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Background: This paper follows up on a project that was launched in 2008 and contributed to the development of the new Italian Society of Occupational Medicine (SIML) guidelines for the road haulage industry., Objective: To reach a better understanding of occupational illness amongst truck drivers, in order to define appropriate health monitoring protocols and promote a healthy life-style., Methods: We assessed 673 male drivers (mean age 43.85 years, SD 9.56; mean working seniority 27.28 years, SD 10.59), employed by 46 different companies. The drivers, who were gradually recruited in the study over the years, had a maximum of 8 re-assessments each, for a total of 2608 examinations. We applied a survey protocol consisting in a medical examination, questionnaires for the most common risks and instrumental and laboratory tests in compliance with SIML guidelines., Results: We identified a total of 44 work-related diseases: 22 cases of noise-induced hearing loss (NIHL) and 22 cases of lumbar degenerative disc disease. As regards metabolic disorders, we observed 28 cases of diabetes mellitus, in most cases (71.4%) as a first diagnosis or under poor therapeutic control. We observed poorly-controlled hypertension in 103 drivers, the majority of whom (54%) were diagnosed for the first time. Over 30% of the workers in our study were obese and approximately 40% were tobacco smokers. We identified just 9 individuals (1.3%) with a positive toxicological screening for use of recreational drugs. Our data confirm a high prevalence of occupational illness amongst truck drivers. Cardiovascular and metabolic conditions require close monitoring.

From 2008 to 2011, according to an experimental protocol, 490 truck drivers (mean age 42.5, seniority 26.1 years) were subjected to visits and health check-up. The prevalence of work-related diseases was 4.7%: 15 cases of hearing loss and 8 of lumbosacral disease. In the 9.2% it was necessary to give some restrictions to the truck drivers' fitness to work (because of musculoskeletal disease, heart disease, diabetes etc), 0.8% was judged permanently unfit. We have found also 1% with positive drug test. Health check-up has allowed the diagnosis of many unknown or not controlled disease, first of all metabolic and cardiovascular diseases, which could have been a role in increasing accident or in reducing future workers' fitness to work. In the implementation of health surveillance programs, the occupational physicians must not forget that to ensure adequate safety standards is necessary to evaluate not only drugs assumption, but also the psychological and physical integrity of truck drivers, planning appropriate tests and medical examinations.

Background and Objectives: The aim of this paper was to analyze the results of the first year of a study on truck drivers'safety and health. The project, which started in 2008, is promoted by EBITRAL (trade unions and business joint association) and carried out by Occupational Medicine Department of Ospedali Riuniti di Bergamo. The final objective is to improve health conditions of truck drivers, by defining appropriate health surveillance protocols in order to asses fitness for work and by promoting the application of healthy life-styles among the workers. The first step required the collection of bio-statistical data, in order to analyze prevalence and incidence of work-related diseases in the future., Methods: In the first year, 226 truck drivers (mean age 42. 7years, SD 9.5; mean working seniority 26.8 years, SD 10.6) were evaluated via application of an experimental survey protocol: medical examination, questionnaires for the main risks (low back pain, alcohol and drug consumption, sleepiness, etc), instrumental and laboratory tests (ECG, eye test, audiometric test, blood test, urinary drugs test)., Results: We observed 11 work-related diseases: 8 cases of hearing loss caused by chronic exposure to noise and 3 cases of low back disk disease. In 22 cases (9.7%) it was necessary to apply some restrictions to the truck drivers' fitness for work, first of all because of cardiovascular diseases and musculoskeletal disorders. We also found 3 subjects with positive urinary drug test: 1 for cocaine, 1 for methadone, 1 for cannabis. With the application of the experimental survey protocol many unknown diseases were also diagnosed (cardiovascular diseases, arterial hypertension, diabetes mellitus, etc), which could have played a role in increasing accident risk or, without an appropriate therapy, in reducing workers' future fitness for work., Discussion: This first year of experience made it possible to collect bio-statistical data on truck drivers' work-related diseases. As regards fitness for work, we observed that drug consumption is not the most relevant health problem to consider in order to improve truck drivers' safety and citizens' safety on the road.