Health Risks Associated with Occupational Exposure to Ambient Air Pollution in Commercial Drivers: A Systematic Review

Abstract

Ambient air pollution is a major global health problem and commercial drivers are particularly exposed to it. As no systematic assessment of the health risks associated with occupational exposure to ambient air pollution in this population had yet been carried out, we conducted a systematic review using a protocol-driven strategy. Papers published from inception to April 20, 2018 in MEDLINE, EMBASE, CINAHL, African journals online, the Cochrane library, ISRCTN WHO ICTRP, and the Web of Science and Scopus databases were screened for inclusion by two independent reviewers. Original articles with at least an available abstract in English or French were included. The initial search retrieved 1454 published articles of which 20 articles were included. Three studies reported a significant difference in white blood cells (106/L) among commercial motorcyclists compared to rural inhabitants (5.041 ± 1.209 vs. 5.900 ± 1.213, p = 0.001), an increased risk of lung cancer (RR = 1.6, 95%CI 1.5–1.8) in bus drivers and an increased standardized mortality ratio (SMR) in bus drivers from Hodgkin’s lymphoma (SMR 2.17, 95%CI 1.19–3.87) compared to white-collar workers. Other studies also found that drivers had more oxidative DNA damage and chromosome breaks. Four papers failed to demonstrate that the drivers were more exposed to air pollution than the controls. Three other studies also reported no significant difference in lung function parameters and respiratory symptoms. The genetic polymorphisms of detoxifying enzymes were also not homogeneously distributed compared to the controls. There is some evidence that occupational exposure to ambient air pollution among commercial drivers is associated with adverse health outcomes, but the existing literature is limited, with few studies on small sample size, methodological weaknesses, and contradictory findings—thus, further research is recommended.

Effects of nurses’ shiftwork characteristics and aspects of private life on work-life conflict

“…It was frequently confirmed that nurses worked more than 3-shift rotations for more than five consecutive days, working with less than 24-hours of rest between shifts, working with less than two nurses on night shifts, a backward rotation working system, etc. A previous study found that a backward rotation working system results in a worse work-life balance [24]. In October 2019, guidelines issued for night shifts for nursing staff proposed a night shift planning, including guaranteeing rest (48 hours and over) between consecutive two-night shifts, and limiting periods of consecutive night shifts to less than three days [25].…”

Assessing the exposure and hazard of diesel exhaust in professional drivers: a review of the current state of knowledge

“…Current occupational epidemiological studies have been criticised for the use of imprecise proxies for diesel exposure, with occupational mortality often linked to years in job or against workers in non-exposed occupations (Fang et al 2010;Sun et al 2014). There have been reviews investigating the health effects of ambient pollution to commercial drivers (Lawin et al 2018), biomarkers of occupational exposure (Brucker et al 2020) and occupational exposures to diesel exhaust (Pronk et al 2009). However, none have identified studies investigating where and when the highest exposures for professional drivers occur and how these exposures could be mitigated.…”

Occupational Exposure to Air Pollution in Africa: Boda Boda Riders in Kampala

“…Occupational exposure to air pollution is of particular concern where workers spend long periods close to emission sources, especially where air pollution regulations are not effectively implemented (Ngo et al, 2015;Fang et al, 2010). A systematic review of studies looking at occupational exposure of commercial bus drivers and motorcyclists to ambient air pollution found a signi cant difference in white blood cells amongst commercial motorcyclists, and an increased risk of lung cancer and Hodgkin's lymphoma amongst bus drivers, but found that the existing literature is limited (Lawin et al, 2018). In one of the few African studies, Ngo et al (2015) examined occupational exposure to roadside emissions in Nairobi, and found that bus drivers had signi cant exposure to black carbon (a component of PM 2.5 ) probably from vehicle smoke due to poor engine maintenance.…”