Health has always been closely linked with occupation. Sound health in relation to vocation and employment is the most important aspect of the very life of an individual who works and to the society as a whole. Occupational hazards natural in the work environment have become more prominent in the post-industrial societies. These include a wide range of health problems ranging from asthma, heart attack, high blood pressure, stress and other psychological disorders, with many more to list. Occupational health is therefore, an aspect seeking attention at the individual, group and community levels. The related study deals with ergonomics—a link between the worker and his working environment. This would have impact on the body and discomfort reflected in various parts of the body bringing about certain health problems.

India after its independence has become one of the largest human resources of the world. This advancement of industrialization provided employment to a huge number of people in India and more than 170 million people are employed in various industries apart from those directly or indirectly engaged in cultivation and other agricultural activities. Transport in India is an imperative part of the nation's financial system. The rapid augmentation of India's urban population has put colossal strain on all transport systems. Bus drivers have to work in different environmental condition. Pollution is one of the main hindrances of their day to day work. As because of different environmental exposure drivers are exposed different type of respiratory problems. In driving performance the physical and psychological health of the bus driver is a serious factor.

The present study was carried out with the participation of 103 city bus drivers working in Medical college transportation system. As the population size was limited, all drivers have been invited to participate in the study. It is worth mentioning that having at least one year of experience, not having severe mental disorders as well as not having a second job were considered as initial criteria to include drivers in the study. Drivers who met the inclusion criteria, signed informed consent before participating in the study.

In this study, data collection has been conducted in several phases. As the primary phase, the information related to bus drivers' demographic and job characteristics as well as baseline job stress were obtained. Then, physiological parameters included systolic blood pressure (BP), diastolic blood pressure, and heart rate (HR) were measured twice; the first measurements were done before driving, in a situation in which the drivers were exposed to the minimum levels of environmental stressors.

Analysis of data

The mean and the standard deviation (SD), as well as number and percentage, were reported to describe the data. Then, the normality of data was tested by means of the Kolmogorov-Smirnov tests. Using the independent-samples T-tests and One-way ANOVA tests, the mean of variables were compared within various groups. All statistical analyses were performed using the SPSS 22.

The study revealed that majority of the study population belonged to the age group of 50-60 years (35.5%) with the mean age of 45.8 (10.12) years. All of them were male. Majority belonged to the general caste (63.6%), nuclear family (52.4%) and were Hindu (82%), currently married (87.1%). Regarding educational qualification and socio-economic status majority of them had passed middle (48.9%) level and belonged to upper (41.6%) socio economic class respectively. The study population consisted of drivers (50.6%) and conductors (49.4%). Majority of them were working for minimum 10 hours per day (52.8%) with the daily mean working period of 10.11 (1.37) hours. Regarding period of service, most of them had work experience of workers who did night shifts, majority had worked at night for 2 days/week (63.64%) (Table 1). Regarding general survey, majority of the drivers had normal (55.55%) BMI with the mean (SD) of 24.6 (3.35); while 44.32% of each of conductors had normal BMI and overweight 44.32% with the mean BMI of 25.3 (3.17). Regarding blood pressure most of the drivers had normal (72.22%) BP with the mean (SD) of 119/76 (10.41/7.53); while majority of the conductors had normal (80.69%) blood pressure with the mean (SD) of 122/78 (13.87/8.0) mm/Hg. Majority of drivers and conductors had no pallor (95.56% and 86.36%), cyanosis (100% each), jaundice ((98.89% and 98.86%) or vitamin deficiency signs (96.67% and 96.58% respectively)

Table 1: Demographic Parameters

Table 2: Distribution of study population according to personal health practices in drivers (n=90).

while 35.14% of the conductors had faced the same in last 12 months, but only 13.51% had that in last 7 days. Regarding respiratory problems, only 5.56% and 15.91% of drivers and conductors respectively had some sort of respiratory problems. While bronchial asthma (80%) was commonest among drivers, bronchial asthma and COPD (35.71% each) both had been equally recognized as commonest among conductors. Regarding cardio-vascular diseases, 17.78% 27.27% of drivers and conductors respectively had some sort of CVD problems, hypertension being the commonest problem. Regarding neurological problems, only (1.11% and 2.27%) of the drivers and the conductors respectively had some neurological problems in last 12 months. Regarding gastro-intestinal problems, only (2.22% and 9.10%) of the drivers and the conductors respectively had some form of GI problems in last 12 months. Gastritis or peptic ulcer was the commonest problem. Regarding ophthalmological, ENT, urological, orthopaedic, dermatological problems; 7.78%, 3.33%, 2.22%, 13.33%, 3.33% of the drivers and 9.10%, 3.4%, 4.55%, 7.95%, 12.5% of the conductors had some sort of eye, ENT, urological, orthopaedic, dermatological problems respectively in last 12 months. Regarding Endocrinal/ metabolic problems, 26.66% of the drivers and 34.09% of the conductors had some sort of problems within last 12 months and majority of them who suffered, had diabetes (70.83% and 76.66% respectively). Only 2.22% of the drivers and 1.14% of the conductors had suffered from dengue & malaria respectively in last 12 months. Around 10% of the drivers and 9.10% of the conductors had suffered from piles and inguinal hernia in last 12 months respectively. Regarding occupational injuries, only 7.78% of the drivers had suffered occupational injuries ever in his occupational lifetime and of those who suffered majority (57.14%) had fracture. Among conductors only 4.55% had suffered, some sort of occupational injuries ever in their occupational life and of those who suffered, majority had either fracture (50%) or internal injuries (50%). Multivariate analyses revealed that participants who used to do night shifts had higher odds of having good personal health practice score (Table 3). Multivariate analyses revealed that participants aged less than 44 years and who served their occupation for less than 6 years had higher odds of not suffering from musculoskeletal morbidities (Table 4). Multivariate analyses revealed that participants aged less than 44 years and who served their occupation for less than 6 years had higher odds of low morbidities.

