If the Indian truck drivers are known to be more prone to HIV than any other segment of the population, in the US too they are more at risk of contracting a whole range of health problems than most others.
They account for nearly 15 percent of U.S. work-related deaths. Obesity is rampant among them. Many don't bother to wear seatbelts because their stomachs get in the way, says a study commissioned by the Transportation Research Board, an arm of the National Academy of Sciences.
Of course the trucking industry has the most fatalities of all occupations. The Bureau of Labor Statistics says truck drivers account for nearly 15 percent of all worker deaths in the most recent data available, from 2005. (The death rate per 100,000 is higher for other occupations.) Of those trucker deaths, 80 percent involved traffic accidents, the bureau said.
Truck drivers also report more injuries, such as sprains, than workers in any other category, according to the Occupational Safety and Health Administration. Many of them unload the goods they carry, risking back injuries.
As many as half of drivers are regular smokers, compared to about one-fifth of all Americans. Many truckers are obese, and only about one in 10 get regular aerobic exercise.
Sleep apnea, which is linked to obesity, is rampant too. An industry study a few years ago found 28 percent of drivers had it; that compares with about 4 percent in the general population who have the disorder.
Sleep apnea is a common disorder that can be serious. In sleep apnea, your breathing stops or gets very shallow. Each pause in breathing typically lasts 10 to 20 seconds or more. These pauses can occur 20 to 30 times or more an hour.
The most common type is obstructive sleep apnea. That means you are unable to get enough air through your mouth and nose into your lungs. When that happens, the amount of oxygen in your blood may drop.
Untreated, sleep apnea can cause high blood pressure and other cardiovascular disease, memory problems, weight gain, impotency, and headaches. Moreover, untreated sleep apnea may be responsible for job impairment and motor vehicle crashes.
Truckers pose unique challenges when it comes to improving health, said Ilene Masser, director of such a program for faculty and staff at New York University Medical Center. They sit for long periods, are out on their own, eat a lot of fast food and most of them are men, who often need more prodding than women to make changes, she said.
Drivers are tested every two years to maintain their licenses, which are issued by states. Waivers can be granted, but generally commercial drivers can't be licensed if they have severe high blood pressure or severe heart conditions. Other aspects of drivers' health, like weight and smoking, aren't regulated.
"They can't say, 'You can't be obese' and they can't force you to stop smoking,'" said Gerald P. Krueger, a psychologist who compiled "The government shouldn't regulate that. But we've been trying to educate people to the linkage between being a healthy person and a safe driver."
Krueger said trucking companies need to do more to foster better health among their employees, whether it's to reduce health care costs or hang onto employees in an industry where turnover is high and shortages growing.
The Federal Motor Carrier Safety Administration estimates there are 1.3 million long-haul drivers nationwide and is considering tightening its rules for conditions including diabetes and high blood pressure. And many companies are stepping up their own efforts at improving health.
"It takes a while to undo years and years and years of unhealthy behavior," said Christie Cullinan of the American Trucking Associations, which represents about 2,000 companies and suppliers. "But I think companies are having to look at this because of the skyrocketing health care costs and related workers compensation costs."
Encouraging the drivers to go in for regular BP cholesterol checks, making available green tea, water and diet drinks in vending machines, even walking rings at some points are among the various initiatives currently undertaken by the truck companies.
Sammy Belvin, a driver for Oklahoma-based Melton Truck Lines, has been getting advice from a wellness coordinator with the company. He carries weights in his truck, and for meals, he eats cereal and cooks chicken breasts on an electric grill in his cab.
A driver for 23 years, Belvin says these days he's not the only one jogging around in the mornings before he drives off for the day.
Lisa Miles, an independent driver based in Fort Wayne, Ind., lifts weights in the cabin of her semi, too, while her partner driver takes the wheel. She gave up smoking three years ago and now is trying to lose 30 pounds.
"It's real easy to let your personal health be the last of your priorities," she said.
William Rundle is one of the drivers for Schneider National who benefited from his company's aggressive effort to treat sleep apnea.
"It's wonderful to be able to function during the day now," he said, adding that he has more energy and makes his deliveries on time. He said his company has also persuaded him to quit smoking and eat better.
Changes are worth it. About three-quarters of employers with at least 1,000 workers have a wellness program, she said. And for every dollar invested, they get about $3.14 back, including savings on health care costs and added productivity.