Fatigue can be a significant problem for commercial motor vehicle (CMV) drivers. The lifestyle of a long-haul CMV driver may include long and irregular work hours, inconsistent sleep schedules, poor eating and exercise habits, and mental and physical stress, all contributors to fatigue. Shiftwork is associated with lacking, restricted, and poor-quality sleep and variations in circadian rhythms, all shown to negatively affect driving performance through impaired in judgment and coordination, longer reaction times, and cognitive impairment. Overweight and obesity may be as high as 90% in CMV drivers, and are associated with prevalent comorbidities, including obstructive sleep apnea, hypertension, and cardiovascular and metabolic disorders. As cognitive and motor processing declines with fatigue, driver performance decreases, and the risk of errors, near crashes, and crashes increases. Tools and assessments to determine and quantify the nature, severity, and impact of fatigue and sleep disorders across a variety of environments and populations have been developed and should be critically examined before being employed with CMV drivers. Strategies to mitigate fatigue in CMV operations include addressing the numerous personal, health, and work factors contributing to fatigue and sleepiness. Further research is needed across these areas to better understand implications for roadway safety.

Objective: The goal of this study was to compare cell phone usage behaviors while driving across 3 types of cell phones: handheld (HH) cell phones, portable hands-free (PHF) cell phones, and integrated hands-free (IHF) cell phones. Naturalistic driving data were used to observe HH, PHF, and IHF usage behaviors in participants’ own vehicles without any instructions or manipulations by researchers. Methods: In addition to naturalistic driving data, drivers provided their personal cell phone call records. Calls during driving were sampled and observed in naturalistically collected video. Calls were reviewed to identify cell phone type used for, and duration of, cell phone subtasks, non–cell phone secondary tasks, and other use behaviors. Drivers in the study self-identified as HH, PHF, or IHF users if they reported using that cell phone type at least 50% of the time. However, each sampled call was classified as HH, PHF, or IHF if the talking/listening subtask was conducted using that cell phone type, without considering the driver's self-reported group. Results: Drivers with PHF or IHF systems also used HH cell phones (IHF group used HH cell phone in 53.2% of the interactions, PHF group used HH cell phone for 55.5% of interactions). Talking/listening on a PHF phone or an IHF phone was significantly longer than talking/listening on an HH phone (P <.05). HH dialing was significantly longer in duration than PHF or IHF begin/answer tasks. End phone call task for HH phones was significantly longer in duration than the end phone call task for PHF and IHF phones. Of all the non–cell phone–related secondary tasks, eating or drinking was found to occur significantly more often during IHF subtasks (0.58%) than in HH subtasks (0.15%). Drivers observed to reach for their cell phone mostly kept their cell phone in the cup holder (36.3%) or in their seat or lap (29.0% of interactions); however, some observed locations may have required drivers to move out of position. Conclusions: Hands-free cell phone technologies reduce the duration of cell phone visual–manual tasks compared to handheld cell phones. However, drivers with hands-free cell phone technologies available to them still choose to use handheld cell phones to converse or complete cell phone visual–manual tasks for a noteworthy portion of interactions.

Over 6.5 million commercial vehicle drivers were operating a large truck or bus in the United States in 2020. This career often has high stress and long working hours, with few opportunities for physical activity. Previous research has linked these factors to adverse health conditions. Adverse health conditions affect not only the professional drivers’ wellbeing but potentially also commercial motor vehicle (CMV) operators’ safe driving ability and public safety for others sharing the roadway. The prevalence of health conditions with high impact on roadway safety in North American CMV drivers necessitates empirical epidemiological research to better understand and improve driver health. The paper presents four challenges in conducting epidemiological research with truck and bus drivers in North America and potential resolutions identified in past and current research. These challenges include (1) the correlation between driving performance, driving experience, and driver demographic factors; (2) the impact of medical treatment status on the relationship between health conditions and driver risk; (3) capturing accurate data in self-report data collection methods; and (4) reaching the CMV population for research. These challenges are common and influential in epidemiological research of this population, as drivers face severe health issues, health-related federal regulations, and the impact of vehicle operation on the safety of themselves and others using the roadways.