wake state instability, or “within-subjects variability” 

of neurobehavioral performance under conditions of sleep loss, makes it 

difficult to evaluate, in advance, whether a person can maintain optimal 

performance capability over time. Moreover, people differ substantially in 

the amount of sleep they need on a regular basis to maintain normal 

performance capability,93,94 as well as in the severity of performance 

impairment they exhibit when getting insufficient sleep.94 This “betweensubjects variability” makes it difficult to assess whether a specific 

individual has obtained enough sleep to perform optimally. Little is known 

about these two sources of variability in the detrimental effects of chronic 

sleep loss on neurobehavioral functioning. Yet, understanding and 

predicting within-subjects and between-subjects variance is essential with 

regard to safety in transportation operations. Therefore, identifying 

behavioral or biological markers of wake state instability and interindividual variability in vulnerability to impairment from chronic sleep 

loss should be key components of future research on truck driver fatigue 

and safety. 

Advance warning of wake state instability, Dr. van Dongen concluded, would allow truck 

drivers to stop for a nap before serious performance lapses occur. 

Dr. Orfeu Buxton (University of Chicago at the time of the conference and now at 

Harvard Medical School) presented evidence that endocrine function was closely related 

to sleep and sleep quality.95 He defined “sleep debt” as semi-chronic, partial sleep 

restriction and reported that sleep debt may lead to an increased risk of obesity and 

diabetes. He cited the finding by Spiegel et al. that sleep debt has a broad impact on 

metabolic and endocrine systems, inducing a pre-diabetic state.96 Chronic partial sleep 

deprivation was associated in this study and others with impaired glucose metabolism, 

abnormal cortisol (stress hormone) regulation, altered growth hormone (GH) profiles,97

altered autonomic function (elevated sympathovagal balance), and impaired immune 

function.98
50

Dr. Buxton noted that poor sleep quality (which entails a loss of slow-wave sleep, or 

SWS) and aging can reduce GH secretion, leading in turn to loss of leanness. He 

speculated that sleep loss could have harmful metabolic and endocrine effects even if it 

does not lead to subjective sleepiness, as some sleep deprivation experiments have been 

able to dissociate objective and subjective sleepiness, and subjective sleepiness reports 

are often unreliable. He also noted that sleep loss might play a role in a metabolic 

syndrome of obesity, insulin resistance, and hypertension that is becoming an 

increasingly common and intractable health problem.*

 

Dr. Buxton outlined a number of needs for future research. One is for studies of the 

relationship between sleep debt and both obesity and metabolic function among workers 

in transportation, health care, and other industries where extended work and habitually 

restricted sleep are common. Second, there is a need for experiments to determine how 

many hours in bed a person needs on the weekend to recover the sleep loss from the 

preceding work week. Third, longitudinal studies of sleep and health are needed. Finally, 

Dr. Buxton noted a need for mechanistic studies of how sleep loss impairs metabolism 

and may promote obesity, insulin resistance, and hypertension so that rational countermeasures can be developed. 

Studies by Stoohs and colleagues reported that sleep-disordered breathing is a common 

problem among long-haul truck drivers99 and that this problem increases significantly 

after six days of sleeping only four hours per day.100 At the conference, Dr. Christopher 

Drake (Henry Ford Hospital) presented evidence on the causes and consequences of 

obstructive sleep apnea (OSA), and the implications of OSA for commercial truck 

drivers. In OSA, a sleeping person’s airway closes, causing cessation of breathing for at 

least 10 seconds and sometimes more than a minute. Obstructive sleep apnea, Dr. Drake 

noted, results in functional sleep deprivation, in which a person spending 8 hours in bed 

might get the equivalent of only 51⁄2 hours of sleep. Airways are more likely to collapse 

during rapid eye movement (REM) sleep, when a person loses muscle tone. This is 

particularly important because OSA is positively correlated with obesity and large neck 

size, two indicators that are prevalent among truck drivers. The presence of OSA also is 

associated with daytime sleepiness (or even worse for truck drivers who work all night: 

nighttime sleepiness that is compounded by the attempt to defy the circadian sleep cycle.) 

Dr. Drake commented that there is a low correlation between subjective sleepiness and 

objective measures of performance decrements due to sleep debt. Drivers may not know 

that it is essential to take a nap. An article by Dingus, Hardee, and Wierwille supports 

this claim, noting that “a relatively large percentage of drivers are unaware of the onset of 

drowsiness while driving.”101 Dr. Drake added that some individuals are less skilled than 

 

*

 A scholar not at the conference, Dr. Steven Lockley of Harvard University, suggested that diabetes for 

shift workers may be due to eating meals at the wrong circadian phase, rather than to sleep disruption per 

se. See Steven W. Lockley, “Functional Physiology of the Circadian Clock,” presentation at National 

Science Foundation Chautauqua course, “Circadian Biology: From Clock Genes and Cellular Rhythms to 

Sleep Regulation,” May 30, 2003, Harvard University. 
51

others in detecting that they are sleepy. Drivers who fail to recognize the symptoms of 

fatigue, Dr. Drake said, were the ones most likely to have accidents. He stated that a high 

percentage of truck driver fatalities were associated with drivers falling asleep at the 

wheel. In support of this concern, Dr. Torbjorn Akerstedt commented that young workers 

and male workers were more likely to have accidents on the night shift. *

It would be useful to obtain data on actual sleep for different subgroups of drivers—e.g., 

union vs. nonunion, employee drivers vs. independent owner-operators vs. dependent 

owner-operators who regularly work for the same shipper, younger drivers vs. older 

drivers, and drivers who work in various sub-sectors of for-hire and private trucking. 

Subgroup analysis might identify drivers particularly in need of fatigue countermeasures. 

It is known, for example, that older people have greater difficulty than younger people 

have in sleeping at an adverse time in the circadian cycle. On the other hand, there is a 

self-selection effect: those who continue to work as truck drivers are systematically more 

likely than newly hired drivers to be able to tolerate typical driver work schedules 

because those with work schedule tolerance problems eventually find other jobs. 

Dr. Torbjorn Akerstedt (Karolinska Institute, Sweden) made a conference presentation 

reviewing the literature concerning shift work effects on health and wellbeing.†

 Dr. 

Akerstedt said that there have been few studies on shift work and mortality subsequent to 

the 1972 paper by Taylor and Pocock, which found no effect.102 Still, Dr. Akerstedt 

reported, studies have found that shift work was associated with cardiovascular disease, 

digestive problems, lack of appetite, diabetes, and complications of pregnancy (preterm 

birth, spontaneous abortion, and low birth weight). It also is associated with increased 

accident risk; night driving greatly raises the risk of fatal collisions. At least 3⁄4 of the 

shift-working population, Dr. Akerstedt found, was affected by disturbed sleep and 

wakefulness. He noted the problem of involuntary sleep at work: 25% of night shift 

process operators who can sit down while watching screens fall asleep on the job and are 

often unaware that they have done so. Younger workers are at highest risk of falling 

asleep at work on the night shift, even though laboratory studies show that daytime sleep 

becomes more difficult with increasing age. 

Dr. Akerstedt said that the literature is inconclusive concerning whether shift work is 

associated with depression, cancer, or sickness absence. Night shift workers have 

elevated levels of cortisol and thyroid stimulating hormone. He noted that people who are 

worried about getting up early enough have less slow wave sleep, so that their sleep is of 

lower quality. These problems may affect both safety and health among truck drivers, but 

more research is needed in this area. 

 

*

 The report on the presentation by Dr. June Fisher is out of conference sequence and grouped with social 

and behavioral consequences rather than with sleep disorders, because her presentation emphasized the 

effects of stress on transit bus drivers. It can be found in the section on “Health Consequences of Job 

Stress” below. 

†

 His written summary of these remarks, including extensive references to the scholarly literature, is 

included on the accompanying CD-ROM and at http://www.ilir.umich.edu/TIBP/truckdriverOSH. 
52

Dr. Ann Williamson of the University of New South Wales made a conference 

presentation on work/rest schedules, driving arrangements, and fatigue in long distance 

road transport. She presented Australian data on heavy truck crashes, showing that 49% 

involved fatigue, 48% involved speeding, and 14% involved illegal alcohol intoxication. 

The high percentage of heavy truck crashes occurring at night reflects driving patterns: 

truck drivers tend to drive then because the roads are less crowded at night. 

Dr. Williamson reported results of Australian surveys of bus drivers and of long distance 

truck drivers regarding fatigue. Drivers said that fatigue affected driving in several ways: 

• Slower to react (almost half agreed) 

• Poorer gear changes (more than 40% agreed) 

• Driving too slowly (more than one-third) 

• Poorer steering (more than one-third) 

• Less aware of other traffic (more than one-quarter) 

Strategies used by more than 75% of drivers to deal with fatigue included listening to 

music or the radio, ventilation, caffeine drinks, walking or kicking their tires; but fewer 

than a quarter found these strategies helpful. A strategy used by only about a third of 

drivers, stay-awake drugs, was the only strategy rated as helpful by over half of the 

drivers. 

More than 75% of drivers tried sleep as a remedy for fatigue, but, surprisingly, fewer than 

half found sleep helpful. Williamson’s surveys suggested that drivers often were able to 

take only short naps when they needed extended sleep. Extended sleep, however, is 

impractical when drivers are on tight schedules that they do not control. 

The survey results indicated that flexibility in scheduling rest is important in avoiding 

fatigue. Staged driving (called relay or “meet-and-turn” in the U.S.), in which drivers 

from two different locations meet halfway, exchange loads, and return to their points of 

origin, requires that each driver coordinate with the other. The lack of control in 

scheduling rest breaks when needed aggravates the problem of driver fatigue in staged 

driving. 

In addition to surveys, Dr. Williamson conducted field studies of different driving 

arrangements, assessing their impact on driver fatigue and performance. One study by 

Williamson, Feyer, and Friswell required drivers to do three trips between Sydney and 

Melbourne (a distance of 900 km).103 The first trip used staged driving; the second was 

driving solo and following standard driving hours regulations; and the third was driving 

solo but exempt from these regulations, so that drivers had flexibility to take rest breaks 

whenever they wished. For each trip, Dr. Williamson and her colleagues continuously 

measured driving performance (speed and steering variability) and heart rate. They also 

assessed fatigue with four off-road tests given at the beginning and end of each trip, 

measuring perceptual sensitivity, reaction time, vigilance, and tracking an unpredictable 

stimulus. Drivers experienced slightly more fatigue on staged trips. Pre-trip fatigue had 

an important impact on fatigue during the trip. 
53

In another field study, Dr. Williamson and colleagues assessed driver fatigue on very 

long trips (4,500 km or more) in Western Australia.104 They compared solo driving to 

two-up driving (called “team driving” in the U.S.), in which a pair of drivers alternate, 

one resting in the sleeper berth of the moving truck while the other drives. They took the 

same fatigue measurements as in the staged driving study. Although two-up drivers had 

more break time, solo drivers had longer sleep periods and were more likely to sleep at 

night. Two-up drivers tended to be more fatigued and to perform worse than the solo 

drivers. Williamson et al. found that a long (at least overnight) stationary rest was the 

best way to manage fatigue. She noted at the conference that professional drivers can 

manage one drive of 16 hours well; but a 16-hour drive, followed by a 6 hour rest, 

followed by a second 16-hour drive leads to performance problems on the second 16-

hour drive. 

Dr. Williamson and colleagues also conducted a laboratory study comparing the impacts 

of fatigue and alcohol intoxication on performance.87,88 This study compared 20 longhaul truck drivers to 19 people not employed as drivers. Subjects were given several 

performance tests after 28 hours of sleep deprivation. The same subjects were given these 

performance tests on another occasion without sleep deprivation but with varying doses 

of alcohol. Williamson et al. compared performance deterioration associated with fatigue 

to the performance deterioration associated with alcohol intoxication at a BAC of 0.05%. 

Based on this comparison, they found that, “at the end of periods of waking of 17-19 

hours, performance levels were low enough to be accepted in many countries as 

incompatible with safe driving.”105 Arnedt et al. reported similar findings.89

Dr. Williamson’s conference presentation asserted a “need for models of fatigue 

management programmes that have demonstrated effectiveness in handling the 

compromise between operational requirements and fatigue management.” She called for 

future investigations of the effect of breaking up long breaks into two shorter breaks and 

of the differences between day and night driving. Dr. Williamson said that researchers 

also “need validated and sensitive measures of fatigue to demonstrate effective fatigue 

management.”* †

 

*

 Ann Williamson, PowerPoint presentation at April 24-25, 2003 conference, included in on the 

accompanying CD-ROM and at http://www.ilir.umich.edu/TIBP/truckdriverOSH. †

 A paper not addressed at the conference noted an important requirement for sensors that can measure 

fatigue: they must be “able to distinguish the impairment ‘signal’ against a highly variable ‘noise” from the 

driving environment.” Stephen H. Fairclough and Robert Graham, “Impairment of Driving Performance 

Caused by Sleep Deprivation or Alcohol: A Comparative Study,” Human Factors, Vol. 41, No. 1, March 

1999, pp. 118-128 at pp. 118-119. 
54

Dr. Drew Dawson (University of Southern Australia) gave a presentation on regulating 

fatigue-related risk in transport. He presented a diagram with four quadrants: 

Safe and 

Permitted 

Unsafe and 

Permitted 

Safe and 

Not Permitted

Unsafe and 

Not Permitted

He argued that it is unwise for regulators to permit unsafe practices, and is also unwise 

for regulators not to permit practices that are safe. Instead, Dr. Dawson said, regulations 

should be tailored so that only the top left and lower right quadrants apply: all safe 

practices are permitted, and all unsafe practices are not permitted. He suggested a deal 

that would allow regulatory improvements. Regulators would ban practices that are 

unsafe and now permitted, and in exchange, regulators would allow practices that are safe 

but not now permitted. 

Dr. Dawson said that regulators have tried to manage fatigue indirectly, by limiting work 

hours. He argued that regulators should focus on the opportunity to obtain sufficient sleep 

rather than limiting work hours.*

 Furthermore, Dr. Dawson argued that regulators should 

focus on reducing the risks associated with fatigue and not just reducing fatigue. Risk 

assessment must consider both the likelihood of a performance failure and the 

consequences of a performance failure. Risk may be low, he asserted, for employees 

doing office work or training, moderate for a team of drivers transporting innocuous 

cargo in a rural area, but high for a single driver transporting hazardous material through 

a densely populated area. 

Dr. Dawson proposed offering motor carriers a choice of two regulatory systems. First, 

they could choose a traditional system of HOS regulation, in which driver hours would be 

regulated. This might be appropriate for small carriers and owner-operators. 

Alternatively, they could choose a fatigue risk-management system that would provide 

more flexibility than traditional HOS regulation but would also entail a greater 

information-reporting burden. 

