{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T06:47:04Z","timestamp":1785566824010,"version":"3.56.0"},"reference-count":43,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2022,11,29]],"date-time":"2022-11-29T00:00:00Z","timestamp":1669680000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ezintsha\u2019s research capacity development portfolio"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Cardiovascular disease (CVD) is the leading cause of death globally. The occupational challenges of bus drivers may increase their risk of CVD, including developing obesity, hypertension, and diabetes. We evaluated the medical records of 266 bus drivers visiting an occupational medical practice between 2007 and 2017 in Johannesburg, South Africa, to determine the health status of bus drivers and investigate risk factors for CVD, and their impact on the ability to work. The participants were in majority male (99.3%) with a median age of 41.2 years (IQR 35.2); 23.7% were smokers, and 27.1% consumed alcohol. The median body mass index (BMI) was 26.8 m\/kg2 (IQR 7.1), with 63.1% of participants having above normal BMI. Smoking, BMI, and hypertension findings were in line with national South African data, but diabetes prevalence was far lower. Undiagnosed hypertension was found in 9.4% of participants, uncontrolled hypertension in 5.6%, and diabetes in 3.0%. Analysis by BMI category found that obesity was significantly associated with increased odds of hypertension. Uncontrolled hypertension was the main reason for being deemed \u2018unfit to work\u2019 (35.3%). Our research highlights the need for more regular screening for hypertension and interventions to address high BMI.<\/jats:p>","DOI":"10.3390\/ijerph192315890","type":"journal-article","created":{"date-parts":[[2022,11,30]],"date-time":"2022-11-30T02:21:57Z","timestamp":1669774917000},"page":"15890","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Retrospective Medical Record Review to Describe Health Status and Cardiovascular Disease Risk Factors of Bus Drivers in South Africa"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3911-7241","authenticated-orcid":false,"given":"Susan C.","family":"Aitken","sequence":"first","affiliation":[{"name":"Genesis Analytics, Johannesburg 2196, South Africa"},{"name":"School of Health Systems and Public Health, University of Pretoria, Pretoria 0002, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3597-1643","authenticated-orcid":false,"given":"Samanta T.","family":"Lalla-Edward","sequence":"additional","affiliation":[{"name":"Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maren","family":"Kummerow","sequence":"additional","affiliation":[{"name":"Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stan","family":"Tenzer","sequence":"additional","affiliation":[{"name":"Farraday Medical Centre, Johannesburg 2001, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0924-3178","authenticated-orcid":false,"given":"Bernice N.","family":"Harris","sequence":"additional","affiliation":[{"name":"School of Health Systems and Public Health, University of Pretoria, Pretoria 0002, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. D. Francois","family":"Venter","sequence":"additional","affiliation":[{"name":"Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alinda G.","family":"Vos","sequence":"additional","affiliation":[{"name":"Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa"},{"name":"Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,29]]},"reference":[{"key":"ref_1","unstructured":"World Health Organisation (2019, September 30). Fact Sheet: Cardiovascular Diseases (CVDs). Geneva: World Health Organisation. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/cardiovascular-diseases-(cvds)."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1177\/0956462413512803","article-title":"HIV prevalence and risk in long-distance truck drivers in South Africa: A national cross-sectional survey","volume":"25","author":"Bello","year":"2014","journal-title":"Int. J. STD AIDS"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Lalla-Edward, S.T., Fobosi, S.C., Hankins, C., Case, K., Venter, W.D.F., and Gomez, G. (2016). Healthcare programmes for truck drivers in sub-Saharan Africa: A systematic review and meta-analysis. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0156975"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1080\/09540121.2017.1280127","article-title":"Social and structural factors related to HIV risk among truck drivers passing through the Iringa region of Tanzania","volume":"29","author":"Kohli","year":"2017","journal-title":"AIDS Care"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"878","DOI":"10.26719\/emhj.19.056","article-title":"Workplace stress and its relation to cardiovascular disease risk factors among bus drivers in Egypt","volume":"25","author":"Mohsen","year":"2019","journal-title":"East. Mediterr. Health J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1002\/ajim.22821","article-title":"Relationships of working conditions, health problems and vehicle accidents in bus rapid transit (BRT) drivers","volume":"61","author":"Cendales","year":"2018","journal-title":"Am. J. Ind. Med."},{"key":"ref_7","first-page":"36","article-title":"Time spent sitting during and outside working hours in bus drivers: A pilot study","volume":"3","author":"Yates","year":"2015","journal-title":"Prev. Med. Rep."