Bus Driver Occupational Health and Ergonomic Evaluation in UK

Introduction and Background

Bus drivers endure a multitude of work-related health issues due to the nature of their work. They drive consistently long hours, must remain alert to potential accidents, and do not receive high pay. This can lead to higher-than-normal employee turnover rates, which in turn results in a lower quality of service for customers. Researchers have aimed at identifying the specific work-related health problems that plague bus drivers.

Research shows bus drivers often suffer from high blood pressure and musculoskeletal pain in the form of neck and lower back pain. This may be due to constant vibration while driving and poorly designed seats and bus driver cabins. Another potential cause for these illnesses is the constant stress of the job. Bus drivers cite the risk of potentially aggressive passengers and bad weather conditions as major stressors.

This dissertation aims to show, through interviews with bus drivers and managers and a supporting literature review, how driving long hours can be detrimental to the health of a bus driver, and how ergonomic evaluation may help ease the burden bus drivers face every day during long driving shifts. The results of the interviews and the literature review revealed several determinants of stress and occupational hazards for bus drivers — from low pay to bad weather conditions. Bus drivers must also contend with poorly designed seats and bus driver cabins that contribute to low back pain and early departure from their jobs.

Ergonomic evaluation is one means by which the UK and Europe can improve the occupational health and safety of bus drivers. By improving seat design and restricting the placement of bus stops, meaningful steps can be taken to improve the work environment for bus drivers in the UK and Europe. This is a qualitative study that used the answers of nine bus drivers and three bus managers to understand the overall picture of bus driver occupational hazards.

Chronic health problems arise from a multitude of causes. When they are work-related, they can be difficult to prevent. Bus drivers experience work-related illness at a higher rate than workers in virtually any other occupation or industry (ATU, 2016). Work-related illnesses can stem from contracting common diseases due to the close proximity of numerous strangers entering the bus each day. Bus drivers may also become chronically ill due to the position they are seated in for hours at a time. Job-related hazards from bus driving contribute to a 120% above-average rate for chronic illnesses (ATU, 2016). When research identified the epidemic of work-related illnesses in bus drivers, some researchers began to identify ways to prevent and combat the problem. The first step was ergonomic evaluation.

Bus driving can be a difficult activity to sustain over time. Bus drivers often experience lower back pain and pain in the ankles, neck, and knees from their prolonged seated position (Tranchard, 2012). It is a demanding job, and bus drivers in the UK and Europe require the development of comfortable seating through ergonomic evaluation in order to successfully endure long driving hours. Ergonomic evaluation, also termed workstation assessment, ensures that a bus driver's workstation is ergonomically designed to maximize productivity and lessen the risk of injury (Patchong, 2014). Such assessments are also performed to support a reduction in employee turnover rates that rise due to work-related injuries.

Ergonomic evaluation considers driver fatigue, comprising both cognitive and physical components. "Physical fatigue is related to perceptual-motor adjustments specific to the driver task and to discomfort caused by prolonged sitting. Cognitive fatigue can be subdivided into task-related and sleep-related fatigue" (Vink, 2014, p. 522). While possible countermeasures to physical fatigue include passive and active micro-movements along with stimulation of macro-movements, sleep-related fatigue within the cognitive fatigue area is known to be intervention-resistant (Vink, 2014). This means ergonomic evaluation should aim primarily at the elimination of physical fatigue.

Fatigue symptoms are a common occurrence for bus drivers throughout the world, and particularly in the UK and Europe. A recent study examined the effects of bus driving for prolonged periods of time along with overall job quality compared to coach drivers. The researchers noted the multitude of health problems bus drivers experience due to their long work hours in a seated position. "…the risk of heart disease for bus drivers [is] twice that of their conductor colleagues. They also suffer gastrointestinal disorders, musculoskeletal problems and poor mental health" (Williamson et al., 2013, p. 189). The study also stated that bus drivers endure high amounts of fatigue, stress, and low job satisfaction, and cited the European Working Condition Survey as considering bus driving in Europe to be the worst occupation in terms of working conditions, working hours, and potential risks of physical violence.

Bus drivers go through many challenges when performing their duties. They encounter violent outbursts from customers (Williamson et al., 2013), back problems, and other health problems — all of which contribute to a high employee turnover rate (Lannoo and Verhofstadt, 2016). The high turnover rate is due to high demands (making it to each bus stop on time, dealing with traffic), low support (limited ergonomic design for seats, no structured provision for exercise or physical therapy), and low control (limited ability to choose shifts or to determine how job demands are met) (Lannoo and Verhofstadt, 2016). Because occupational stress in bus drivers is so consistently reported, it can no longer be considered an infrequent occurrence. Occupational stress in bus drivers is a wide-ranging phenomenon both in the UK and throughout Europe (Patchong, 2014). Therefore, exploration of measures that can improve and prevent occupational stress for bus drivers is necessary, and one such potential solution is ergonomic evaluation of seating and driver positioning.

Bus drivers endure physical fatigue and stress, creating potential occupational hazards and safety concerns due to the nature of their work. They work long hours, typically in the same position for hours at a time (Arezes et al., 2013). When they drive, they must also deal with difficult access to their bus cabins due to engine placement and old seating that has not been ergonomically designed. "…it was observed that the bus cabins of all companies surveyed did not allow easy access due to the presence of the vehicle engine. The height and distance from the steering wheel did not allow the driver a good posture" (Arezes et al., 2013, p. 602). When seating is not ergonomically designed, it creates potential problems for the bus driver's posture, back, and limbs.