Dr. Dawson’s fatigue risk-management proposal, which has been implemented in 

Australia for railroads and aviation, requires employers to designate an executive who 

can be held accountable for safety problems that are reasonably foreseeable. Carriers 

would educate their employees about their responsibilities to ensure that drivers have an 

adequate opportunity for sleep. Carriers would establish an auditable, quantitative 

methodology to ensure that employees have obtained sufficient sleep to operate safely. 

 

*

 Validation of Dr. Dawson’s strategy of focusing on the opportunity to obtain sufficient sleep, rather than 

limiting work hours, is a potential topic for future research. The FMCSA focused on sleep rather than on 

working time in its 2003 regulatory changes. 
55

Dr. Dawson stressed the need for shared responsibility. As his presentation (included on 

the accompanying CD-ROM and at http://www.ilir.umich.edu/TIBP/truckdriverOSH) 

states, “The employer is responsible for providing staff with a shift system that permits 

sufficient opportunity to rest and recover. In determining this, the employer must 

acknowledge the non-work activities and responsibilities of the employee. . . . The 

employee is responsible for using their allocated time off to obtain sufficient sleep in 

order to work safely. If this has not been possible, as a condition of employment, they 

must notify their employer that they may have had insufficient sleep.” 

Dr. Dawson proposed quantitative measures to ensure that drivers have had sufficient 

sleep. These measures would include a “start rule” stating that a driver is unfit to work if 

he or she has obtained less than 5 hours of sleep in the 24 hours prior to commencing 

work, or less than 12 hours of sleep in the 48 hours prior to commencing work. In 

addition, the “finish rule” would specify, “The period from wake-up to the end of shift 

should not exceed the amount of sleep obtained in the 48 hours prior to commencing the 

shift.” 

Under this proposal, if either the start rule or the finish rule were violated, the driver 

would be required to notify the line manager. The dispatcher could then assign the driver 

to a late start (so that he or she could obtain additional sleep), an early finish, or an 

alternative job assignment where the risks from fatigue are less serious. Alternatively, the 

driver might take countermeasures such as napping or ingesting caffeine, or take sick 

leave. If, however, the employee failed to notify his line manager about the violation of 

the start or finish rule, then the employee would assume at least partial responsibility for 

any fatigue-related accidents, reducing the liability of the carrier. A similar system is 

used in Australian rail, where dispatchers ask employees how much sleep they have had 

in the past 24 and 48 hours prior to selecting their assignment. 

Dr. Dawson stressed the need for the fatigue risk-management system to be simple to 

understand and based on readily measurable evidence (e.g., hours of sleep in the past 24 

hours, rather than the driver’s circadian phase) so that employees have a sense of 

engagement and ownership. Quantifiable measures must be available quickly enough to 

meet operational needs. The fatigue risk management system can employ two distinct 

strategies: altering shifts in a manner that reduces fatigue, and changing operations so that 

fatigue is less likely to result in poor job performance. 

In the discussion that followed, an analogy was drawn between sleep testing and drug 

testing. A requirement that workers certify sleep away from work could be perceived as 

an invasion of privacy. Still, we already have drug and alcohol testing for transport 

workers; reports on fatigue are equally relevant to safety and no more intrusive. Another 

concern was driver cooperation in reporting sleep; a driver who repeatedly reported 

insufficient sleep and the need for either an alternative assignment or sick leave might be 

subject to disciplinary action. 

Dr. Dawson was asked whether the alternative fatigue management system he proposed 

was feasible for a small company. He answered that a trade association for Australian 
56

aviation companies has developed a standardized fatigue management system that 

Australian regulators have approved and that small aviation maintenance firms just adopt 

this off-the-shelf plan. 

One conference participant suggested a study of whether use of caffeine avoids the 

deterioration of driving performance associated with fatigue. Dr. van Dongen suggested a 

similar study involving the use of Provigil (modafinil), a wakefulness-promoting drug 

used to treat narcolepsy. Dr. Audrey Newell (Oakwood Healthcare System) questioned 

whether it was appropriate to prescribe a narcolepsy drug to patients without any medical 

problem; rather, work schedules should be redesigned so that healthy humans can tolerate 

them. 

A number of participants asserted at the conference that shipper demands contribute to 

driver fatigue problems that affect safety. One participant suggested doing a field 

experiment in which shippers change their practices to ensure that drivers receive 

adequate rest. Such an experiment would probably have to provide financial 

compensation to the shippers for the extra costs that they incur. 
57

Causes of Driver Fatigue and Sleep Deprivation 

Fatigue and sleep deprivation are common problems for truck drivers. Many long-haul 

truck drivers face chronic partial sleep deprivation. Mitler et al. studied eighty long-haul 

drivers over a five-day period, finding that their electrophysiologically verified sleep 

averaged only 4.78 hours per day—and only 3.83 hours of sleep per day for those drivers 

on a steady night schedule.106 While research on fatigue has emphasized long-haul 

drivers, fatigue also affects local/short haul truck drivers. Hanowski et al. monitored 42 

local/short haul drivers for approximately two weeks each with video cameras and 

sensors, finding evidence of driver fatigue such as driving for periods with eyes 80%-

100% closed.107

What causes driver fatigue? Brown identified three aspects of working arrangements that 

determine fatigue: “(a) the length of continuous work spells and daily duty periods; (b) 

the lengths of time away from work that are available for rest and for continuous sleep; 

and (c) the arrangement of duty, rest, and sleep periods within the 24-h cycle of daylight 

and darkness, which normally entrains individuals’ circadian rhythms.”108 Truck drivers, 

Brown asserted, are particularly at risk for fatigue because their work schedules are 

irregular and beyond the driver’s personal control; their sleep breaks often occur during 

the day when conditions are not favorable for sleep; they experience stresses in the truck 

cab such as heat, noise, and vibration; and they continue working even when fatigued in 

order to reach their destination. The latter is consistent with Beilock’s finding that 

schedule pressures often induced truck drivers in Florida to violate HOS regulations or 

speed limits, particularly for drivers who were driving solo, had long trip distances, or 

refrigerated loads,109 as well as with Williamson’s findings discussed above. Arnold et al. 

surveyed truck drivers and motor carrier managers in Australia regarding causes of driver 

fatigue, finding that the cause most often cited by both groups was driving long hours.70

Akerstedt and colleagues have authored several studies on work schedules, sleep, and 

fatigue. An EEG study by Torsvall and Akerstedt showed that ships’ engineers who 

worried about being awakened while they were on call did not sleep well.110 Truck 

drivers are commonly in this situation, having sleep breaks while awaiting telephone 

notification at an unpredictable time informing them of the availability of their next load 

(a situation explicitly permitted by the current HOS regulations). Similarly, a survey by 

Akerstedt et al. of over 5,000 employed adults in Sweden found that problems unwinding 

after work often disturbed sleep.111 At the conference, Dr. Akerstedt said that the 

strongest correlates of fatigue were night work, a long time awake, and backwards 

rotation of shifts; day sleep and early shift starting times had weaker correlations with 

fatigue. It was unclear, Dr. Akerstedt said, whether on-demand scheduling led to fatigue. 

A study by Cziesler et al. noted the importance of circadian principles in designing work 

schedules.112 They studied 85 industrial shift workers who initially had a weekly 

backward shift rotation (an 8-hour phase advance, in which workers’ start times rotate 

from day to night to afternoon). Workers were happier, and their productivity was higher, 

when their shift rotation was changed to a forward rotation (an 8-hour phase delay, in 

which workers’ start times rotate from day to afternoon to night) once every 21 days. 
58

Monk identified a problem with slow rotation (such as every 21 days) or steady night 

shifts: workers revert from a nocturnal schedule to a diurnal schedule during the weekend 

in order to spend time with family and friends, undermining the adaptation to night 

work.113 But Knauth114 concurred with Cziesler et al. that forward rotation was better for 

workers than backward rotation. 

Truck driver work schedules, however, often are not in accord with the Czeisler et al. 

recommendation. As Saltzman and Belzer noted, a 1962 amendment to the federal HOS 

regulations for interstate truck drivers permitted a driver in a hurry—or a carrier 

dispatching a driver for maximum productivity—to adopt an 18-hour cycle: 10 hours of 

driving, followed by eight hours off-duty, followed by another driving cycle.37 This is a 

substantial backward rotation of up to 6 hours per day compared with 8 hours per week 

reported in the Czeisler et al. study. As noted above, even the new HOS regulations have 

within them the potential for substantial backward or forward schedule rotation, if the 

driver does not work or drive the maximum possible hours. In the example in Tables 4 

and 5, assuming the driver drives all available hours and does not use any time for nondriving labor, the driver experiences a three-hour backward rotation with the new 

regulations. If the work pattern requires even shorter days, the backward rotation can 

become even more pronounced. All of the predictable options made for the HOS 

regulations, therefore, go “out the window” as drivers’ true practice reflects the often 

quite irregular demand for trucking services. 

This irregular nature of driver work/rest cycles presents an additional systemic problem. 

Truck drivers often must work or attempt to sleep at an inappropriate circadian phase. If a 

person’s work/rest cycle is synchronized with the solar day, the endogenous circadian 

signal helps the individual maintain alertness for a full 16 hours. In the early evening 

homeostatic sleep pressure – the need for restorative sleep after a long time awake – 

begins to build, and eventually helps the individual fall asleep. At 3 AM, after the first 

few hours of sleep have relieved the homeostatic pressure, the circadian signal helps the 

individual stay asleep. Similarly, if a person whose circadian clock has been entrained to 

the solar day tries to work all night, homeostatic pressure and the circadian signal will 

combine to make him or her sleepy.115 Furthermore, sleeping during the day may be 

difficult, even if he or she has been awake for a long time. 

One conference participant said that regional freight generally is loaded early evening, 

and the driver is required to deliver it by the following morning. In these circumstances, 

when the carrier’s operations have a daily pattern of local freight pickup and overnight 

delivery (as in the regional LTL market), city drivers will work during the day while road 

drivers will run through the night. These drivers’ problems arise paradoxically on and 

following the weekend, when they shift to their families’ normal day shift and back again 

to the night shift the next week. 

Several conference participants cited the need for further study regarding how much sleep 

truck drivers actually get. It is well known, however, that drivers often do not accurately 

record sleep in diaries, so it might be better to use an actigraph to register hand 

movements indicating that the driver is awake. Drivers, however, can manipulate 
59

actigraph measurements; even EEG measurements can be manipulated by putting the 

electrodes on a person other than the one the researchers intended to study. 
60

Health Consequences of Driver Work Schedules 

In 1908, a brief by Louis Brandeis persuaded a property-rights-oriented U.S. Supreme 

Court to uphold the constitutionality of an Oregon statute limiting women’s work to ten 

hours per day, on the grounds that longer work hours could injure the health of women 

workers.116 While at the time it was controversial even to limit women’s hours, 

proponents could justify it based on protective concerns. We now know that long and 

irregular work hours have an adverse effect on the health of workers in some 

occupations, notably including truck driving, regardless of gender. Saltzman and Belzer 

argued that improved driver health was potentially a large benefit of stricter federal 

regulation of driver work hours.37 The report by Hamelin55 (included on the 

accompanying CD-ROM and at http://www.ilir.umich.edu/TIBP/truckdriverOSH) notes 

that high driver turnover makes a portion of the costs of poor driver health an external 

cost from the perspective of motor carriers, which implies that free markets provide less 

than the efficient level of driver health. 

Truck drivers may not fully recognize the harmful effects of their work schedules on their 

lives until the long-term effects have become evident. Spelten, Barton, and Folkard 

examined the extent to which shift workers underestimate the harmful impact of their 

jobs on their health and well-being.117 They surveyed retired British police officers who 

had experienced shift work prior to retirement (typically at age 50) and then taken on new 

jobs, generally on the day shift. They also surveyed current British police officers. The 

retirees gave two measures of their health, fatigue, and anxiety levels while they had been 

police officers: their recollection of how they would have scored them at the time, and the 

score that they now thought was accurate. Their “at the time” scores reported fewer 

problems than did their post-retirement assessments. Nevertheless, their “at the time” 

scores were similar to the scores reported by currently employed police officers. Spelten 

et al. concluded that shift workers lose sight “of what normal (i.e., day-work) life is like. 

That is, they may habituate to a gradual lowering of their well being, subjective health, 

etc., and hence consider (and thus rate) themselves as relatively ‘normal.’118

As Saltzman and Belzer reported,37 chronic partial sleep deprivation is a major cause of 

driver health problems. Spiegel et al. found that restricting sleep in healthy young men to 

four hours per night for a mere six nights “is associated with striking alterations in 

metabolic and endocrine function.” Specifically, sleep debt reduced glucose tolerance and 

thyrotropin concentrations, and it increased evening cortisol concentrations and the 

activity of the sympathetic nervous system. “The effects are similar to those seen in 

normal ageing and, therefore, sleep debt may increase the severity of age-related chronic 

disorders” such as diabetes and hypertension;96 see also Leproult et al.119 This 

hypertension may account for the high risk of stroke found among truck drivers in 

Denmark.120

Other researchers have confirmed the harmful effects of partial sleep deprivation on 

healthy, working-age men. One study assessed the impact on blood pressure of overtime 

work that limited sleep. Blood pressure was significantly higher following a day with 

overtime work and only three to four hours of sleep than it was following an eight-hour 
61

workday and approximately eight hours of sleep.121 Another study compared immune 

function after a normal night of sleep to that after a night when subjects were not allowed 

to sleep between 10 p.m. and 3 a.m. The researchers found that “even a modest 

disturbance of sleep produces a reduction in natural immune responses,” resulting in 

increased vulnerability to infection.122 A third study measured sympathetic nervous 

system activity, both on nights when subjects were allowed to sleep and on nights when 

subjects were awakened at 3 a.m. and kept awake until 6 a.m. They found that partial 

sleep deprivation raised nocturnal catecholamine levels, which can contribute to 

cardiovascular disease.123 This laboratory finding was supported by epidemiological 

evidence: middle-aged men who suffered sleep loss as a result of rotating shifts had 

higher risks of coronary heart disease than men working only during the day.124

Working long or irregular hours may have other harmful effects on health in addition to 

those related to partial sleep deprivation. For reviews of the literature, see Michie and 

Cockcroft,125 Spurgeon et al.,

126 Harrington,127 and Sparks et al.128 An epidemiological 

study in Sweden examined the impact of long work hours on mortality between 1973 and 

1996 among approximately 11,000 men and 9,500 women born between 1926 and 1958. 

