{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T06:01:55Z","timestamp":1785132115927,"version":"3.55.0"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to identify occupational and behavioral factors associated with fatigue among long-distance truck drivers along the Kenya\u2013Uganda transport corridor. A secondary objective was to assess the robustness of identified associations by applying LASSO penalized regression as a sensitivity check.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A cross-sectional analytical study was conducted among 207 long-distance truck drivers at the Busia and Malaba border crossings. Fatigue was assessed using the Chalder Fatigue Questionnaire (CFQ-11) with binary scoring. Missing data were addressed using multiple imputation by chained equations (MICE;\n                      <jats:italic>m<\/jats:italic>\n                      = 20). Factors associated with fatigue were examined using multivariable logistic regression with predictors selected on theoretical grounds from the occupational fatigue literature. LASSO logistic regression was applied as a secondary analysis to confirm that associations were stable under coefficient penalization. Firth penalized logistic regression was conducted as a sensitivity analysis to evaluate the stability of findings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The prevalence of occupational fatigue was 52.2% (95%\n                      <jats:italic>CI<\/jats:italic>\n                      : 44.8\u201358.6%). Substance use (adjusted\n                      <jats:italic>OR<\/jats:italic>\n                      = 8.64; 95%\n                      <jats:italic>CI<\/jats:italic>\n                      : 4.30\u201317.33;\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001) and longer daily driving hours (adjusted OR = 1.23 per additional hour; 95%\n                      <jats:italic>CI<\/jats:italic>\n                      : 1.10\u20131.37;\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001) were independently associated with fatigue. Both associations were retained under LASSO penalization, supporting their robustness.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Occupational fatigue affects a substantial proportion of long-distance truck drivers and is strongly associated with substance use and extended daily driving hours. Public health and transport-sector interventions should prioritize fatigue prevention through substance-use reduction strategies, driver wellness programmes, and enforcement of regulations limiting excessive driving hours to improve driver health and road safety.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1831315","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T05:41:23Z","timestamp":1785130883000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Occupational and behavioral factors associated with fatigue among long-distance truck drivers on the Kenya\u2013Uganda transport corridor"],"prefix":"10.3389","volume":"14","author":[{"given":"Nelson","family":"Kilimo","sequence":"first","affiliation":[{"name":"Department of Public and Global Health, Faculty of Health Sciences, University of Nairobi","place":["Nairobi, Kenya"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kellen","family":"Karimi","sequence":"additional","affiliation":[{"name":"Department of Public and Global Health, Faculty of Health Sciences, University of Nairobi","place":["Nairobi, Kenya"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olipher","family":"Makwaga","sequence":"additional","affiliation":[{"name":"Center for Infectious and Parasitic Diseases Control Research (CIPDCR), Kenya Medical Research Institute (KEMRI)","place":["Busia, Kenya"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Verena","family":"Struckmann","sequence":"additional","affiliation":[{"name":"Department of Health Care Management, Technical University of Berlin","place":["Berlin, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1016\/S0001-4575(97)00026-2","article-title":"Hours of work and perceptions of fatigue among truck drivers","volume":"29","author":"Arnold","year":"1997","journal-title":"Accid Anal Prev."},{"key":"B2","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1177\/1035304617728440","article-title":"Why do long distance truck drivers work extremely long hours?","volume":"29","author":"Belzer","year":"2018","journal-title":"Econ Labour Relat Rev."},{"key":"B3","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1016\/j.trf.2024.05.016","article-title":"Heavy vehicle driver fatigue: observing work and rest behaviours in Australia","volume":"104","author":"Casey","year":"2024","journal-title":"Transp Res Part F."},{"key":"B4","doi-asserted-by":"publisher","first-page":"e14259","DOI":"10.1111\/jsr.14259","article-title":"Development of sleepiness in professional truck drivers","volume":"34","author":"Ahlstr\u00f6m","year":"2025","journal-title":"J Sleep Res."},{"key":"B5","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1016\/j.jtte.2017.07.005","article-title":"Driver sleepiness, fatigue, careless behavior and risk of motor vehicle crash and injury: population based case and control study","volume":"4","author":"Bener","year":"2017","journal-title":"J Traffic Transp Eng."},{"key":"B6","doi-asserted-by":"publisher","first-page":"331","DOI":"10.37268\/mjphm\/vol.22\/no.3\/art.1745","article-title":"Prevalence of driving fatigue and its associated factors among logistic truck drivers in Malaysia","volume":"22","author":"Che Hasan","year":"2022","journal-title":"Malaysian J. 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