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Occupational stress high among SLTB Colombo District bus drivers: Local study 

13 Feb 2022

  • Researchers recommend accessible mental health services, routine health check-ups, healthy working rosters 
BY Ruwan Laknath Jayakody  A high level of prevalence of occupational stress of 52.1% was observed among Sri Lanka Transport Board (SLTB) bus drivers in the Colombo District, per a local study. The study also identified several factors associated with occupational stress, with modifiable factors including person-related factors such as tobacco usage and being alert at the end of the day with good concentration, and factors related to the work life including working for more than 10 hours daily and over six days per week, while non-modifiable factors included having work experience less than 10 years.  These findings were made in an original research article on the “Prevalence and associated factors of occupational stress among bus drivers of the SLTB in the Colombo District” which was authored by D.K. Illangasinghe and M.A.A.P. Alagiyawanna (attached to the Health Promotion Bureau), D.B.D.L. Samaranayake (attached to the Colombo University’s Medical Faculty’s Community Medicine Department) and N. Fernando (attached to the General Sir John Kotelawala Defence University) and published in the Journal of the College of Community Physicians of Sri Lanka 27 (3) in November 2021.  Job stress, Illangasinghe et al. explained, is the response that people may have when presented with work demands which are not matched to their knowledge and abilities, and thus challenges their ability to cope. Stress, according to T. Cox, A. Griffiths and E. Rial-Gonzale’s “Research on work-related stress”, occurs in varying levels of work circumstances, and cuts across all hierarchical categories, thus becoming, per the World Health Organisation’s “Raising awareness of stress at work in developing countries”, a key occupational risk factor. C. Murray and A. Lopez’s “Global burden of disease and injury: Comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020” estimated that stress-related mental health conditions are considered highly predominant in terms of disabilities. The International Labour Organisation’s (ILO) “Workplace stress: A collective challenge”, has named occupational stress as the 21st Century disease. Also, Illangasinghe et al. added that occupational stress causes a pronounced economic impact (the ILO’s “Making markets work for jobs: World of work report”, predicted a cost of £ 530 million in 2006, due to absences caused by sicknesses owing to stress as perceived by workers). D. Sonnentage and M. Frese’s “Handbook of psychology” has recognised the salient inter-relationship between work and mental health.  Concerning the bus drivers’ profession, Illangasinghe et al. noted that work stress plays a key role due to the nature of their work with exposure to everyday stress behind the wheel being a unique dimension in a bus driver’s life. An Indian study noted that bus driving can be regarded as a high strain occupation, with increases in the risks of physiological and psychological issues. S. Taklikar’s “Occupational stress and its associated health disorders among bus drivers” mentioned that operating public transit vehicles is among the most stressful and unhealthy occupations. P. Schnall, M. Dobson, E. Rosskam, R. Elling and A. Landsbergis’s “Unhealthy work” showed that compared to workers in other jobs, bus drivers are more likely to experience cardiovascular diseases, gastrointestinal disorders and musculoskeletal disorders, while occupational stress is believed to play a significant role in causing them. Bus driving is a particularly stressful job, Illangasinghe et al. pointed out, as it has high psychological demands and little decision making control, in combination with low levels of social support. Additionally, Illangasinghe et al. added that though the main task of bus drivers is to drive safely and maintain a timely schedule, these two tasks are inherently contradictory.
  1. Kompier’s “Bus drivers: Occupational stress and stress prevention: A manual for bus drivers” added that job factors that contribute to developing stress in bus drivers are work shift schedules, irregular meal times and poor nutrition, traffic congestion, prolonged driving, constant visual and mental alertness, and driving during night hours in adverse weather conditions. An American study found that bus drivers below 50-years in terms of age had job stress. In Asian cultures, per Illangasinghe et al., the injurious nature of occupational stress among bus drivers has been stressed, which in turn increases the risk of physical as well as psychosocial ailments, and a predisposition to poor health. In terms of continuously growing threats to drivers’ wellbeing, Y. Hlotova, O. Cats and S. Meijer’s “Measuring bus drivers’ occupational stress under changing working conditions” mentioned growing traffic, aggressive passengers and increasingly tight running schedules due to market competition.
Bus drivers working conditions were, according to Illangasinghe et al., studied extensively by researchers and the public transport industry, due to the inherent nature of the job’s unpopularity in the market, the high labour turnover and early retirement caused by health problems. Kompier reported that over 50% of bus drivers considered their job to be very demanding, stressful and rushed, with 55% and 53% naming peak running times and public enquiring, respectively, as the main stressors, while 25% reported that the schedules were so tight that safety was compromised on a daily basis. Driving a bus is consequently considered as an occupation with a potential danger for health and the overall wellbeing with bus drivers having, per Illangasinghe et al., higher levels of absenteeism and disabilities than other occupational groups. Schnall et al. added that they more than often experience psychological problems, a strong feeling of fatigue, tension, and mental overload, sleeping problems, and physical risks such as musculoskeletal disorders, and various cardiovascular problems.  