Even controlling for age and for behavioral factors such as smoking, drinking, and use of 

tranquilizers, regular overtime of more than five hours a week was associated with higher 

mortality rates for five years following the overtime.129 Knutsson noted the lack of 

conclusive evidence that shift work shortens life spans or increases the risk of cancer; but 

his literature review found some evidence that shift work increased the risk of diabetes 

and metabolic disturbances and strong evidence that shift work increased the risk of 

coronary heart disease, complications of pregnancy, and peptic ulcers.130

Other studies have examined the impact of long or irregular work hours on specific health 

problems: 

• Extended working periods desynchronize the internal circadian rhythms of longhaul drivers who work many hours per day and have work/rest cycles less than 

twenty-four hours.131

• Irregular hours and night work raise the risk of being hospitalized for ischemic 

heart disease (IHD).132 Professional drivers are at greater risk of IHD if they work 

long hours.133 This cardiac risk may increase partly because professional drivers 

who spend long hours behind the wheel tend to have a higher body mass index.134

• Working over 40 hours per week doubled the risk of acute Helicobacter pylori 

infection (associated with peptic ulcers), even controlling for age, sex, and marital 

status.135

• A group of Dutch truck drivers working an average of 11.4 hours per day had 

insufficient recovery after work from sympathoadrenal activation. Their elevated 

catecholamine levels were associated with increased psychosomatic health 

complaints.136, 137

Apropos of this research, Dr. June Fisher commented that there is an extraordinarily high 

level of cardiovascular disease among bus drivers in Scandinavia and Germany. She 

suggested that the reason might be that weekly shift rotations are common practice there 

(perhaps rooted in an egalitarian desire to share the burden of working night shifts). 
62

Health Consequences of Job Stress 

Truck drivers experience stress for several reasons. Long hours and extended periods 

away from home cut them off from friends and family; and even on days home from 

work, they may be too tired to nourish their marriages or their relationships with their 

children. Unless their home lives are exceptionally stressful, they likely will enjoy their 

off-duty hours less if they are spent in the sleeper berth of a truck rather than at home. In 

fact, regularly being “stuck” on the road in a strange city puts intolerable stresses on 

many—perhaps most—average people, and truck drivers may be stranded in undesirable 

locations as well. Owner-operators often are under intense financial pressure, finding it 

difficult to make the required loan or lease payments on their truck. Package drivers may 

experience stress because of intense work—a combination of many stops per day and 

pressure to pick up and deliver on time. A study of package drivers in the U.S., for 

example, found that their mean score on a standard scale of psychological stress was at 

the 91st percentile for the general adult population.138 Truck drivers also may experience 

stress from dealing with customers to whom they deliver loads: they often are required to 

wait in their trucks for long and unpredictable periods of time before being brought in to 

the dock to load or unload; are denied opportunities for food, water, and restroom 

facilities; and are treated disrespectfully by shipping and receiving personnel. 

Some studies of job stress among drivers have focused on bus rather than truck drivers. 

For example, Raggatt and Morrissey found that physiological measures of heart rate, 

blood pressure, catecholamines, and cortisol confirmed that long-distance bus drivers 

experience stress during long work shifts.139 Sluiter et al. found that this stress response 

may be aggravated if long-distance bus drivers do not have adequate resting times during 

trips and a duty-free recovery period between trips.140

Bus and truck drivers have somewhat different job duties; for example, dealing with 

passengers is an important job duty for bus drivers, while loading and unloading cargo is 

an important job duty for many truck drivers. Employment conditions in the urban transit 

segment of bus transportation may be affected by stark economic differences with 

trucking: urban transit drivers work for subsidized, government-owned monopolies and 

are often protected by union contracts, whereas truck drivers work for private companies 

facing intense market competition and, in the TL sector, are rarely unionized. Urban 

transit drivers also are not subject to the same federal HOS regulations as are interstate 

truck or bus drivers. Still, both urban transit and long-distance bus drivers encounter 

some of the same problems as truck drivers do, such as whole body vibration and 

difficulty unwinding after work. Long-distance bus drivers, like regional and long-haul 

truck drivers, are often away from home and work at times when their circadian clock is 

set for sleep, and they often have irregular work schedules. While the differences 

between bus driving and truck driving are important, research about stress among bus 

drivers may nevertheless have some relevance for truck drivers. 

At the conference, Dr. June Fisher (University of California-San Francisco) presented 

research she conducted with Dr. David Ragland of the University of California-Berkeley 

on how job stress affects the health of urban transit operators (including not only bus 
63

drivers, but also trolley and cable car drivers and light rail workers). Dr. Fisher directs the 

MUNI Health and Safety Study, a large study of workers in San Francisco’s MUNI urban 

transit system. This study began in 1978 as a result of concern about occupational health 

by Transport Workers Union Local 250A, which represents MUNI employees. 

Researchers conduct biennial medical exams mandated for urban transit drivers by the 

U.S. Department of Transportation, and they use the exam results to analyze health 

trends. Two important features of the study are that, first, providers conducting the 

medical exams have knowledge about the work environment and, second, researchers 

have ongoing interactions with both MUNI management and the union. 

Dr. Fisher reported that the MUNI study found a high rate of hypertension among urban 

transit workers, which she attributed to stress. The separation rate was higher for 

hypertensive MUNI workers than for non-hypertensive workers, even controlling for age. 

Dr. Fisher reviewed studies conducted by others of urban transit operators’ health and 

safety, noting that transit operators have higher than average levels of cardiovascular and 

musculoskeletal risk. 

Dr. Fisher said that some health behaviors of MUNI transit workers contributed to health 

risks. Body mass index was higher, on average, for employees with over 10 years of job 

tenure than for newly hired employees. Employees with five or more years of job tenure 

with MUNI smoked more cigarettes per day and consumed many more alcoholic drinks 

per week than did newly hired employees. Dr. Fisher raised the question of whether these 

behaviors were maladaptive coping mechanisms for dealing with job stress. 

Dr. Fisher showed a diagram about occupational stress, first presented to MUNI transit 

operators in 1986 by the late Professor Bertil Gardell. Stressors include both overload 

(e.g., time pressure or more task complexity than the operator is prepared to handle) and 

“underload” (e.g., too simple a job role relative to the operator’s capabilities). Other 

stressors include ambiguous job instructions and awkward work postures. Stress can be 

affected, Gardell’s diagram indicated, by decision latitude regarding one’s own work 

(e.g., control over job content, work methods, and pace, and physical freedom); social 

support from supervisors, family, and friends; and control over future prospects (e.g., 

information about major changes at work and access to continuing education). 

Dr. Fisher reported that drivers who face substantial time pressure (because they get 

behind the timetable and must strain to get back on schedule) exhibit physiological stress, 

as indicated by their cortisol and adrenaline levels. Such drivers take more frequent sick 

leaves and more often report stomach pains. Other occupational stressors in urban transit 

besides time pressure include violence, troublesome passengers, traffic, lack of 

supervisory support, shift work, and long work hours. The consequences of transit 

operator health problems for the MUNI urban transit system, Dr. Fisher continued, 

include absenteeism, increased workers’ compensation costs, increased turnover, and 

early disability retirement. 

Dr. Fisher recommended that future research include work-based fatigue studies, 

physiological and biochemical monitoring studies at work and rest, assessment of the 
64

impact of rest periods on vigilance and fatigue, studies of unwinding, development of 

methods to reduce maladaptive coping strategies, and studies of how changes in the work 

environment affect hypertension. 

A potential topic for future research is to determine the extent to which research findings 

concerning job stress among long-distance bus drivers and urban transit workers are 

applicable to truck drivers. 
65

Social and Behavioral Consequences of 

Employment as a Truck Driver 

A review by Costa noted the impact of nonstandard work schedules on social 

relationships:141

People engaged in shift- and night work are frequently out of phase with 

society, and can face greater difficulties in their social lives because most 

family and social activities are arranged according to the day-oriented 

rhythms of the general population. Consequently, shift work can lead to 

social marginalization due to the mismatch between the shift workers’ 

time budgets (working hours, commuting, and leisure times) and the 

complex organization of social activities. 

Truck driving jobs, especially in long-distance trucking, entail not only long and irregular 

work hours, often at night, but also frequent travel away from home and pressure to meet 

tight deadlines. Mr. Ron Jager, an owner-operator, noted at the conference that living in 

your truck is like living in an RV—only you don’t get to choose where you go. These 

difficult job characteristics may have adverse social, behavioral, and other consequences 

for truck drivers and their families. 

Dr. Lawrence Root (University of Michigan School of Social Work and Institute of Labor 

and Industrial Relations) presented qualitative data on the effects of long work hours on 

work and family issues. In the U.S. labor force as a whole, most of the employees taking 

family leave or requesting flexible hours are women. He noted, however, that long work 

hours for men also had a substantial impact on the family. He presented statements about 

work hours and family from three male blue-collar workers, interviewed by Dr. Root’s 

University of Michigan colleagues: 

. . . the thing that I remember the most was that my father used to work 

seven days a week. Even though we had all the material things that we 

could ever want, he was hardly ever there. . . He was always at work. 

That’s what I remember the most about my father growing up. . . . I don’t 

want to have the same relationship with my son—I don’t want my son to 

remember me as someone who worked all the time. 

—Harold, a new employee at “Sylvania” 

I would work every overtime there was to cover for the fact that my wife 

didn’t work outside the house. But like I said she was there to raise the 

kids. I know whenever they went to school they had some food in they 

stomachs and that they had the right clothes on. And I know when my 

girls went to school they wasn’t in elementary with a face full of make-up 

on. Because she was there to see them walk out that door and to see them 

when they came back in that door. But a lot of people wasn’t that 

fortunate. Kids leave out and they have maybe another thing of clothes in 
66

their backpack. But my wife would make sure that when you leave outta 

there, “Let me see what you got in that bag.” You know what I’m saying. 

(laughs) So that all paid off. 

—Arthur, 30-year worker at “Sylvania” 

[Overtime and shift-work] got me away from them more than I should 

have ‘cause I, I worked long hours. When I worked midnights, one of the 

reasons I worked midnights is made more money. I did it for 31⁄2 years. I 

could go in like when they were goin’ to bed. And I you know be home 

and asleep when they got home from school I was there. And I liked that. 

My wife hated it and I didn’t realize how much she hated it. That almost 

caused us to be divorced. . . . I thought, “Yeah you’re complainin’ ya got 

kids, ya got 2 dogs, ya got a nice house. Why don’t ya—.” Not being very 

sympathetic. That’s why I say she put up with more than I realized. . . . 

She said, “You don’t get off midnights, you’re not gonna have anyone ta 

come home to.” And that’s when I knew she was serious. (laughs) . . . I 

tried not to let work interfere with my kids. And I think sometimes I let it 

interfere with my wife. ‘Cause the kids were more of the priority and I just 

always thought the wife would understand. And I learned like I saw about 

that midnights and that she didn’t understand. She didn’t understand why 

she wasn’t being more a priority. (pause) Work came first on Saturday. 

—Don, approaching retirement at “Sylvania” 

Dr. Root also presented data from the University of Michigan Trucking Industry Program 

(UMTIP) driver survey in 1997 and 1998, which included over-the-road truck drivers 

who were employees as well as owner-operators. Ninety-seven percent of the respondents 

were male, 61% were married, and 57% had children. Between the last trip and the trip 

during which they were interviewed, 52% had slept at home, while 42% had slept in their 

truck. Twenty-six percent said they were “not at all satisfied” with the amount of time 

they have at home, while 21% said that their company was “not at all concerned” with 

the need for time at home and the well being of the families of truck drivers in their 

employ. 

Dr. Root noted several challenges for work-family balance with truck drivers. First, the 

stress of long work hours for truck drivers is compounded by often being far from home. 

Second, work-family discussions often have provided little attention to truck drivers and 

other predominantly male occupations because of the traditional view that work-family 

balance is mainly of concern to women. Third, programs such as family leave and 

flexible scheduling may be more difficult to implement in the context of trucking. 

Finally, basic improvements to make trucking more “family friendly” require looking 

more fundamentally at the structure of the work relationship. 

In the discussion at the conference, several people addressed social relationships of truck 

drivers. Dr. Dawson reported on a study he did of Australian rail workers, who seemed to 
67

over-report time that they spent with their children. He said that a successful shift worker 

in Australian railroads often had traditional marriage with a stay-at-home wife who did 

everything for him at home. Dr. Quinlan said that truck drivers have a terrible 

work/family balance, but there is relatively little research on this. Dr. Newell noted that 

the wife of a trucker is like a single mom, assuming almost all of the responsibility for 

taking care of the children and the home. The U.S. military provides support for the 

spouses of soldiers who recently went to Iraq. Could something similar, Dr. Newell 

asked, be provided for spouses of truck drivers? Dr. Dawson replied that Australian rail 

workers have support groups for spouses and a “lend a husband” program for home 

repairs. 

Dr. Newell suggested a study of the impact of trucking employment on relationships with 

spouses and children. Do the children of long-haul truck drivers lack parental help with 

homework and have difficulty in school? Does employment as a long-haul truck driver 

increase the likelihood of divorce? Alternatively, do frequent absences from the home 

provide a respite from family conflict and reduce the likelihood of divorce? The latter 

could be the case if long-haul truck drivers are disproportionately likely to have poor 

interpersonal skills. 

Dr. Fisher noted the harmful behavioral consequences of employment as an urban bus 

driver. Such drivers face conflicting role demands. They need to maintain constant 

vigilance to maintain safety. They face pressure to stay on schedule. They are required to 

be nice to passengers, even troublesome passengers. Bus drivers deal with their tensions 

by smoking and drinking. They do not drink on the job, but they drink more after work 

once they start working as drivers. Dr. Fisher saw a need to study methods to reduce 

maladaptive coping strategies among bus drivers. 

Truck drivers, too, may employ maladaptive coping strategies and behaviors related to a 

life on the road. Further research could determine if employment as a truck driver leads to 

increased smoking, poor diet, lack of exercise, and an increased incidence of sexual 

relations with prostitutes (a practice that contributed to the spread of AIDS in Africa). 

More importantly, future research could evaluate potential countermeasures, such as the 

wellness-counseling program for professional drivers evaluated by Hedberg et al.142

When John Siebert said that OOIDA members did not have unusually high health 

insurance costs, Dr. Newell was puzzled. Since truck drivers have higher rates of 

diabetes, hypertension, and other chronic diseases, their use of medical services should be 

higher as well; and these conditions are expensive to treat. She suggested that truck 

drivers may not be getting needed medical care because of scheduling problems and 

being out of town. 

Dr. Newell’s suggestion at the conference was confirmed by a subsequently published 

study by Solomon et al.

143 This study found that 47% of long-distance truck drivers 

surveyed in 2002 lacked a regular health care provider. Fifty-six percent of drivers 

“reported difficulty making a healthcare appointment while at home . . . due to their work 

schedule. . . .[and 62%] needed healthcare. . . but did not seek it because they were on the 
68

road working.”144 Future research could explore ways of organizing the provision of 

medical care so that truck drivers have access to health services, including continuity of 

care needed for effective diagnosis and treatment. 
69

Developing a Research Agenda on Truck Driver 

Occupational Safety and Health 

Near the end of the conference, participants broke up into discussion groups organized by 

area of interest. The following section includes a literature review on issues raised at the 

conference and issues that have arisen in discussions with interested parties since the 

conference. It also includes the reflections of the conference participants regarding what 

they had learned and where research should be directed. 