The study had revealed that a significant portion of drivers and conductors were suffering from musculoskeletal morbidities, while age and duration of service remained as significant determinants of not only musculoskeletal, but overall morbidity. These malpractices could further jeopardize their physical health. Working as a bus driver and conductor is mainly either a sedentary or stressful job, or both. Bad road conditions with dust and increasing air pollution are complicating the situation. Most people would feel too tired to go for regular exercise.

1. Moore RM, Kaczmarek RG. Occupational hazards to health care workers: diverse, ill-defined, and not fully appreciated. Am J Infect Control 1990;18:316–27.
2. Crutcher JM, Lamm SH, Hall TA. Procedures to protect health-care workers from HIV infection: category I (health-care) workers. Am Ind Hyg Assoc J 1991;52:A-100–A-103.
3. World Health Organization. Occupational health [Internet], 2021. Available: https://www.who.int/health-topics/occupational-health [Accessed 11 Sep 2021].
4. The Lancet. COVID-19: protecting health-care workers. The Lancet 2020;395:922.
5. McDiarmid MA. Hazards of the health care sector: looking beyond infectious disease. Ann Glob Health 2014;80:315.
6. Arif AA, Delclos GL. Association between cleaning-related chemicals and work-related asthma and asthma symptoms among healthcare professionals. Occup Environ Med 2012;69:35–40.
7. Ratner PA, Spinelli JJ, Beking K, et al. Cancer incidence and adverse pregnancy outcome in registered nurses potentially exposed to antineoplastic drugs. BMC Nurs 2010;9:15.
8. Trapé M, Schenck P, Warren A. Latex gloves use and symptoms in health care workers 1 year after implementation of a policy restricting the use of powdered gloves. Am J Infect Control 2000;28:352–8.
9. Coggon D, Harris EC, Poole J, et al. Mortality of workers exposed to ethylene oxide: extended follow up of a British cohort. Occup Environ Med 2004;61:358–62.
10. Vaughan TL, Stewart PA, Teschke K, et al. Occupational exposure to formaldehyde and wood dust and nasopharyngeal carcinoma. Occup Environ Med 2000;57:376–84.
11. Maslach C, et al. Burnout in health professionals. In: Ayers S, Baum A, McManus C, eds. Cambridge Handbook of Psychology, Health and Medicine. 2nd ed. Cambridge University Press, 2001:427–30.
12. Davis KG, Kotowski SE. Prevalence of musculoskeletal disorders for nurses in hospitals, long-term care facilities, and home health care: a comprehensive review. Hum Factors 2015;57:754–92.
13. Phillips JP. Workplace violence against health care workers in the United States. N Engl J Med 2016;374:1661–9.
14. Centre for Disease Control and Prevention. National Institute of Occupational Health and Safety. State of the Sector: Healthcare and Social Assistance. Atlanta, GA, USA, 2009.
15. Liese B, Dussault G. The state of the health workforce in sub-Saharan Africa: evidence of crisis and analysis of contributing factors. Washington, DC, USA: The World Bank, 2004.
16. Ministry of Health, Ghana Health Service. Occupational Health and Safety Policy and Guidelines for the Health Sector. Ghana, 2010.
17. Patwary MA, O’Hare WT, Sarker MH. Assessment of occupational and environmental safety associated with medical waste disposal in developing countries: a qualitative approach. Saf Sci 2011;49:1200–7.
18. Nuwayhid IA. Occupational health research in developing countries: a partner for social justice. Am J Public Health 2004;94:1916–21.
19. Ministry of Health, Ghana Health Service. Occupational Health, Safety & Environmental Management in the Context of COVID-19: A Guide for Health Care Workers, 2021.
20. Arksey H, O'Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol 2005;8:19–32.