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.shaw.2015.02.001","article-title":"Surveying the Impact of Work Hours and Schedules on Commercial Motor Vehicle Driver Sleep","volume":"6","author":"Hege","year":"2015","journal-title":"Saf. Health Work"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.aap.2016.08.024","article-title":"Understanding the role of sleep quality and sleep duration in commercial driving safety","volume":"97","author":"Lemke","year":"2016","journal-title":"Accid. Anal. Prev."},{"key":"ref_10","first-page":"725","article-title":"Work patterns, sleeping hours and excess weight in commercial drivers","volume":"65","author":"Lemke","year":"2015","journal-title":"Occup. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.aap.2015.09.001","article-title":"NIOSH national survey of long-haul truck drivers: Injury and safety","volume":"85","author":"Chen","year":"2015","journal-title":"Accid. Anal. Prev."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"113","DOI":"10.3233\/WOR-121553","article-title":"Health survey of U.S. long-haul truck drivers: Work environment, physical health, and healthcare access","volume":"46","author":"Apostolopoulos","year":"2013","journal-title":"Work"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"175","DOI":"10.3233\/WOR-131649","article-title":"Primary health care needs for a priority population: A survey of professional truck drivers","volume":"49","author":"Angeles","year":"2014","journal-title":"Work"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1002\/ajim.22293","article-title":"Obesity and other risk factors: The National Survey of U.S. Long-Haul Truck Driver Health and Injury","volume":"57","author":"Sieber","year":"2014","journal-title":"Am. J. Ind. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1097\/JOM.0000000000000650","article-title":"Sleep, Dietary, and Exercise Behavioral Clusters among Truck Drivers with Obesity: Implications for Interventions","volume":"58","author":"Olson","year":"2016","journal-title":"J. Occup. Environ. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"561","DOI":"10.3109\/01612840.2010.488783","article-title":"Occupational stressors and the mental health of truckers","volume":"31","author":"Shattell","year":"2010","journal-title":"Issues Ment. Health Nurs."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1097\/JOM.0000000000000522","article-title":"Repeated Cross-Sectional Assessment of Commercial Truck Driver Health","volume":"57","author":"Thiese","year":"2015","journal-title":"J. Occup. Environ. Med."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Tu, Z., He, J., Zhou, N., and Shen, X. (2021). Driver-passenger communicative stress and psychological distress among Chinese bus drivers: The mediating effect of job burnout. BMC Public Health, 21.","DOI":"10.1186\/s12889-021-10618-x"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e032025","DOI":"10.1136\/bmjopen-2019-032025","article-title":"Cross-sectional study of the health of southern African truck drivers","volume":"9","author":"Fischer","year":"2019","journal-title":"BMJ Open"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1097\/JOM.0000000000000734","article-title":"The Work Organization of Long-Haul Truck Drivers and the Association with Body Mass Index","volume":"58","author":"Hege","year":"2016","journal-title":"J. Occup. Environ. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1002\/ajim.22584","article-title":"Obesity indices are predictive of elevated C-reactive protein in long-haul truck drivers","volume":"59","author":"Wideman","year":"2016","journal-title":"Am. J. Ind. Med."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Sangaleti, C.T., Trincaus, M.R., Baratieri, T., Zarowy, K., Ladika, M.B., Menon, M.U., Miyahara, R.Y., Raimondo, M.I., Silveira, J.V., and Bortolotto, L.A. (2014). Prevalence of cardiovascular risk factors among truck drivers in the South of Brazil. BMC Public Health, 14.","DOI":"10.1186\/1471-2458-14-1063"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"405","DOI":"10.13075\/ijomeh.1896.00638","article-title":"Poor weight control, alcoholic beverage consumption and sudden sleep onset at the wheel among Italian truck drivers: A preliminary pilot study","volume":"29","author":"Rosso","year":"2016","journal-title":"Int. J. Occup. Med. Environ. Health"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"S39","DOI":"10.1097\/EDE.0000000000001003","article-title":"Professional driver\u2019s job stress and 8-year risk of cardiovascular disease: The Taiwan bus driver cohort study","volume":"30","author":"Wu","year":"2019","journal-title":"Epidemiology"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1097\/JOM.0000000000000422","article-title":"Commercial driver medical examinations: Prevalence of obesity, comorbidities, and certification outcomes","volume":"57","author":"Thiese","year":"2015","journal-title":"J. Occup. Environ. Med."},{"key":"ref_26","first-page":"560","article-title":"Risk Factors for cardiovascular disease, metabolic syndrome and sleepiness in truck drivers","volume":"105","author":"Mansur","year":"2015","journal-title":"Arq. Bras. Cardiol."