⇒ What countermeasures might be taken to address driver fatigue? 

A review article by Rosa et al. listed several possible interventions to promote adjustment 

to night work and shift work:145 

• Redesigning work schedules (e.g., forward rotation of shifts rather than backward 

rotation) 

• Rest periods or scheduled naps within shifts to relieve fatigue 

• Exposure to bright light to reset circadian clocks 

• Physical activity and conditioning 

• Pharmacological aids 

• Eating habits conducive to sound sleep hygiene 

• Individual behavioral techniques (e.g., relaxation training to reduce stress) 

A recent review by Knauth and Hornberger asserted that extending work shifts beyond 8 

hours leads to fatigue unless there are sufficient breaks during the shift and time after the 

shift for complete recovery. Employees, they continued, need at least 11 hours off 

between two work shifts, as rest periods of 8 to 10 hours may allow only 3 to 5 hours of 

sleep.146 At the conference, Dr. Akerstedt said that shift workers were better off if they 

worked a few long shifts provided that they had frequent days off (e.g., working 12 hours 

two days in a row, followed by two full days off work). 

⇒ How serious is the effect of irregular and unpredictable scheduling? How can 

policy-makers reduce the irregularity and unpredictability of scheduling without 

introducing potentially devastating costs into the logistics chain? 

Truck drivers often face a problem that most factory shift workers do not: highly irregular 

and unpredictable schedules, as well as work that takes them away from home as a 

normal process, so whether drivers could productively take the kind of time off suggested 

by Akerstedt depends greatly on the nature of the work process*

. Horowitz et al. found 

 

*

 At the time that J.B. Hunt implemented the famous increase in compensation that was the subject of the 

study by Belzer, Rodriguez, and Sedo, they also offered a “get-home” policy that promised the drivers that 

two weeks after they asked to be home the company would get them home regardless of cost. See Belzer, 

Michael H., Rodriguez, Daniel A., and Sedo, Stanley A. (2002), “Paying for Safety: An Economic Analysis 

(Continued on next page) 
70

that maintaining a consistent sleep schedule facilitates adaptation to night work.147

Conference participants noted, however, that shipper cooperation is necessary to provide 

predictable work schedules that allow drivers to sleep well. Trucking is very demanddriven, reflecting both the power of shippers and industrial practices such as just-in-time 

inventory systems. Drivers often do not know when to be ready for work. A dispatcher or 

broker may string a driver along regarding when a load will be ready, and the driver stays 

awake expecting a job, but then the job may not start until 12 hours later. Dispatchers can 

telephone the driver during a rest break to notify him or her when to report back to work. 

The sleep disruption may substantially affect the driver’s recovery from fatigue and 

eventually damage his or her health. An operational change that would reduce driver 

fatigue would be to notify drivers regarding the timing of their next dispatch at the end of 

their tour of duty. Effecting this change would require a major cultural change in the 

trucking and shipping community, which is accustomed to demanding service whenever 

the freight is ready to move, and on very short notice. 

⇒ Will some people naturally tolerate the scheduling problems that are traditional in 

trucking and transportation? What personal characteristics explain differences in 

drivers’ ability to deal with night work or irregular shifts? 

At the conference, Dr. Rogers said that some people are better able than others to tolerate 

night work or irregular shifts. A recent review by Costa reported, “it is not yet completely 

clear to what extent personal characteristics influence long-term tolerance to night work 

and hence whether they can be used as possible predictors for such tolerance.”148 Further 

research to predict which individuals best tolerate driver work schedules would be useful 

for personnel selection. 

⇒ What time or other intervention might help truck drivers better recover from sleep 

loss without harming their health? 

Dr. Reid said there was a need to know more about recovery from sleep loss. Dr. 

Akerstedt suggested conducting field experiments on fatigue with companies using 

different work schedules, compensating companies for incurring higher costs associated 

with the study. Dr. Drake suggested an experiment in which truck drivers would be paid 

to sleep, assessing whether this offsets the financial incentive of mileage-based pay to get 

less than an adequate amount of sleep. Dr. Fisher suggested a field study of the impact of 

rest periods on fatigue. 

⇒ How can drivers and other workers similarly situated better unwind after work? 

How can unwinding be accomplished without the use of self-medication? How 

can drivers be socially reintegrated after a stressful day of driving? 

 

(Continued from previous page) 

of the Effect of Compensation on Truck Driver Safety,” (Washington, DC: United States Department of 

Transportation, Federal Motor Carrier Safety Administration), pp. 8, 75. 
71

Dr. Fisher also saw a need for further studies of unwinding after work. Dr. Newell noted 

that medical interns and residents are very tired after a 36-hour work shift but still cannot 

get to sleep immediately because they are too wound up; drivers may face similar 

problems, particularly if they have been driving under severe time pressure or during 

adverse weather conditions. Some of the interventions mentioned by Rosa et al.145 might 

help with unwinding. One topic for future research is the impact of biofeedback-assisted 

relaxation training for drivers on their ability to get to sleep promptly after completing a 

work shift. It would also be useful to assess the impact of exercise programs on the 

quantity and quality of driver sleep. 

⇒ How might the interests of carriers and shippers be structured to align with the 

health interests of drivers? 

A conference participant said that trucking firms with poor management practices (e.g., 

those that accept jobs below cost) also tend to have fatigue problems because they do not 

refuse loads that impose extremely demanding work schedules. Another participant 

suggested conducting a field experiment that tries to get shippers to change their practices 

so that drivers can get more rest and avoid fatigue. 

⇒ What are the long-term health implications of addressing drivers’ inability to 

adjust to irregular shift schedules by using pharmacologic or other approaches 

that force or trick the body to conform to commercial scheduling demands? 

Some studies have examined the use of benzodiazepines149 and melatonin150 to address 

sleep problems associated with the circadian clock. Van Cauter and Turek, however, 

argued that “pharmacologic approaches may be acceptable for the short-term treatment of 

jet lag but not for the long-term management of shift work.”151 Although these drugs may 

achieve a safety goal by tricking the body in the short term, regular use to overcome 

fatigue or sleepiness may have the long run effect of damaging the driver’s health. 

Another approach for the chronic sleep problems of truck drivers with irregular work 

schedules might be that suggested by Czeisler et al.: using exposure to bright light to 

increase alertness during night work shifts, and nearly complete darkness during daytime 

rest periods to facilitate sleep.152 In ten two-week studies of eight men, they found that 

the light/darkness treatment increased daytime sleep in night shift workers by an average 

of two hours per day. The Cziesler et al. experiment entailed exposure to bright light 

throughout the night shift—something that is not feasible for truck drivers working at 

night. 

A potential future research project might assess the impact on fatigue of equipping 

sleeper berths of trucks with bright lights (~10,000 lux) and having drivers use eyeshades 

if they sleep during the day in motels with insufficient light-blocking drapes. Drivers who 

needed to drive during the night and sleep during the day could reset their circadian 

clocks by brief exposure to bright light at night and complete darkness during their rest 

periods. Other aspects of sleeper berth design, such as more extensive soundproofing, 

also may merit study. 
72

⇒ Should additional public or private highway rest areas be created to provide 

drivers with a safe place to stop and sleep? 

A potential topic for future research not addressed at the conference is the extent to which 

construction of additional highway rest areas or expansion of parking facilities at existing 

rest areas would improve highway safety. This has been the subject of numerous studies 

by transportation researchers, whose policy recommendations often have been blunted by 

truck stop operators opposed to public solutions to what they see is a private problem. For 

an example of such research, see FHWA (2002)153

⇒ How do we design and implement successful remediation programs in support of 

healthier, safer truck drivers? 

Success in improving truck driver occupational safety and health depends not only on 

scientific understanding of linkages between employment and health, but also on 

effective implementation of remedial programs. It is therefore important to conduct 

research on how to disseminate knowledge of best practices and how to secure the 

cooperation of the relevant parties—employee drivers, owner-operators, for-hire carriers, 

private carriers, unions, shippers, consignees, and others—in adopting these practices. 

⇒ Field studies appear to be a necessary component of a successful research agenda. 

Can researchers gain access to the affected private-sector firms? 

Field studies require the involvement of affected parties. At the conference, Mr. Madar of 

the Teamsters said that his union was willing to participate in field studies related to 

driver occupational safety and health, but that they would want to be consulted at the 

outset—not presented with a fait accompli negotiated between researchers and trucking 

companies. Fortunately, this conference included representatives of a variety of industry 

groups, including the Teamsters, OOIDA, the American Trucking Associations, the 

Motor Freight Carriers Association, the American Moving and Storage Association, and 

the American Insurance Association. Consultations with these groups and others in the 

industry are essential for good research on truck driver occupational safety and health. 

⇒ How can the research community get the attention of drivers themselves? How 

can drivers better communicate their needs to researchers? Can collaborative 

research be designed that engages the trucking community so that they believe 

their full range of interests have been considered? 

Engagement is necessary to ensure that best practices are understood and adopted. A 

study in the 1970s by Kochan, Dyer, and Lipsky noted the benefits of involving labor 

unions in efforts to improve occupational safety and health.154 Research on truck driver 

occupational safety and health could similarly assess the effectiveness of cooperative 

labor-management programs, either in the union sector (involving parcel, LTL, or other 

carriers and the Teamsters) or in the nonunion sector (involving TL carriers and OOIDA, 

for example). 
73

⇒ Can research validate the proposed regulatory emphasis on restorative sleep rather 

than working time? 

This was the approach recommended by Dr. Drew Dawson, and the approach taken by 

the Federal Motor Carrier Safety Administration in its 2003 and 2005 regulations. Does it 

work? 

⇒ Do safety and health pay? What would it take to reconfigure incentives in the 

trucking industry to align industry practices with public health goals for truck 

drivers? 

The cooperation of individual drivers, too, is crucial to efforts to improve occupational 

safety and health. Drivers value their health. They also, however, value their earnings and 

the chance to spend non-working time at home. If wage rates are constant, shorter work 

hours imply lower earnings. Furthermore, strict limits on work hours sometimes require 

drivers to stop and take their required break in the sleeper berth of their truck, even if 

they are not tired and though they would prefer to continue driving until they reach home. 

Belzer, Rodriguez, and Sedo showed how driver compensation predicts safety both for 

the drivers and for the carriers for whom they work. However, they have not been able to 

demonstrate the extent to which the cost of this higher compensation offsets the safety 

and health benefits. Since a market becomes more efficient if it can internalize 

externalities, such as safety and health, it might make sense to consciously structure 

trucking regulations that line up individual and firm incentives with social objectives 

such as highway safety. Researchers should study the extent to which driver preferences 

change when they are provided with more complete information about the health and 

safety consequences of current driving practices. 

• Would effective communication of occupational safety and health information 

persuade drivers to accept some sacrifice in earnings? 

• Would it persuade them to accept the need to stop for a rest break if they cannot 

reach home before they reach limits on work hours? 

• Would it persuade drivers (as well as trucking companies, shippers, and policy 

makers) that they deserve compensation for the health and mortality risks they 

take? 

• Would full information on the health and safety consequences of current labor 

market practices persuade motor carriers, shippers, and consignees that better 

compensation for drivers is in their business interest? 

• Would such information persuade the public that their greater safety, as well as 

the cost of driver health care and the cost of shorter work lives, is worth the cost 

of paying drivers more money and reducing their work stress? 

• Would policy makers accept the notion that drivers deserve greater bargaining 

power to improve their earnings? 

• Could dynamic programs such as safety benchmarking be used to identify 

characteristics of safe firms and foster the development of continuous 

improvement among motor carriers? 
74

We have consolidated the full set of recommendations in the following tables. The wide 

range of interests, fields of study, and disciplines represented at the conference speaks to 

the breadth of the problem faced by these workers. Data needs were a high priority for 

many of the scholars who participated, because without data, research cannot begin, and 

without data, research has little impact. 

Table 10. Research Needs: Data 

⇒ The development of more systematic data on morbidity on truck driver 

occupational safety and health is critical for any research agenda on this 

population. Health and safety as well as working conditions are difficult to 

measure for this mobile and hard-working population. 

⇒ Data must be collected on life expectancy and disability specific to truck drivers 

without having to rely on privately funded and collected data that may not 

represent population outcomes well. 

⇒ Another important area for future research is to replicate with American data the 

foreign epidemiological studies concerning the incidence of disease among truck 

drivers. 

⇒ Are workers’ compensation statistics on occupational injuries and illnesses 

consistent with other data sources, such as Annual Survey of Occupational 

Injuries and Illnesses conducted by the Bureau of Labor Statistics? 

⇒ Quantify the risk drivers face due to extended exposure to highway, wind, engine, 

and mechanical noise associated with trucking operations. 

⇒ Field studies appear to be a necessary component of a successful research agenda. 

Can researchers gain access to the affected private-sector firms? 

⇒ Special studies should be undertaken on the effects of team operations on truck 

driver occupational safety and health. Data should be collected on the nature of 

operations as well as the effects of real-world operations on drivers and their 

families. 

Occupational safety and health does not exist in a vacuum. Occupations are situated 

within industries and they are set within a marketplace. People do not perform work in 

the abstract or as a hobby; they do it in trade for the money they use to pay their cost of 

living and to support their families. As part of the economic process, work is subject to 

pressures that may induce or force people to make a bigger trade than they thought they 
75

were making. For truck drivers, their work may be in trade for family life and it may be 

in trade for their health and longevity. It is essential, therefore, to undertake the research 

required to determine the extent of that tradeoff. While it is unlikely that the character of 

the trucking job will change fundamentally in the foreseeable future, anything scientists 

and policy makers can do to mitigate the damage and provide full information to 

everyone participating in the economic process, the more likely the outcome will be fair. 

Table 11. Research Needs: Economics and Industrial Organization 

⇒ How might the interests of carriers and shippers be structured to align with the 

health interests of drivers? 

⇒ Do safety and health pay? What would it take to reconfigure incentives in the 

trucking industry to align industry practices with public health goals for truck 

drivers? 

⇒ Motor carriers justify team operations because they believe they provide a costeffective way of improving service (thus improving the competitiveness of 

trucking in comparison with other transportation modes). 

o How safe are team operations compared with solo operations on 

similar roadways? 

o Building on FMCSA’s “Impact of Sleeper Berth Usage on Driver 

Fatigue,”155 how frequently are the conditions recommended on the 

basis of focus groups and intensive study of team drivers maintained in 

actual operations? 

o What are the long-term health and safety effects of team driving? 

o Do the economic benefits of team operations outweigh the social, 

health, and safety costs? 