In Sri Lanka, according to the National Transport Commission’s “National Transport Statistics 2017”, there were approximately 10,000 bus drivers employed by the SLTB, with the highest allocation maintained in the Colombo District. The urban driving environment itself causes, as Illangasinghe et al. observed, multiple stressors to bus drivers. According to W. Hansini, M. Wijesooriya and J. Dodankotuwa’s “The effectiveness of stress management interventions on reducing occupational stress: A study with special reference to an apparel firm in Sri Lanka”, health-based occupational stress contributes to an increasing proportion of worker compensation claims, healthcare-related issues, disability, absenteeism and productivity losses. Additionally, acute non-infectious diseases caused by road traffic accidents have, per Illangasinghe et al., increased gradually. For both chronic and acute non-communicable diseases (NCDs), the perceived stress and lack of alertness among drivers due to occupational stress has become a predominant risk factor.  Therefore, Illangasinghe et al. performed a descriptive, cross sectional study among a sample of 631 SLTB bus drivers in the Colombo District, covering 12 depots, from January to March 2019. Professional full-time bus drivers attached to the SLTB in the preceding six months were recruited while bus drivers who were engaged in temporary or emergency services, and in luxury fleets, and those who had already been diagnosed as suffering from a mental illness, were excluded. A simple random sampling method was used to select the sample from the sampling frame comprising the name register of 1,271 drivers, from each of the 12 depots.  The Effort-Reward Imbalance questionnaire was administered to detect the prevalence of occupational stress as it showed psychometric properties and assessed the stress levels in terms of high efforts, high over commitment and low rewards. Another self-administered questionnaire was developed to assess the associated factors for work stress, such as factors related to the family (e.g., the number of children, and the time spent with the family), the economy (e.g., the monthly income, and loan repayments), health and lifestyle (e.g., tobacco and alcohol consumption, and chronic NCDs), work life (e.g., work experience, and daily working hours), the perception of the driving performance, and the environment (e.g., difficulties faced inside and outside the bus).  The overall response rate was 630/99.8%. All the drivers were males. The majority were in the 41 to 50-years age group (273/43.3%) followed by the 31 to 40-years age group (224/35.6%). A large majority were Sinhalese (589/93.5%) and were current users of tobacco (361/99.8%), out of which, 57/9% used only smokeless tobacco (e.g., betel chewing with tobacco leaves). At the end of the day, only 21/3.3% had good concentration (perceived alertness by the driver himself). Approximately one third (209/33.7%) worked as professional bus drivers (as a bus driver on a permanent basis at the SLTB) for more than 10 years. Almost half worked six days per week (345/54.9%). A proportion of 525/83.3% worked for 11 to 14 hours per day. The prevalence of occupational stress was 52.1%. Work factors such as working overtime, shift patterns and running hours were associated with job stress. Frequent driving hours after 5 a.m. and 5 p.m., working 10 hours or more per day and having shift duty showed statistically significant factors for occupational stress.  Five other factors were statistically significant, namely current tobacco use, good concentration and alertness at the end of the day, work experience for 10 years and less, working for six days and more per week, and working for more than 10 hours per day. The prevalence of overall occupational stress was considerably high (52.1%). This, Illangasinghe et al. emphasised, indicates the need for the attention of the public transport authorities for preventive interventions and hence, advocacy is needed on the prompt implementation of preventive strategies urgently.  Current tobacco users showed almost 10 times higher occupational stress than non-smokers.  Work-related factors such as working overtime, working shifts, tight running times, running late, time pressure and shift patterns were found to be associated with stress factors experienced by bus drivers. Working experience of more than 10 years had a significant association with job stress, a finding which may be due to, per Illangasinghe et al., the company’s monotonous work environment causing stress among older groups. Drivers who maintained good alertness till the end of the day experienced more stress (52.1%) than those who did not.  In conclusion, Illangasinghe et al. recommended that accessible and confidential mental health services be established in order to provide psychosocial support for the SLTB bus drivers, mental wellbeing programmes be conducted by the Transport Ministry and the SLTB as capacity building sessions when recruiting drivers, putting in place a routine health screening system for the prevention of NCDs among bus drivers, having an annual health check-up at institutional level centres, and maintaining healthy and suitable working rosters depot-wise, in order to prevent irreversible burnout resulting from work stress, and for managing overburdened working days, hours and running times.  Other public health concerns and implications include the fact that unaddressed job strain can end up with occupational diseases such as burnout (per the International Classification of Diseases 11th Revision, a syndrome that results from chronic workplace stress which has not been successfully managed), and associated factors for job strain such as tobacco use and alcohol consumption which directly or indirectly cause NCDs and road traffic accidents, thus leading to even more high morbidity, mortality and disability rates.


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