Driving Behaviors, Cardiovascular Disease Risk Factors, Road Traffic Crashes, and Their Association with Fatigue in Urban Taxi Drivers

Introduction: Taxi drivers face unique challenges that can impact their health and safety, including driving behaviors, cardiovascular disease (CVD) risk factors, road traffic crashes (RTC), and fatigue. This study aimed to investigate the associations between these factors and fatigue in urban taxi drivers. Aims: To examine the relationship between driving behaviors, CVD risk factors, RTC, and fatigue in urban taxi drivers and to determine the prevalence of RTC and fatigue levels in this population. Methods: This is a cross-sectional study. A convenience sampling method was used to recruit 130 taxi drivers in San Francisco, United States. Data were collected using structured questionnaires that assessed demographic information, work factors, health characteristics, driving behaviors, and fatigue levels. Statistical analyses, including chi-square tests, were performed to explore associations between variables. Results: The majority of taxi drivers were middle-aged, primarily male, and worked an average of 41 hours per week. About 22% of drivers reported at least one RTC in the past year. Based on perceived fatigue scales (0-10), the mean level of fatigue in the prior week was 3.93 (±2.50), fatigue before bedtime was 5.2 (±2.60), and fatigue upon awakening was 3.5 (±2.40). The overall fatigue level (the sum of the 3 fatigue scales) was 12.7 (±5.98). Perceived high fatigue levels were significantly associated with shorter sleep duration (X²=6.66, p=0.01), good or poorer self-rated health (X²=9.53, p=0.003), and higher mental exertion (X² = 9.51, p=0.002). However, overall fatigue levels were not significantly associated with self-reported RTC. The findings of this study showed that high mean CVD risk factors (≥ 4 risks out of 9). Past and present medical history variables and family history of CVD variable are not statistically associated with abnormal sleep or perceived high fatigue. Conclusion: This study highlights the challenges faced by urban taxi drivers, including high workloads, stress, shorter sleep duration, and fatigue. While perceived high fatigue was associated with certain factors, such as sleep duration and mental exertion, no significant association was found with self-reported RTC. Interventions focusing on sleep hygiene, fatigue management, and policy changes are warranted to improve the health and safety of taxi drivers. Further research with larger samples and longitudinal designs is needed to enhance our understanding of these associations and inform targeted interventions in this population.