⇒ To what extent does the higher claims cost for workers’ compensation cases with 

attorney representation stem from attorneys selectively agreeing to represent 

clients who have a strong case and large potential claims? 

o To what extent does the mere involvement of an attorney affect the 

outcome? 

o Do attorneys win larger settlements than the claimants would have 

received without attorney representation, or are attorneys involved in 

cases more likely to have larger settlements? 

o How can we weigh the costs of allowing workers’ compensation 

claimants to shop for doctors against the individual’s right to choose 

his or her own medical care? 

Before beginning the research agenda, it is important to assess the nature of the health 

and safety problem. The situation of commercial motor vehicle drivers is particularly 

difficult because their health and safety risks are caught up in a confounding context – 

one that may mask the true sources of the problem. The focus on individual and particular 
76

safety and health issues often may miss the mediating factors that are most important. To 

build on the example cited in the conference, if economic forces compel drivers to work 

such long and irregular hours that it damages their health, it will do no good to focus just 

on those hours of work; the economic forces that compel people to work that hard must 

also be considered. 

Table 12. Research Needs: Assessment 

⇒ Research must be done to assess the subtle linkages between employment 

conditions for drivers and health problems such as diabetes and cardiovascular 

disease because of their heavy toll in morbidity and mortality. 

⇒ Epidemiological and economic analysis must be combined, helping researchers 

estimate of the dollar cost of morbidity and premature mortality associated with 

employment conditions for truck driver 

⇒ Can routine truck inspections readily detect diesel emission problems that can be 

fixed inexpensively by such measures as cleaning or replacing the injectors and 

sealing off leaky gaskets that leak exhaust into the truck cab? 

⇒ Is it cost effective to reduce diesel exhaust exposure by installing filters in the 

heater and air conditioner air intake systems of vehicles such as pickup and 

delivery trucks, urban buses, and taxis that are driven for extended periods in 

congested urban areas? 

⇒ Research should be undertaken to replicate the McGlothlin study of beverage 

delivery drivers with other groups of truck drivers, particularly in LTL and 

package delivery. 

⇒ Research is needed to determine the extent of occupational violence in trucking. 

Researchers should also measure the effects of job stress, including the stress of 

repeated unpredictable dispatch, conflict with dispatchers and supervisors, and the 

stress of isolation from family and social supports. 

⇒ Research also is needed on the causes and consequences of driver turnover, as 

well as on how to provide incentives to drivers that might discourage them from 

hopping from job to job. 

⇒ Research should be supported to determine which tasks are most impaired by 

fatigue. 

⇒ How can research identify behavioral or biological markers of wake state 

instability and inter-individual variability in vulnerability to impairment from 

chronic sleep loss? 
77

Table 12. Research Needs: Assessment (continued) 

⇒ Research should determine the relationship between sleep debt and both obesity 

and metabolic function among workers in transportation, health care, and other 

industries where extended work and habitually restricted sleep are common. 

⇒ There is a need for experiments to determine how many hours of sleep a person 

needs on the weekend (or extended break period) to recover the sleep loss from 

the preceding work week. 

⇒ What are the long term consequences for people who do not get restorative sleep 

during their extended break periods? Do they ever recover from their sleep debt or 

do they just add to it? If so, what are the cumulative consequences for both health 

and safety? 

⇒ Longitudinal studies of sleep and health are needed. Research on sleep 

mechanisms is needed to determine how sleep loss impairs metabolism and may 

promote obesity, insulin resistance, and hypertension so that rational countermeasures can be developed. 

⇒ Research is needed to determine whether shift work is associated with depression, 

cancer, or sickness absence. Is this due to the lack of slow wave sleep and 

therefore due to lower quality sleep at odd hours? 

⇒ Research must be performed to understand the impact of elevated levels of 

cortisol and thyroid stimulating hormone in night shift workers, which includes 

truck drivers. What are the safety and, perhaps most importantly, the health 

implications? 

⇒ Research is needed to construct validated and sensitive measures of fatigue to 

demonstrate effective fatigue management. 

⇒ Does working long or irregular hours have other harmful effects on health in 

addition to those related to partial sleep deprivation? 

⇒ Future research should include work-based fatigue studies, physiological and 

biochemical monitoring studies at work and rest, assessment of the impact of rest 

periods on vigilance and fatigue, studies of unwinding, development of methods 

to reduce maladaptive coping strategies, and studies of how changes in the work 

environment affect hypertension. 

⇒ Research should determine the extent to which research findings concerning job 

stress among long-distance bus drivers and urban transit workers are applicable to 

truck drivers. 
78

Table 12. Research Needs: Assessment (continued) 

⇒ Further research could determine if employment as a truck driver leads to 

increased smoking, poor diet, lack of exercise, and an increased incidence of 

multiple sexual partners. 

⇒ Team operations require a special research focus and needs assessment. Very little 

is known about the health effects of team driving as a special case. While policymakers have little information on the safety impacts, they have virtually no 

information on team driver health and mortality. 

Only after careful data analysis, understanding of the economic forces at work in the 

industry or productive process, and assessment of the problem, is it useful to begin to 

undertake interventions. While we are all in a hurry to find some solutions to the health 

problems facing truck drivers, we should have this foundation before talking about 

interventions. Intervention before assessment of the health problems embedded in the 

productive process may produce interventions that do not work and might even do more 

harm than good. 

Table 13. Research Needs: Interventions and Countermeasures 

⇒ Research could explore ways of organizing the provision of medical care so that 

truck drivers have access to health services, including continuity of care needed 

for effective diagnosis and treatment. 

⇒ How serious is the effect of irregular and unpredictable scheduling? How can 

policy-makers reduce the irregularity and unpredictability of scheduling without 

introducing potentially devastating costs into the logistics chain? 

⇒ Will some people naturally tolerate the scheduling problems that are traditional in 

trucking and transportation? What personal characteristics explain differences in 

drivers’ ability to deal with night work or irregular shifts? 

⇒ What time or other intervention might help truck drivers better recover from sleep 

loss without harming their health? 

⇒ How can drivers and similar workers better unwind after work? How can 

unwinding be accomplished without the use of self-medication? How can drivers 

be socially reintegrated after a stressful day of driving? 

⇒ What are the long-term health implications of addressing drivers’ inability to 

adjust to irregular shift schedules by using pharmacologic or other approaches 

that force or trick the body to conform with commercial scheduling demands? 
79

Table 13. Research Needs: Interventions and Countermeasures (continued) 

⇒ Should additional public or private highway rest areas be created to provide 

drivers with a safe place to stop and sleep? 

⇒ How do we design and implement successful remediation programs in support of 

healthier, safer truck drivers? 

⇒ Can research validate the proposed regulatory emphasis on restorative sleep rather 

than working time? 

⇒ Are self-employed drivers in the U.S., like those in Australia, more likely to have 

safety problems? Are self-employed drivers in the U.S. more likely to have 

nonfatal or fatal crashes? Does unionization in Australia and Canada improve the 

safety records of owner-drivers 

⇒ How effective are the EU’s second-generation tachographs in improving truck 

driver occupational safety and health? 

⇒ Using empirical research techniques, can researchers asses the impact of HOS 

regulations on both productivity and production? 

⇒ What changes can be made in freight yards to reduce the high rate of permanent 

disability among yard workers? 

⇒ Can changes in cab and sleeper berth design reduce noise exposure? 

⇒ Can changes in seat or sleeper berth design reduce exposure to vibration? 

⇒ Can more intensive training and supervision reduce the injury rate among 

inexperienced drivers, dockworkers, and yard workers? How can work be 

redesigned to reduce the negative health and safety consequences of current work 

methods? 

⇒ How can trucking companies establish a “corporate culture” that values safety? 

⇒ Research should be undertaken to evaluate potential countermeasures, such as 

wellness-counseling and fitness program for professional drivers. 

Finally, after all these steps are complete we can turn to education. Education will be 

more successful, and the acceptance of research results more likely, if all the players in 

the industry are part of the original process of data collection, economic analysis, 

assessment, and intervention. If research does not involve these critically interested 

parties, and if research does not integrate these elements, research findings and 

developments may not be well understood or may be ignored. 
80

Table 14. Research Needs: Dissemination and Education 

⇒ How can the research community get the attention of drivers themselves? How 

can drivers better communicate their needs to researchers? Can scholars design 

collaborative research that engages the trucking community so that they believe 

their full range of interests have been considered? 

⇒ Can a small business training program affect the safety records of owneroperators and small motor carriers? Are owner-operators and small carriers that 

understand their costs less likely to face intense financial pressures that lead them 

to drive when they should be sleeping? 

It would be helpful to policy makers to have a coherent strategy for addressing research 

needs related to truck driver occupational safety and health. Ideally, researchers could 

develop proposed projects that are relevant to the most pressing concerns of drivers, 

trucking companies, shippers, government regulators, and other interested parties; and 

then, a group of researchers with a wide range of expertise, working with industry, labor, 

and government representatives, could rank the projects in order of priority. The April 

2003 conference was too short to achieve that objective. Our hope, however, is that there 

will be an ongoing series of conferences, collaborative interactions, and research projects 

to complete this task – especially ones involving cooperation between researchers and the 

industry. The April 2003 conference, however, was an important step in focusing 

attention on the problem. To quote Winston Churchill, “This is not the end. It is not even 

the beginning of the end. But it is, perhaps, the end of the beginning.”156

A central theme of this conference report and literature review has been the need for 

more research on truck driver occupational safety and health. The July 2004 ruling by the 

U.S. Circuit Court of Appeals, striking down the 2003 amendment to HOS regulations on 

grounds that FMCSA had not given sufficient attention to the health of drivers,157

underscores the urgency of research on not only the prevention of highway crashes, but 

also the prevention of job-related diseases, injuries from loading or unloading trucks, and 

other occupational safety and health problems faced by truck drivers. The ultimate goal, 

however, is to achieve improvements in the lives of truck drivers and their families. It is 

not easy to develop effective remedies for truck driver occupational safety and health 

problems that avoid imposing undue operational or economic burdens on drivers, 

carriers, or shippers. This is our challenge. 
81

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1216 (D.C. Circuit, 2004). 
96

Appendix 1: Conference Participants and 

Speaker Profiles 

Participants, April 24–25, 2003, 

Conference on Truck Driver Occupational Safety and Health 

Name Title Institution City 

Torbjorn 

Akerstedt 

Professor, Public Health 

Sciences 

Karolinska Institutet Stockholm, 

Sweden 

Toni Alterman Chief, Illness Effects 

Section, now Senior 

Epidemiologist 

Centers for Disease 

Control, National 

Institute for 

Occupational Safety 

and Health 

Cincinnati, 

OH 

Albert Alvarez Transportation Specialist, 

Research Division 

Federal Motor Carrier 

Safety Administration 

Washington, 

DC 

Michael Belzer Associate Professor, 

Industrial Relations 

Wayne State 

University 

Detroit, MI 

Elyce Biddle Chief Statistician National Institute for 

Occupational Safety 

and Health 

Morgantown, 

WV 

Stephen Burks Assistant Professor and now 

Associate Professor, 

Economics and 

Management 

University of 

Minnesota, Morris 

Morris, MN 

Orfeu Buxton Instructor, Division of Sleep 

Medicine and Associate 

Neuroscientist 

Harvard Medical 

School and Brigham 

& Women's Hospital 

Boston, MA 

Claire Caruso Research Health Scientist National Institute for 

Occupational Safety 

and Health 

Cincinnati, 

OH 

Guang Chen Senior Service Fellow, 

Division of Safety Research 

National Institute for 

Occupational Safety 

and Health 

 Morgantown, 

WV 

Ralph Craft Crash Data Analyst, 

Analysis Division 

Federal Motor Carrier 

Safety Administration 

Fairfax, VA 
97

Participants, April 24–25, 2003, 

Conference on Truck Driver Occupational Safety and Health 

Name Title Institution City 

Drew Dawson Professor, Centre for Sleep 

Research 

University of South 

Australia 

Adelaide, 

Australia 

Christopher 

Drake 

Senior Bioscientific Staff, 

Sleep Disorders Research 

Center and now Senior Staff 

Scientist at the Henry Ford 

Hospital Sleep Center and 

Assistant Professor of 

Psychiatry and Behavioral 

Neurosciences 

Henry Ford Hospital 

and Wayne State 

College of Medicine 

Detroit, MI 

Darrel 

Drobnich 

Senior Director, 

Governmental Affairs 

National Sleep 

Foundation 

Washington, 

DC 

Walter 

Edwards 

Research Department International 

Brotherhood of 

Teamsters (IBT) 

Washington, 

DC 

June Fisher Director, MUNI Health & 

Safety Project and 

Associate Clinical Professor 

of Medicine 

University of 

California, San 

Francisco 

San 

Francisco, 

CA 

Eric Garshick Assistant Professor Harvard Medical 

School 

West 

Roxbury, MA 

Keri Gentilcore Director, Workplace and 

Fleet Safety 

American Trucking 

Associations 

Alexandria, 

VA 

Janie Gittleman Associate Director, Safety 

& Health Research 

Center to Protect 

Workers Rights 

Silver Spring, 

MD 

Sarah Giuliani Fitness Trainer/Coordinator SGLLC/Roadwork Grand 

Rapids, MI 

Lonnie Golden Associate Professor of 

Economics 

Pennsylvania State 

University, Abington 

Abington, PA 

Patrick 

Hamelin 

Director of Research National Research 

Institute for Transport 

Safety (INRETS) 

Arcueil, 

France 

Karen Heaton Doctoral student, Nursing University of 

Kentucky 

Louisville, 

KY 
98

Participants, April 24–25, 2003, 

Conference on Truck Driver Occupational Safety and Health 

Name Title Institution City 

Edward 

Hitchcock 

Senior Service Fellow, 

Human Factors and 

Ergonomics 

National Institute for 

Occupational Safety 

and Health 

Cincinnati, 

OH 

Lee Husting Chief, Intervention & 

Evaluation Section and now 

Health Scientist / Program 

Administrator 

National Institute for 

Occupational Safety 

and Health and 

Centers for Disease 

Control and 

Prevention 

Morgantown, 

WV; Atlanta, 

GA 

Ron Jager Owner-operator (truck 

driver) 

Ro-Jan Taylor, MI 

David Kameras Communication coordinator Teamsters Union Washington, 

DC 

Gerald 

Krueger1

Principal 

Scientist/Ergonomist 

The Wexford Group 

International 

Vienna, VA 

Brenda Lantz Program Director, 

Transportation Safety 

Systems Center 

NDSU Upper Great 

Plans Transportation 

Institute 

Lakewood, 

CO 

Scott Madar2 Assistant Director, Safety 

and Health Department 

Teamsters Union Washington, 

DC 

Michael 

McCann 

Director of Safety & 

Ergonomics 

Center to Protect 

Workers’ Rights 

Silver Spring, 

MD 

James 

McGlothlin 

Associate Professor of 

Health Sciences 

Purdue University West 

Lafayette, IN 

Penelope 

Moyers 

Dean, School of 

Occupational Therapy 

University of 

Indianapolis 

Indianapolis, 

IN 

Audrey Newell Associate Director, Family 

Practice Education Program 

Oakwood Healthcare 

System 

Dearborn, MI 

Katharine 

Newman 

Division Chief, Safety & 

Health Program Analysis & 

Control 

Bureau of Labor 

Statistics 

Washington, 

DC 

 

1

 Prepared presentation for the conference, but was unable to attend. 

