Risks you can’t see
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It’s well known that truck drivers’ health can be at risk from poor diet and a lack of exercise, but there are a number of hidden hazards that can be just as fatal
Words: Derren Hayes Draw a line down the middle of William McElligott’s face and you’ll wonder whether you’re looking at someone in their 80s or late middle age. The left-hand side of the 66-year-old former US truck driver’s face is pitted and sagging after 28 years of exposure through the side window of his lorry, while the right-hand side, shaded by the cab as McElligott delivered milk around Chicago, is taut and unblemished.
McElligott became a case study for photoageing after his picture was published in the New England Journal of Medicine. That too much sun is bad for skin and health generally is hardly new, but what was striking about McElligott’s story is that because the damage occurred gradually over his career he was unaware of it until the latter years. It highlights the fact that not all the health dangers commercial vehicle drivers encounter daily will be immediately obvious or visible.
The McElligott example hit the headlines at around the same time as another story that highlighted the hidden health risks for drivers: the outbreak of legionnaires’ disease in Edinburgh. Although small in number – 359 cases in 2010 according to the latest inalised igures from the Health Protection Agency (HPA) – the potency of the legionella virus makes it particularly dangerous, with around 10% of infections causing death.
Recent HPA research found that professional drivers are ive times more likely to be infected with it than the rest of the population. Most at risk “were those who drove or travelled in a van, who drove through industrial areas, and who spent a lot of time in the car or often had the car window open”. These factors, combined with the fact that men account for two-thirds of cases, the majority aged over 50, puts commercial vehicle drivers at greater risk.
The HPA research suggested the increased incidence of legionella cases in professional drivers could be attributed to stagnant windscreen wiper water – kept between 20C-46C, water is a breeding ground for the legionella bacteria which, when inhaled, can cause pneumonia.
Industrial areas
However, for Karl Collingwood-Thirlway, a legionella control specialist at Archer & Stone, the risks posed by windscreen water reservoirs in the HPA report was focussed on too much by the media. “More relevant is that those with legionnaires’ disease tended to spend more time driving in industrial areas,” he says. “These have a higher proportion of cooling towers. As the recent Edinburgh outbreak showed, when these are not properly controlled it leads to massive exposure, many cases and several deaths.” He says drivers can minimise the risk by using windscreen wash, and if symptoms arise should “seek medical advice early and ask for a legionella antigen test as doctors are unlikely to diagnose legionnaires’ disease unless they are prompted to”.
Compared to legionella, the risks associated with sun exposure have been widely publicised, largely due to the increase in prevalence – there are now 40,000 new cases and nearly 2,000 deaths from skin cancer in the UK each year. Outdoor workers are identiied as a group at risk by government agencies, but McElligott’s case shows it also extends to professional drivers.
Gill Nuttall, chief executive of sun awareness campaign group Factor50, says many transport workers haven’t been given advice on skin care. “A lot of windscreens don’t have protection and you can see the effects, such as liver spots, on the back of commercial drivers’ hands. You also see drivers with sun damage to their arms caused by them leaning out of the window.
“I asked a driver of a large leet operator about what advice he was given on sun cream: he just laughed. There wasn’t any and he didn’t think it was an issue. We need to change attitudes: what’s going to happen one day is that a company will be sued after it is shown an employee got skin cancer as a result of their working environment.” Perhaps the most signiicant hidden risk to commercial vehicle drivers’ health, due to the sheer scale of the issue, is the effect of diesel emissions. Long suspected to cause a range of health problems, The World Health Organisation (WHO) recently upgraded the carcinogenic risk level attached to diesel fumes
from “probable” to “conirmed”. (CM 21/6/12) The WHO’s International Agency for Research on Cancer (IARC) arrived at its conclusion after a panel of experts sifted evidence, gathered globally over the past decade, on the effect of diesel on humans. It included studies of lorry drivers. “Among this population there was an increased risk of developing lung cancer,” says Robert Baan, a senior scientist at the IARC. “These later studies measured the noxious chemicals
workers were exposed to rather than relying on what people remembered [about their working environment].” However, Baan says investment in cleaner engines, combined with fuel-eficient driving initiatives, is likely to have reduced the levels of harmful particles in the atmosphere in Europe (if not in less developed parts of the world) reducing the cancer risk for drivers just starting their career. The WHO has worked with vehicle manufacturers over the past decade to address the issue in a co-ordinated manner across the industry, but there are much simpler things individual hauliers and drivers can do to help mitigate the effects of hidden health hazards, says Roger Bibbings, occupational safety adviser for the Royal Society for the Prevention of Accidents (RoSPA).
Basic health education
Bibbings says a comprehensive risk assessment of the driving environment should help employers identify issues that could cause problems. “That includes speaking to the drivers themselves and ensuring they are given some basic health education, for example about how to use and apply sunscreen properly.” Bibbings says there is a need for the major leet operators to do more proactive prevention work to improve the health of their employees rather than only getting occupational health (OH) involved when there are periods of long-term absence due to illness. “A big part of that is to make the health agenda part of the line managers’ focus. Good OH should look at what can be done to prevent health risks,” he says.
Susan Murray, health and safety adviser for Unite, says employers must focus on preventing their drivers’ exposure to diesel emissions as part of a risk prevention strategy, and believes it is essential that the Health and Safety Executive (HSE) has a robust enforcement programme to make this happen.
The United Road Transport Union (URTU) agrees, but says: “Unfortunately, the HSE has too few inspectors, administrators and clinicians to protect the workforce throughout our industry.” URTU has issued guidance to drivers on how to reduce risks, such as turning off engines in enclosed areas and moving as far away from other vehicles and trafic while taking breaks, as well as closing windows when using windscreen wiper water and always ensuring suficient screenwash is used.
However, Steve Ellis, training manager at the Road Haulage Association, believes most hidden health issues are easily overcome by good health and safety procedures, and that by and large the major leet operators, who set the standards the rest of the industry follow, are ahead of the game. “There’s still this macho image in the industry – most drivers aged over 50 don’t think they need to put sunscreen on. Any reluctance to do so is more likely to come from drivers than employers,” he adds.
If Ellis is right, then perhaps showing the photo of William McElligott at every health and safety brieing will encourage the naysayers to take notice. ■
RESOURCES
Information on sun protection:
sunsmart.org.uk/ hse.gov.uk/skin/sunprotect.htm
Legionella risks:
hse.gov.uk/legionnaires/index.htm hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/LegionnairesDisease/
WHO findings on diesel emissions:
www.iarc.fr/