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Lalla-Edward, S.T., Ncube, S., Matthew, P., Hankins, C.A., Venter, W.D.F., and Gomez, G.B. (2017). Uptake of health services among truck drivers in South Africa: Analysis of routine data from nine roadside wellness centres. BMC Health Serv. Res., 17.","DOI":"10.1186\/s12913-017-2595-3"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"106","DOI":"10.5830\/CVJA-2018-006","article-title":"Prevalence of cardiometabolic risk factors among professional male long-distance bus drivers in Lagos, south-west Nigeria: A cross-sectional study","volume":"29","author":"Amadi","year":"2018","journal-title":"Cardiovasc. J. Afr."},{"key":"ref_29","unstructured":"Labour, D. (1993). Occupational Health and Safety Act (85\/1993), South African Department of Labour."},{"key":"ref_30","unstructured":"World Health Organisation (2020, December 16). HEARTS Technical Package for Cardiovascular Disease Management in Primary Health Care: Evidence-Based Treatment Protocols Geneva: World Health Organisation. Available online: https:\/\/www.who.int\/publications\/i\/item\/hearts-technical-package."},{"key":"ref_31","unstructured":"World Health Organisation (2006). Definition and Diagnosis of Diabetes Mellitus and Intermediate Hyperglycemia, World Health Organisation."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e03147","DOI":"10.1016\/j.heliyon.2019.e03147","article-title":"Prevalence and lifestyle-related risk factors of obesity and unrecognized hypertension among bus drivers in Ghana","volume":"6","author":"Anto","year":"2020","journal-title":"Heliyon"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/2052-4374-25-34","article-title":"Cardiovascular disease risk of bus drivers in a city of Korea","volume":"25","author":"Shin","year":"2013","journal-title":"Ann. Occup. Environ. Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e000348","DOI":"10.1136\/bmjgh-2017-000348","article-title":"Quantifying unmet need for hypertension care in South Africa through a care cascade: Evidence from the SANHANES, 2011\u20132012","volume":"2","author":"Berry","year":"2017","journal-title":"BMJ Glob. Health"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Chidumwa, G., Maposa, I., Kowal, P., Micklesfield, L.K., and Ware, L.J. (2021). Bivariate joint spatial modeling to identify shared risk patterns of hypertension and diabetes in South Africa: Evidence from WHO SAGE South Africa wave 2. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18010359"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Dwane, N., Wabiri, N., and Manda, S. (2020). Small-area variation of cardiovascular diseases and select risk factors and their association to household and area poverty in South Africa: Capturing emerging trends in South Africa to better target local level interventions. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0230564"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1002\/ajim.22795","article-title":"A retrospective analysis of cardiometabolic health in a large cohort of truck drivers compared to the American working population","volume":"61","author":"Thiese","year":"2018","journal-title":"Am. J. Ind. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"216702","DOI":"10.1100\/2012\/216702","article-title":"General characteristics and risk factors of cardiovascular disease among interstate bus drivers","volume":"2012","author":"Hirata","year":"2012","journal-title":"Sci. World J."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2414","DOI":"10.1002\/oby.23005","article-title":"BMI and all-cause mortality in a population-based cohort in rural South Africa","volume":"28","author":"Baisley","year":"2020","journal-title":"Obesity"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"S13","DOI":"10.1093\/ofid\/ofz359.029","article-title":"844. Engagement in HIV Care as an Avenue to Primary Care in Rural South Africa: Results from the Vukuzazi Population Health Platform","volume":"6","author":"Oliver","year":"2019","journal-title":"Open Forum. Infect. Dis."},{"key":"ref_41","first-page":"1","article-title":"Body composition in heavy smokers: Comparison of segmental bioelectrical impedance analysis and dual-energy X-ray absorptiometry","volume":"840","author":"Rom","year":"2015","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1537613","DOI":"10.1080\/16549716.2018.1537613","article-title":"Determinants of body mass index by gender in the Dikgale Health and Demographic Surveillance System site, South Africa","volume":"11","author":"Mashinya","year":"2018","journal-title":"Glob Health Action"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1448250","DOI":"10.1080\/16549716.2018.1448250","article-title":"Demographic, socio-economic and behavioural correlates of BMI in middle-aged black men and women from urban Johannesburg, South Africa","volume":"11","author":"Micklesfield","year":"2018","journal-title":"Glob. Health Action"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/23\/15890\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:29:04Z","timestamp":1760146144000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/23\/15890"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,29]]},"references-count":43,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["ijerph192315890"],"URL":"https:\/\/doi.org\/10.3390\/ijerph192315890","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,29]]}}}