2

 Currently a consultant with ORC Worldwide 
99

Participants, April 24–25, 2003, 

Conference on Truck Driver Occupational Safety and Health 

Name Title Institution City 

Arthur Oleinick Associate Professor, 

Environmental Health 

Sciences 

University of 

Michigan 

Ann Arbor, 

MI 

Thomas Perrot Senior Project Manager ANTARES Group Landover, 

MD 

Peter Phillips Professor of Economics University of Utah Salt Lake 

City, UT 

Berlin, 

Germany; 

Dieter Plehwe Research Scholar at WZB 

and at the time of the 

conference, Lecturer, 

Department of Sociology 

Social Science Center 

Berlin and Yale 

University New Haven, 

CT 

Len Poirier President, Local 4268 Canadian Auto 

Workers 

Waterford, 

ON 

Stephanie Pratt Epidemiologist, Division of 

Safety Research 

National Institute for 

Occupational Safety 

and Health 

Morgantown, 

WV 

Mark Price Student, Department of 

Economics 

University of Utah Salt Lake 

City, UT 

Les Pryce Financial Secretary, Local 

4268 

Canadian Auto 

Workers 

Scarborough, 

ON 

Michael 

Quinlan 

Professor of Industrial 

Relations and 

Organisational Behaviour 

University of New 

South Wales 

Sydney, 

Australia 

Kathryn Reid Research Assistant 

Professor, Center for Sleep 

and Circadian Biology 

Northwestern 

University 

Evanston, IL 

Daniel 

Rodriguez 

Assistant Professor and now 

Associate Professor, City 

and Regional Planning 

University of North 

Carolina 

Chapel Hill, 

NC 

William Rogers Vice President, Safety, 

Training, and Technology 

Motor Freight 

Carriers Association 

Washington, 

DC 
100

Participants, April 24–25, 2003, 

Conference on Truck Driver Occupational Safety and Health 

Name Title Institution City 

Lawrence Root Professor and Director, 

Institute of Labor and 

Industrial Relations 

University of 

Michigan 

Ann Arbor, 

MI 

Roger Rosa Senior Scientist, Office of 

the Director 

National Institute for 

Occupational Safety 

and Health 

Washington, 

DC 

Robert 

Rothstein 

Vice President and General 

Counsel 

American Moving 

and Storage 

Association 

Alexandria, 

VA 

Gregory 

Saltzman 

Professor of Economics and 

Management 

Albion College Albion, MI 

Ian Savage College Lecturer and 

Assistant Department Chair, 

Economics 

Northwestern 

University 

Evanston, IL 

Nancy Scibek Research Division Federal Motor Carrier 

Safety Administration 

Washington, 

DC 

John Sestito Assistant Director for 

Surveillance 

National Institute for 

Occupational Safety 

and Health 

Cincinnati, 

OH 

John Siebert Project Manager Owner-Operator 

Independent Drivers 

Association 

Foundation 

Grain Valley, 

MO 

Bethany 

Slingerland 

Government Affairs and 

Transportation 

National Sleep 

Foundation 

Washington, 

DC 

Thomas Smith Professor of Environmental 

Health 

Harvard School of 

Public Health 

Boston, MA 

David Snyder 

(participated by 

conference call) 

Vice President and General 

Counsel 

American Insurance 

Association 

Washington, 

DC 

Jeffrey Stern Professor of Psychology University of 

Michigan-Dearborn 

Dearborn, MI 
101

Participants, April 24–25, 2003, 

Conference on Truck Driver Occupational Safety and Health 

Name Title Institution City 

Meg Sweeney Office of Advanced Studies Bureau of 

Transportation 

Statistics 

Washington, 

DC 

Wendine 

ThompsonDawson 

Doctoral student, 

Economics 

University of Utah Salt Lake 

City, UT 

Hans Van 

Dongen 

Research Assistant 

Professor of Sleep and 

Chronobiology and now 

Associate Research 

Professor 

University of 

Pennsylvania School 

of Medicine; 

Washington State 

University 

Philadelphia, 

PA; Spokane, 

WA 

Patricia Waller 

(Prepared 

presentation for 

conference but 

unable to 

attend; now 

deceased) 

Senior Research Scientist, 

Center for Transportation 

Research; Director Emerita, 

University of Michigan 

Transportation Research 

Institute 

Texas A&M 

University; University 

of Michigan 

Transportation 

Research Institute 

Chapel Hill, 

NC 

Ann 

Williamson 

Director, NSW Injury Risk 

Management Research 

Center 

University of New 

South Wales 

Sydney, 

Australia 

Speaker Profiles 

Torbjorn Akerstedt, PhD, is Professor of Behavioral Physiology at the Karolinska 

Institute. He is the past president of the European Sleep Research Society and recipient of 

the University of Pisa Sleep Award. He has authored 100+ papers on sleep, stress, and 

work hours. He is the Associate Editor of the Journal of Sleep Research and Biological 

Psychology, and is on the editorial board of several other journals. He has organized 

several international meetings on sleepiness and transport. 

Michael H. Belzer, PhD, is Associate Professor of Industrial Relations at Wayne State 

University and Adjunct Associate Research Scientist at the University of Michigan’s 

Institute of Labor and Industrial Relations. Dr. Belzer's research interests include all 

facets of trucking industry organization and operations, labor-management relations, and 

employment policy. He has studied the relationship between truck driver pay (both 

method and level) and safety, as well as issues related to truck driver hours of work. Dr. 
102

Belzer currently serves as the Associate Director of the Sloan Foundation’s Trucking 

Industry Program (TIP). He is Director of the Wayne State University Trucking Industry 

Benchmarking Program. He is the founding chairman of Transportation Research 

Board’s Task Force on Trucking Industry Research and currently serves as Chairman of 

the Committee on Trucking Industry Research of the Transportation Research Board and 

is also a member of the TRB Freight Systems Executive Board. He is a member of the 

TRB Truck and Bus Safety Committee and also serves as a member of the Committee on 

Freight Regulation and Economics, and served on the Steering Committee for the 2005 

National Safety Council Truck and Bus Safety and Security Symposium. From 2000 to 

2003, Dr. Belzer served on the Committee for Review of the Federal Motor Carrier 

Safety Administration’s Large Truck Crash Causation Study, formed by Transportation 

Research Board under authority granted by Congress to the National Research Council. 

He is the author of Sweatshops on Wheels as well as numerous peer-reviewed articles on 

industrial relations with special attention on the trucking industry. 

Stephen V. Burks, PhD, is an Associate Professor of Economics and Management at the 

University of Minnesota, Morris. His B.A. is from Reed College, and he has an M.A. 

from Indiana University, Bloomington, in philosophy, focusing on the philosophy of 

science. He spent a decade working at blue-collar jobs in the trucking industry, during the 

period surrounding deregulation, after which he returned to graduate work at the 

University of Massachusetts Amherst, in economics. He received his Ph.D. in 1999, 

writing a dissertation on how the microeconomics of reciprocity and equity, in the 

employment relationship, affected the restructuring of the labor and product markets in 

U.S. motor freight after deregulation. While writing, he worked as a graduate researcher 

for the University of Michigan Trucking Industry Program (UMTIP, a Sloan Foundation 

program), with whom he then did a post-doctoral fellowship. He is pursuing two 

overlapping research directions; the first on the role of social preferences (such as trust 

and reciprocity) in employment relationships, using behavioral economic experiments 

framed in field settings (currently supported by the University of Minnesota and the 

MacArthur Foundation), and the second on several aspects of trucking industry 

economics (supported in 2000 and 2001 by UMTIP, and in 2003 by the Trucking 

Industry Program, Georgia Institute of Technology). 

Orfeu Marcello Buxton, PhD, is an instructor at Harvard Medical School in the 

Division of Sleep Medicine. After receiving a B.S. in Behavioral Neuroscience from the 

University of Pittsburgh and a stint as the owner of a fitness equipment repair and 

moving business, Dr. Buxton began his graduate work in Neuroscience at Northwestern 

University. In work with Dr. Fred W. Turek, he primarily examined the interaction of 

circadian rhythms and sleep in rodents. For his thesis work, in collaboration with Dr. Van 

Cauter, he studied the effects of exercise, sleep, darkness, and a hypnotic on the timing 

and adjustment of the human circadian system. Dr. Buxton's recent work examined the 

effects of high-intensity exercise on metabolism and neuroendocrine secretion that vary 

with the time of day of the exercise. 

Ralph Craft, PhD, has worked in Washington over the past 22 years as a: Transportation 

Lobbyist for the National Conference of State Legislatures; Assistant Executive Director 

of the International Bridge, Tunnel and Turnpike Association; Director of Transportation 
103

Research for the National Governors’ Association; Transportation Lobbyist for the State 

of New Jersey; Transportation Specialist for the Office of Motor Carriers, Federal 

Highway Administration; and presently as a Crash Data Analyst for the Federal Motor 

Carrier Safety Administration. 

In a previous life, Mr. Craft earned a Doctorate in Political Science from Rutgers 

University; worked for and with a number of State legislatures; and published a book and 

many articles about state legislative processes and procedures, including several on State 

legislative review and evaluation of State government programs. 

Drew Dawson, PhD, is the Dean of Research at the University of South Australia in 

Adelaide and Director of the internationally recognized Centre for Sleep Research 

(CFSR). The CFSR is the largest dedicated sleep research facility in Australia. Dr. 

Dawson has gained critical acclaim for his work and is considered a leading international 

authority in the areas of sleep, fatigue, biological rhythms, and hours of work. 

Dr. Dawson has worked extensively with key transport organizations in the rail, road, and 

aviation industries both in Australia and abroad. He currently heads the Australian Rail 

Industry Consortium, focused on the effects of fatigue on shift workers in the field. This 

endeavor has led to the integration of training and education materials for a wide range of 

industries such as mining, manufacturing, and service. Additionally, fatigue-modeling 

software has also been developed for assessing and predicting fatigue levels associated 

with irregular work schedules, allowing better design and management of work hours. 

Collaborating with Transport Canada, the US Federal Rail Administration and the North 

American Motor Carriage Industry, Dr. Dawson has helped develop policy for some of 

the largest transportation networks in the world. 

Dr. Dawson has produced over 60 industry reports, published hundreds of articles and 

papers, and attracted more than 5 million dollars in research grants. Dr. Dawson has also 

been a consultant to over 100 major Australian companies such as BHP, Mobil Industries 

Australia, Qantas, and the Kimberly-Clark Corporation. 

Christopher Drake, PhD, serves as a member of the Senior Bioscientific Staff at The 

Henry Ford Hospital Sleep Disorders and Research Center in Detroit, Michigan. He 

graduated with a degree in Clinical Psychology from Bowling Green State University. 

Previously he served as a fellow at the National Institute of Mental Health, Clinical 

Psychobiology Branch under Dr. Thomas Wehr. He has served as a reviewer for the 

Journal SLEEP, Psychophysiology, Psychological Assessment, Small Group Research 

and Ergonomics. Dr. Drake is currently funded to study the predisposition to transient 

sleep disturbance and the evolution to chronic primary insomnia. He has been the author 

of 30 publications in the fields of sleep medicine and clinical psychophysiology. His 

primary areas of interest include the pathophysiology of insomnia and the causes and 

consequences of daytime sleepiness. 

June Fisher, MD, is currently a senior scientist at the Trauma Foundation, San Francisco 

General Hospital. Her early career was in internal medicine and basic research in 
104

immunology. She has done extensive research on the immunological aspects of 

Pernicious Anemia. In the early 1970’s she worked as a primary care physician in a 

neighborhood health center and did health services research at Stanford University. Since 

1978 she has practiced occupational medicine. For 12 years she headed the Center for 

Municipal Occupational Safety and Health at San Francisco General Hospital. The 

hospital’s Employee Health Service was incorporated into this center. 

She heads two programs: the Training for Development for Innovative Control 

Technology (TDICT) Project and the Muni Health and Safety Study. These programs 

reflect her research activities in areas of health and safety of health care workers and 

urban public transit operators. She has published extensively on occupational stress and 

hypertension in urban transit operators. The studies on transit worker health and safety 

are currently funded by the National Institute for Health. The research projects have been 

done in collaboration with the San Francisco Municipal Railway and Local 250A, 

Transport Workers Union. 

She is a member of the NIOSH Occupational Disease NORA Task Force. She was the 

co-organizer of the first international meeting on urban transit in Stockholm in 1983 and 

has organized several other international panels - the latest one was at the March 2003 

occupational stress meeting sponsored by the American Psychological Association and 

the National Institute for Occupational health and Safety. 

She was the editor for the Urban Transit Bulletin, which was published by the 

International Transport Workers Federation. 

Eric Garshick, MD, is an Associate Professor of Medicine at the Harvard Medical 

School. He is also a Staff Physician at the VA Boston Healthcare System and a 

Physician, Research Staff, Channing Laboratory, Department of Medicine, Brigham and 

Women’s Hospital. He received an MD in 1979 from Tufts University School of 

Medicine, an MOH from the Harvard School of Public Health in 1984, and is Board 

Certified in Internal Medicine, Pulmonary Disease, and Critical Care Medicine. He has 

been a consultant of the US EPA Science Advisory Board, Clean Air Scientific 

Committee for Diesel Emissions. His research interests are the health effects of diesel 

exhaust exposure and the epidemiology of chronic lung disease. He is currently Principal 

Investigator on National Cancer Institute grants studying the relationship between lung 

cancer and diesel exhaust exposure in railroad workers and trucking company workers. 

Janie Gittleman, PhD, is Associate Director for Safety and Health Research at the 

Center to Protect Workers’ Rights. She received her MRP and PhD from Cornell 

University in Health Planning and Epidemiology. Dr. Gittleman joined the National 

Institute for Occupational Safety and Health in 1990 as an Epidemic Intelligence Service 

Officer, and held positions as Section and Branch Chief of the Surveillance and Hearing 

Loss Prevention Branches, in Cincinnati, Pittsburgh, and Atlanta from 1992-1998. From 

1999-2001, she served as a Senior Scientist in the NIOSH Office of the Director in 

Washington, D.C. Dr. Gittleman previously served on the faculty of the Medical College 

of Pennsylvania in the Department of Preventive Medicine. 
105

Dr. Gittleman specializes in occupational disease surveillance. She established the Adult 

Blood Lead Epidemiology and Surveillance Program at NIOSH, which currently 

monitors adult lead poisoning in 35 states nationwide. She has served on numerous CDC 

occupational disease surveillance committees, and was hired by the United States Agency 

for International Development, the Pan American Health Organization, and the World 

Bank to develop surveillance for the reduction of lead in gasoline in Latin American and 

the Caribbean. She recently served as staff member to the Secretary of Health in the 

newly created Office of Public Health Preparedness, and developed benchmarks for state 

accountability for emergency response planning for bioterrorism. She is the author of 

numerous scholarly publications in occupational safety and health with an emphasis on 

state-based disease surveillance. 

Patrick Hamelin, PhD, is a Research Director at the French National Institute for 

Transport and Safety Research (INRETS). He studied Sociology and Economics at Paris 

University “La Sorbonne”, and developed his social science research skills at the Ecole 

Pratique des Hautes Etudes en Sciences Sociales. His previous work includes research on 

the effects of changes in agricultural production on rural space and ways of life, the 

organization of urban transport and the growth patterns of towns, and work organization 

in transport. His research focuses on the relationships among work organization and work 

environment, conditions of work, time of work, kind of wages, safety, and the social 

properties of truck drivers. He has published several articles and books in French and in 

English. 

Dr. Hamelin’s work was quoted in Gearing up for Safety, a report published in 1988 by 

the U.S. Congress, Office of Technology Assessment. This report called for increased 

attention to driver hours of service and fatigue and safety. 

Gerald P. Krueger, PhD, has over 36 years experience as an engineering psychologist 

and ergonomist conducting, managing, and directing multidisciplinary research and 

applications in measurement and prediction of worker performance. He specializes in the 

human performance implications of equipment operator fatigue, sleep deprivation, and 

sustained operations. Dr. Krueger obtained his Ph.D. in engineering and experimental 

psychology from the Johns Hopkins University. He is a graduate of the US Army War 

College and is a certified professional ergonomist (CPE). He is a retired Army colonel 

who served 25-years in Army R&D, culminating in his tour as the military commander 

and technical director of the U.S. Army Research Institute of Environmental Medicine 

(USARIEM). 

Since Army retirement, Dr. Krueger has spent seven years examining commercial driver 

fatigue, and assessing wellness, fitness and driver alertness. In his work for the US DOT 

Federal Motor Carrier Safety Administration’s (FMCSA) and the American Trucking 

Associations, he is the principal lecturer on driver alertness, fatigue, and wellness, health 

and fitness; and he is the operations manager of a large on-the-road field experiment 

evaluating fatigue management technologies with truck drivers in Canada and in the US. 
106

Dr. Krueger has authored over 80 technical publications, book chapters, and contract 

reports – many of them on operator alertness and fatigue – and he continues to make 

numerous formal speeches and presentations at national and international scientific 

meetings and conferences. Dr. Krueger fulfills senior human factors consultant roles for 

several federal agencies, including Dept. of Defense Research and Engineering, the 

Defense Information Systems Agency, the Nuclear Regulatory Commission, and the 

Department of Transportation. He is a Fellow and is very active in two divisions of the 

American Psychological Association (Military Psychology and Applied Experimental 

and Engineering Psychology); is active in technical journal editing, and in leadership 

roles in other Human Factors and Ergonomics Society positions. 

Brenda Lantz, PhD, is the Program Director for the Transportation Safety Systems 

Center branch of the Upper Great Plains Transportation Institute. The Center is 

responsible for software development for commercial vehicle safety enforcement 

programs, as well as safety-related research and analysis. Brenda holds a Masters degree 

in Statistics from the North Dakota State University, and a Ph.D. in Business Logistics 

from Penn State. She has more than 12 years of experience in transportation research, 

primarily in the commercial vehicle safety systems field, and has worked extensively 

with both government and private industry agencies. 

Scott A. Madar, CIH, is a consultant with ORC Worldwide. Previously, Mr. Madar has 

worked as an OSHA compliance officer in North Carolina and spent over 10 years 

working with the International Brotherhood of Teamsters. While serving as the Assistant 

Director of the Safety and Health Department of the IBT, Mr. Madar had the opportunity 

to testify before three congressional subcommittees and the National Transportation 

Safety Board on a variety of transportation safety issues. He has also served as the chair 

of the Occupational Safety and Health Subcommittee of the Labor Research Advisory 

Committee for the Bureau of Labor Statistics. He currently serves on the Commercial 

Truck and Bus Safety Synthesis Program of the Transportation Research Board. Mr. 

Madar recently organized a National Summit on Contractor Safety on behalf of the Duke 

Energy Foundation.

After Mr. Madar obtained his B.S. in biology from The College of William and Mary, he 

went on to earn his M.H.S. in industrial hygiene and safety sciences from The Johns 

Hopkins University. He is a Certified Industrial Hygienist (CIH). 

Michael McCann, PhD, CIH, is Director of Safety and Ergonomics at the Center to 

Protect Workers’ Rights, the research arm of the Building and Construction Trades 

Department, AFL-CIO. He received his PhD in Chemistry from Columbia University in 

1972, became a certified industrial hygienist in 1979, and is authorized to conduct 10- 

and 30-hour OSHA courses as an OSHA Construction Outreach Trainer. Dr. McCann 

participated in a study of hazards of Ready Mixed concrete truck drivers. He has also 

been studying the hazards of heavy equipment such as bulldozers and dump trucks on 

construction excavation sites. He has given presentations at the Construction Safety 

Council Annual Conference and other construction safety conferences, and at safety 

professional conferences. He helped develop and conduct training for construction 
107

workers, including dump truck drivers, at the World Trade Center Emergency Project in 

2001. 

James D. McGlothlin, MPH, PhD, CPE, is an Associate Professor of Industrial 

Hygiene and Ergonomics in the School of Health Sciences at Purdue University. Dr. 

McGlothlin specializes in research in ergonomics and in industrial hygiene engineering 

controls. Prior to Dr. McGlothlin’s appointment to Purdue University, (January 4, 1999) 

he was a senior researcher in ergonomics with the Engineering Control Technology 

Branch, Division of Physical Sciences and Engineering, National Institute for 

Occupational Safety and Health (NIOSH), Cincinnati, Ohio. The author of more than 100 

scientific, technical, and government reports, Dr. McGlothlin served as a course director 

in ergonomics at Northwestern University School of Engineering, Evanston, Illinois, and 

at the University of Cincinnati School of Medicine, Ohio. He has received several awards 

for his research and service to the U.S. Public Health Service, including the Surgeon 

General's Exemplary Service Medal, the Outstanding Service medal, and Commendation 

Medal. He has a Patent (6,094,780) on an ergonomically designed handle. He has served 

on several national and international professional committees, and currently serves on the 

editorial boards of the Occupational Hazards Journal. Dr. McGlothlin received the B.A. 

degree (1975) in psychology, the M.P.H. degree (1977) in epidemiology, and the M.S. 

degree (1977) in environmental and industrial health, all from the University of Hawaii, 

Honolulu. He received the Ph.D. degree (1988) in industrial health with a specialty in 

ergonomics from the University of Michigan, Ann Arbor. Dr. McGlothlin is a Certified 

Professional Ergonomist. You can find out more about Dr. McGlothlin by visiting his 

website at www.DrMcGlothlin.com. 

Katharine Newman is an Economist and the Acting Assistant Commissioner for 

Occupational Safety, Health, and Working Conditions at the Bureau of Labor Statistics. 

She has been with the BLS for 11 years, joining the occupational safety and health 

statistics programs in 1999. In her current position, Ms. Newman has responsibility for all 

aspects of the Annual Survey of Occupational Injuries and Illnesses and the Census of 

Fatal Occupation Injuries. Previously, she worked for the U.S. Bureau of the Census, the 

Office of Management and Budget, and the Brookings Institution. 

Stephanie Pratt, MM, MA, is an epidemiologist at the National Institute for 

Occupational Safety and Health, Division of Safety Research, in Morgantown, West 

Virginia. Her major research interest is occupational motor vehicle safety. She is the 

author of the forthcoming NIOSH document “Work-related Roadway Crashes: 

Challenges and Opportunities for Prevention,” as well as the 2001 NIOSH document 

“Building Safer Highway Work Zones.” Ms. Pratt has also published papers on 

adolescent workers, farm fatalities of youth, older workers, and machinery-related 

fatalities. She contributes regularly to NIOSH policy responses to notices of proposed 

rulemaking. Before coming to NIOSH in 1993, Ms. Pratt worked in the West Virginia 

University, where she managed the State Census Data Center and was involved in 

research projects on maternal and child health. Ms. Pratt holds master’s degrees from 

West Virginia University in applied music and applied social research. 
108

Michael Quinlan, PhD, MSIA, has been involved in occupational health and safety 

(OHS) education, research, practice and policy advice for over twenty years. He is the 

author of numerous articles on occupational health and safety as well as the author or 

editor (including joint editor) of a number of books, including Managing Occupational 

Health and Safety (Macmillan 1991 and 2nd edition 2000), Work and Health (Macmillan 

1993) and Systematic OHS Management (Elsevier, Oxford, 2000). He has acted as a 

policy adviser to both State and Federal governments in Australia on OHS for over ten 

years, serving on a number of committees and working parties. In 2000/2001, he 

undertook an inquiry into safety in the Australian long haul trucking industry for the 

Motor Accidents Authority of New South Wales. He is currently undertaking a study of 

OHS amongst short haul truck drivers as part of a broader project on contingent work 

arrangements. His particular interests include management systems/work organization, 

outsourcing/contingent work and the legal regulation of OHS. Apart from invitations to 

give papers at international conferences and workshops, he is a regular speaker at 

industry conferences and forums. 

Kathryn J. Reid, PhD, received her PhD from the University of Adelaide (Australia) in 

1998. She is currently a Research Assistant Professor at Northwestern University in the 

Center for Sleep and Circadian Biology and the Transportation Center. Dr Reid has 

worked closely with the rail industry in Australia investigating the impact of irregular 

hours of work on sleep, performance, and safety. Her current research interests are on the 

impact of sleep loss and circadian disruption on sleep, performance, health, and safety. 

She is currently developing a new curriculum on drowsy driving for driver education 

programs in Illinois, in collaboration with the Illinois Department of Public Health. She 

has published her work in Nature and in other peer-reviewed journals, and has presented 

at numerous conferences and meetings. 

Daniel A. Rodríguez, PhD, is Associate Professor of City and Regional Planning, UNCChapel Hill BS, 1994, Fordham University; Master of Science in Transportation, 1996, 

Massachusetts Institute of Technology, and Ph.D. in Planning, 2000, University of 

Michigan. Dr. Rodriguez teaches graduate courses in transportation policy, transit 

planning, and urban spatial structure. His research includes behavioral aspects of travel 

demand and truck transportation policy. He has conducted research on transportation 

safety, public transportation, multi-objective decision-making, and intelligent 

transportation systems. Dr. Rodríguez is currently appointed to three standing committees 

of the National Academies’ on Transportation and Land Development, Travel Demand 

Management, and Freight Economics and Regulation, and to the Task Force on Trucking 

Industry Research. Professor Rodríguez has been the recipient of the Transportation 

Research Board’s Fred Burggraff Award (2000) and the Eno Foundation Fellowship 

(1998). He has worked internationally for the World Bank and the Universidad de los 

Andes, Bogotá, Colombia. Dr. Rodríguez is also an Eno Transportation Foundation 

Leadership Fellow and a Fellow at NYU’s Institute for Civil Infrastructure Systems. 

Dr. William C Rogers, PhD, has over 20 years of experience in a wide variety of safety, 

training, and research endeavors in the trucking industry. He is Vice President of Safety, 

Training & Technology at the Motor Freight Carriers Association, a non-profit trade 
109

association established to advance the economic interests of the unionized, less-thantruckload motor carriers. He was the project manager for a recently completed study of 

22,000 workplace injuries and is currently conducting a survey of Teamster truck drivers 

with one million accident free driving miles to determine the techniques they use to 

manage fatigue, particularly during night operations. While serving as Director of 

Research for the ATA Foundation (the research and education arm of the American 

Trucking Associations) he defined the research needs of the trucking industry, identified 

funding sources, and managed and conducted trucking research for government and 

industry sponsors. His projects included research on the adequacy of truck parking at 

public rest areas, a comprehensive fatigue education program for truck drivers, the truck 

driver shortage, the prevalence of sleep apnea among truck drivers, and workplace 

injuries in the trucking industry. He also served in several positions as a civilian 

employee with the US Army, including, Safety director of the US Army Transportation 

Center, Safety Manager at Headquarters, US Army Europe, and Safety Manager of the 

37th Transportation Group, the Army’s line haul motor carrier in Europe. He earned his 

Doctorate in Safety Education at Texas A&M University. 

Lawrence S. Root, PhD, is director of the University of Michigan Institute of Labor and 

Industrial Relations and a professor in the School of Social Work. His area of research is 

the interplay between employment and social well-being. He has worked extensively with 

joint union-management programs. For example, he directed a major educational joint 

counseling program, which provided educational assistance to hourly workers in plants 

throughout the U.S. He also directed a distance learning college program specifically 

designed for autoworkers. For several years, Professor Root has served as chairman of 

the University’s Committee on Labor Standards and Human Rights, which is advisory to 

the President of the university on issues related to the manufacture of licensed goods. He 

is also the director of the Labor and Global Change program, which explores issues 

relevant to labor conditions in a cross-national context. 

Roger Rosa, PhD, is currently a Senior Scientist in the Office of the Director of NIOSH 

in Washington DC. He began his service with NIOSH in 1984 as a Research Psychologist 

in the Cincinnati laboratories following completion of a Ph.D. in Experimental 

Psychology from the University of Cincinnati. Throughout his career, Dr. Rosa has 

performed research on human performance and physiology as affected by shift work, 

biological rhythms, sleep loss, and fatigue. He has authored numerous articles and edited 

books on these and other occupational health and safety topics, served on national 

research committees, and collaborated with other agencies on issues related to working 

hours, stress, and fatigue. 

Robert G. Rothstein, JD, is Vice President and General Counsel of the American 

Moving and Storage Association (“AMSA”) in Alexandria, Virginia, where he 

specializes in legal, regulatory, and safety matters related to the moving and storage 

segment of the motor carrier industry. 

Mr. Rothstein has been with AMSA since October 2001. He spent nine years as general 

counsel with the Truckload Carriers Association, and was previously engaged in the 
110

private practice of law, concentrating in labor and employment law and litigation on 

behalf of management. He also spent seven years as a staff attorney with the Interstate 

Commerce Commission. 

Mr. Rothstein holds a B.B.A. degree in Finance from the University of Miami, a J.D. 

from Nova University, and a Master of Laws degree in labor law from Georgetown 

University. Between college and law school he hauled frozen vegetables between Florida 

and the Northeast. He maintains a current commercial driver’s license (CDL). 

Gregory M. Saltzman, PhD, is E. Maynard Aris Professor of economics and 

management at Albion College and adjunct research scientist at the Institute of Labor and 

Industrial Relations, University of Michigan. Previously, he taught social policy at 

Brandeis University and labor relations at Ohio State University. A paper by Greg 

Saltzman and Mike Belzer, “The Case for Strengthened Motor Carrier Hours of Service 

Regulations,” was published in the Summer 2002 issue of Transportation Journal. This 

paper summarized the medical and epidemiological literature on the impact of long and 

irregular work schedules on driver health, identified market failures that justify 

government regulation of driver hours, and noted statutory requirements that the U.S. 

Department of Transportation protect driver health. Dr. Saltzman’s other papers include 

studies of labor law, personnel selection procedures, reimbursement systems for mental 

health services, public-sector collective bargaining, and union organizing. He received 

his training as an economist at MIT, the London School of Economics, and the University 

of Wisconsin–Madison. 

Ian Savage, PhD, has been a member of the faculty of both the Department of 

Economics and the Transportation Center at Northwestern University since 1986. He is 

also the Assistant Chairperson of the Economics Department, and during 2000-01 was 

the Acting Associate Director of the Transportation Center. He earned a bachelor's degree 

in economics from the University of Sheffield and a Ph.D. from the School of Economic 

Studies/Institute for Transport Studies at the University of Leeds. Dr. Savage specializes 

in urban transportation, and the analysis of safety regulation and safety performance. He 

has conducted research into the safety of most modes of transportation. Most recently, he 

completed a book on The Economics of Railroad Safety (Kluwer Academic Publishers, 

1998). Prior to that, he was part of a five-year study of the economics of safety regulation 

in the trucking industry. He has also published widely on the economics of transit 

finances and operations and, more specifically, the impacts of competition and 

privatization. 

Mr. John Siebert, MS, EdSp, is a researcher and communications/training specialist, 

who works in the OOIDA Foundation producing educational materials and training 

modules specifically for independent truckers. He also performs primary survey research 

concerning driver behavior and attitudes. He has a lengthy background in academic and 

corporate communications and training. He earned his B.S., M.S., and Ed.Sp. degrees 

from Central Missouri State University. 
111

Thomas J. Smith, PhD, CIH, is currently Professor and Director of the Industrial 

Hygiene Program at the Harvard School of Public Health. Dr. Smith has long been 

interested in the design and implementation of exposure assessments for epidemiologic 

studies, particularly the estimation of past exposures. Recently a new assessment was 

begun as part of an NCI funded cohort study with Dr. Eric Garshick, Harvard Medical 

School, which will investigate lung cancer mortality in the US trucking industry. This 

new study will attempt to determine if there is a distinct risk from diesel engine 

emissions, as opposed to general combustion emissions and particles from all sources, 

such as trucks, automobiles, and home heating. Dr. Smith is also interested in the 

relationship between external exposure and internal dose, specifically the uptake and 

metabolism processes. He and his colleagues have developed a computer controlled 

apparatus to briefly expose volunteers to low levels of airborne chemicals (doses in the 

range of every day exposures) while making precisely timed measurements of exhaled 

breath levels during and after exposure. These data are used to estimate each subject’s 

uptake and metabolism of the material, which can better define their personal dose and 

risk from the chemical and who has the highest risk. All of Dr. Smith’s graduate work 

was performed at the University of Minnesota. 

David F. Snyder, JD, is Vice President and Assistant General Counsel for the American 

Insurance Association (AIA), specializing in legal reform, automobile insurance and 

other transportation issues. He also provides staff support for AIA's International 

Committee. His responsibilities include drafting legislation and regulations, testifying, 

managing litigation and communicating with the media. 

Mr. Snyder joined AIA in 1987 after working for Nationwide Insurance, managing its 

government affairs in its largest premium volume state. He left AIA in 1990 to work for 

State Farm Insurance Company and later returned to AIA. Prior to these positions, he 

served the Commonwealth of Pennsylvania as General Counsel of the Commerce 

Department, Deputy Attorney General in Torts Litigation and Legislative Liaison for the 

Insurance Department. Earlier, he was counsel to a federal agency. These positions 

included trial and appellate litigation, in-house legal counsel and government affairs 

responsibilities. 

Meg Sweeney, PhD, is a project manager/technical report writer for the Office of 

Highway Safety at the National Transportation Safety Board. She returned to the Safety 

Board after serving two years as a Transportation Specialist at the Bureau of 

Transportation Statistics. From 1994 to 2002, Dr. Sweeney was a Transportation 

Research Analyst in the Safety Studies Division in the Office of Research and 

Engineering. Prior to her service at the NTSB, she was a Project Manager at Advanced 

Resource Technologies, Inc. and a Consortium Research Fellow at the U.S. Army 

Research Institute. Dr. Sweeney received her B.A. in Psychology from Boston College 

and her M.A. and Ph.D. in Applied Experimental Psychology from George Mason 

University. 

Hans P.A. Van Dongen, PhD, is Research Assistant Professor of Sleep and 

Chronobiology in the Department of Psychiatry, University of Pennsylvania School of 
112

Medicine. He received an M.S. degree in astrophysics and a Ph.D. degree in 

chronobiology and sleep from Leiden University in the Netherlands. The focus of his 

work is on inter-individual variability in sleep and wakefulness; previous and current 

projects investigated inter-individual differences in circadian phase and inter-individual 

differences in vulnerability to performance impairment from sleep loss. Dr. Van Dongen 

recently published a study of the neurobehavioral effects of chronic sleep restriction 

relative to acute total sleep deprivation with David F. Dinges. The results led to the 

formulation of a novel “cumulative excess wakefulness” hypothesis for progressive 

impairments from sleep loss. Dr. Van Dongen is also active in the development of 

statistical techniques for time series analysis, which serves as a basis for his involvement 

in the biomathematical predictive modeling of performance deficits from sleep loss for 

the prevention of sleepiness-related human error. 

Patricia F. Waller, PhD, was a Senior Research Scientist with the Center for 

Transportation Safety at Texas A & M University. She previously served as Director of 

the Transportation Research Institute at the University of Michigan, retiring in 1999. 

Prior to going to Michigan in 1989, she was Associate Director for Driver Studies at the 

University of North Carolina Highway Safety Research Center, Research Professor in the 

UNC School of Public Health, and founding director of the UNC Injury Prevention 

Research Center. She served on the Board of Directors of ITS AMERICA from 1991 

through 1999 and chaired the Transportation Research Board's Group 3 Council, 

Operations, Safety, and Maintenance of Transportation Facilities, and the Group 5 

Council, Intergroup Resources and Issues. 

Her background in heavy truck transportation began in the early 1970's. She worked with 

the U.S. DOT, including FHWA, Office of Motor Carriers (BMCS previously), and 

NHTSA on heavy truck issues. In 1976 she served on a 6-member TRB panel to review 

and advise FHWA on their Heavy Truck Safety 5-Year Research Plan. She has served as 

Principal Investigator on several federal contracts concerning heavy truck safety, and 

served on the TRB Committee on Motor Vehicle Size and Weight (heavy trucks) since it 

began as a task force in 1979 to 1999. She also was a member of the TRB Special 

Committee for Truck Safety Data Needs Study; and on the Human Factors Workshop on 

Heavy Truck Safety for the Office of Technology Assessment. She served as Vice-Chair 

of the National Motor Carrier Advisory Committee and was subsequently appointed 

Chair. In 1995, she chaired the research sessions at the First National Conference on 

Truck and Bus Safety and was a participant in preparing the output of that meeting. She 

also worked with the Office of Motor Carrier Safety to develop guidelines, based on the 

input from the conference, to promote heavy truck safety through public and private 

initiatives. She continued to work closely with Office of Motor Carriers on such issues as 

driver fatigue, Hours of Service, and truck safety research needs. She passed away 

August 15, 2003. 

Ann Williamson, PhD, conducts research in occupational health and safety. After 

working as a Research Scientist for the New South Wales Government in the Department 

of Industrial Relations, Division of Occupational Health for seven years, she moved to 

the National Institute of Occupational Health and Safety where she was Principal 
113

Research Scientist and Head of the Human Factors and Ergonomics Unit. Ann's main 

research interests include the effects of fatigue and long and irregular working hours 

especially relating to long distance road transport, the role of behavior in the causes of 

injury and the neurobehavioral effects of exposure to workplace hazards. This work has 

continued following her move to the University of New South Wales, where Ann was 

founding Executive Director of the NSW Injury Risk Management Research Centre. Ann 

has published extensively in the scientific literature and has also been an invited speaker 

at a wide range of national and international conferences, and an invited member of a 

number of government committees on occupational health and safety. 
114

Appendix 2: Agenda 

Agenda, April 24–25, 2003, Conference on Truck Driver 

Occupational Safety and Health 

Thursday, April 24, morning 

Activity Time Topic Speakers 

Continental 

breakfast 7:30-8:30 

Plenary 8:30-10:30 An Introduction to Trucking Dr. Michael Belzer 

8:30-8:40 Introduction and Purpose of the Conference Dr. Michael Belzer 

8:40-8:45 Keynote: The Need for a Agenda on Truck 

Driver Occupational Safety and Health 

Dr. Patricia Waller 

[unable to attend] 

8:45-8:55 

How Many Trucks, How Many Miles? 

Heavy Freight Vehicles in the U.S., 1977-

1997 

Dr. Stephen Burks 

8:55-9:15 Sweatshops on Wheels: Winners and Losers 

in Trucking Deregulation Dr. Michael Belzer 

9:15-9:35 

Market Failures, Economic Efficiency, and 

the Need for Federal Regulation of Truck 

Driver Work Hours 

Dr. Gregory Saltzman 

9:35-9:55 European Trucking: Health and Safety 

versus Competitiveness? Dr. Dieter Plehwe 

9:55-10:15 

Trucking in Australia: Lessons from the 

Recent Inquiry (2001) into OHS in Long 

Haul Trucking 

Dr. Michael Quinlan 

10:15-10:30 Discussion 

Break 10:30-10:45 

Plenary 10:45-12:25 Surveillance Chair: Dr. Janie 

Gittleman 

10:45-11:05 Fatigue and Sleepiness in the Workplace: 

Can We Track It? Dr. Roger Rosa 

11:05-11:25 Truck Driver Injury and Illness Data from 

the Bureau of Labor Statistics Katharine Newman 

11:25-11:45 Truck Crash Data: Truck Drivers Dr. Ralph Craft 

11:45-11:55 Data Sources Available at BTS Dr. Meg Sweeney 

11:55-12:05 

An Analysis of CMV Driver Traffic 

Conviction Data to Identify High Safety Risk 

Motor Carriers 

Brenda Lantz 

12:05-12:25 CFOI and FARS Data on Truck Crashes: 

Apples and Oranges? Dr. Stephanie Pratt 
115

Agenda, April 24-25, 2003, Conference on Truck Driver Occupational Safety and Health 

(continued) 

Thursday, April 24, afternoon 

Lunch 12:25-1:10 Welcome from the Dean of the College of 

Urban, Labor and Metropolitan Affairs 

Wayne State University and Lunch 

Dean Alma Young 

CULMA 

Plenary 1:10-2:55 Exposure, Injury, and Fitness Chair: Dr. William 

Rogers 

1:10-1:30 Diesel Exhaust Health Effects: Trucking 

Industry Particle Study 

Dr. Eric Garshick 

1:30-1:50 Workers Compensation Claims Experience in 

Unionized LTL Carriers 

Dr. William Rogers 

1:50-2:10 An Ergonomic and Cardiovascular Stress 

Evaluation of Soft Drink Beverage 

Deliverymen 

Dr. James McGlothlin 

2:10-2:25 Occupational Hazards of Ready Mixed 

Concrete Truck Drivers 

Dr. Michael McCann 

 Gettin’ in Gear: Wellness, Health & Fitness 

for Commercial Drivers 

Dr. Gerald P. Krueger 

[unable to attend] 

2:25-2:45 Discussion 

Break 2: 45-3:00 

Plenary 3:00-5:15 The Economics of Safety Chair: Dr. Michael 

Belzer 

3:00-3:30 Pay, Work Hours, and Driver Safety Dr. Daniel Rodriguez 

3:30-3:50 Transportation Safety Dr. Ian Savage 

3:50-4:20 Occupational Safety and Health in Trucking: 

An Australian and European Perspective 

Dr. Michael Quinlan 

4:20-4:50 Professional Drivers’ Working Time as a 

Factor of Flexibility and Competitiveness in 

Road Haulage 

Dr. Patrick Hamelin 

4:50-5:30 Discussion 

Break 5:30-6:00 

Reception 6:00-6:30 

Dinner 6:30-7:30 

Panel 

Session 

7:30-9:30 Panel Discussion: HOS regulations; reactions 

to presentations on health and safety; effects 

on industry, on driver work life and earnings 

Robert Rothstein, Ron 

Jager, David Snyder 

[participated by 

conference call] 
116

Agenda, April 24-25, 2003, Conference on Truck Driver Occupational Safety and Health 

(continued) 

Friday, April 25 

Continental 

breakfast 

7:00-8:00 

Plenary 8:00-9:45 Safety Issues and Sleep Chair: Scott Madar 

8:00-8:20 Effects of Fatigue on Safety: Tired or Drunk, 

What's the Difference? 

Dr. Kathryn Reid 

8:20-8:40 Fatigue and Safety: Chronic Sleep Loss, 

Wake State Instability, and Inter-Individual 

Differences 

Dr. Hans Van Dongen 

8:40-9:00 Chronic Sleep Loss Leading to Obesity, 

Diabetes 

Dr. Orfeu Buxton 

9:00-9:20 Sleep Apnea: Prevalence, Risk Factors, & 

Consequences Relevant to the Trucking 

Industry 

Dr. Chris Drake 

9:20-9:40 Pressure of Work Organization on Health: 

Lessons from Transit 

Dr. June Fisher 

9:40-9:45 Discussion 

Break 9:45-10:00 

Plenary 10:00-12:00 Preliminary Analysis of OOIDA Member 

Data 

Chair: John Siebert 

10:00-10:35 Work Hours, Sleep and Health Dr. Torbjorn Akersted 

10:35-11:10 Evaluating Different Work-Rest Schedules 

and Arrangements for Long Distance Road 

Transport: Risk Factors for Fatigue and the 

Role of Regulation 

Dr. Ann Williamson 

11:10-11:30 I was so Tired – I had a Vision: A Fatigue 

Risk Management System for Road Transport 

Dr. Drew Dawson 

11:30-11:45 Work and Family Issues: The Effects of Long 

Work Hours 

Dr. Lawrence Root 

11:45-12:00 Discussion 

Lunch 12:00-12:45 

Break outs 12:45-2:30 By area of interest 

Plenary 2:30-3:30 Review and Next Steps: Develop Research 

Agenda 

Chair: Dr. Michael 

Belzer