This dissertation provides an analysis of what potential solutions ergonomic evaluation offers bus drivers and what current problems bus drivers face while working long hours. This is a qualitative study that highlights responses from 12 participants — nine bus drivers and three managers — from three different bus companies in the United Kingdom. The interviews provide the basis from which to understand how beneficial ergonomic evaluation is to the occupational health and safety of bus drivers. The literature provides supplementary information that allows for proper understanding and analysis of the problem and its potential solutions.

Problem Statement: The occupation of bus driver carries the potential for several health problems, stemming primarily from long work hours and uncomfortable seating. Preventative measures must be taken to reduce bus driver turnover rates and increase comfort for on-duty bus drivers. The focus of this qualitative study is on ergonomic evaluation and the ways in which it can improve bus driver occupational health and safety. Given the growing evidence of work-related illnesses for bus drivers, ergonomic evaluation may become a standard practice capable of minimizing the risk of physical fatigue and occupational hazards for bus drivers in the UK and Europe.

Although some bus companies in the UK and Europe have included ergonomic evaluation in their repertoire of preventative measures, evidence still shows work-related health problems remaining as the primary concern for bus drivers, alongside persistently high employee turnover (Musson, 2013). This may be due to a failure to establish consistent standards or practice, or improper adherence to existing policy. If the issue of occupational health and safety remains without adequate solutions, it could lead to continued work grievances and work-related diseases for bus drivers.

Research Questions:

Significance of the Problem: High employee turnover and increased health problems associated with bus driving are important issues to combat and prevent. Because employee turnover for bus drivers remains so high, bus companies do not retain effective and experienced drivers. Less experienced drivers are linked to higher rates of fatal vehicle accidents (Scenario Committee on Accidents and Traumatology, 2012). Without the necessary standards and strategies to minimize bus driver turnover, bus companies could face continual instability, resulting in lower quality service for customers and decreased profits.

The various health problems that bus drivers experience on an ongoing basis — including high blood pressure, obesity, and back and neck problems (Committee, 2012) — add to high employee turnover and reduce the quality of driving and service that customers experience. If bus drivers receive training to combat physical fatigue brought on by long hours of driving, and are provided a cabin that is ergonomically designed, this may help combat the chronic physical ailments that plague bus drivers in the UK and Europe, while also leading to higher quality service, greater customer satisfaction, and increased profits for bus companies.

Literature Review: Bus Driver Health, Turnover, and Working Conditions

This literature review focuses on the history of buses in the United Kingdom and the employee turnover rates that have become closely associated with the occupation of bus driver. Several articles highlight studies covering bus driver sickness, high employee turnover, work disability, and absenteeism. Other articles cover constraints within the bus driver's working situation, as well as an examination of how ergonomics and ergonomic layout of the bus driver's cabin can contribute positively to occupational health and safety outcomes.

The United Kingdom has a rich history of bus use. What began as the horse bus era — when John Greenwood started the first omnibus service in the UK in 1824, along the route between Pendleton and Manchester — was a horse-drawn omnibus preferred by the middle class over more expensive cab rides. "This no-frills vehicle was 'little more than a box on wheels.' Although short-journey stagecoaches were not new, the omnibus plied for hire along its route, picking up and setting down passengers along the way" (Higgs, 2014, p. 82). At the time, omnibuses were staffed by a conductor and driver and drawn by two horses. Even then, the conditions were horrendous.

Higgs goes on to describe the presence of fleas in the dry hay that lined the floor and the filth that accumulated when the hay became wet. "The interior of the omnibus is notoriously stuffy and poorly ventilated, with no air except when the door is opened. Add in the steam of damp umbrellas and the hazard of pickpockets and you have the journey from hell" (Higgs, 2014, p. 83). Although the conditions were hard to contend with as a passenger, they must have been worse still for the driver and conductor who had to endure them every single day for hours at a time. Even in the beginnings of bus transport in the UK, drivers had to deal with a myriad of problems that contributed to occupational stress and hazards. Coupled with longstanding low wages, bus drivers have faced difficult working conditions for a long time. One source places the monthly salary average for bus drivers in parts of Europe at approximately $1,900 in the UK, rising only to $2,300 in Norway (Worldsalaries, 2016).

Following the horse bus era came the first motor buses. While some experiments in public transportation took the form of steam buses in the 1830s, 1903 saw the official start of motor bus services, first in Eastbourne and then in Helston (Dodgshon, 2013). Within a decade, motor buses replaced horse buses, growing to over 3,500 vehicles. "By 1913 there were 3,500 licensed buses in London, each seating 35 passengers. By 1914, because of their speed, low fares, appeal to the working class, and the ease with which they could be placed on new routes, they were a close competitor to the electric tramway in the capital" (Dodgshon, 2013, p. 471). With the increase in motor bus usage and growing demand, bus drivers had to contend with new challenges — including greater exposure to disease (Dodgshon, 2013) and increased workload.

In the decades that followed, bus services in Britain were nationalized through the Transport Act of 1947, which allowed the British Transport Commission (BTC) to acquire the Thomas Tilling bus services as well as the large independent Red & White operator (St. John Thomas, 2014). After the war era, poor management of buses, coaches, cars, and railways led to a reassessment of working practices, partly driven by the notably high employee turnover rate among bus drivers (Anderson, 2004). Bus drivers had to endure several hours of strangers entering and leaving the bus each day, sometimes carrying illnesses or exhibiting violent behavior that, while not constant, took a cumulative toll on many bus drivers' health as they became increasingly stressed, sick, and fatigued (Anderson, 2004).

These books and articles help gauge how working conditions have not improved significantly over time, but have often worsened. As more people use buses and more bus drivers are needed, the need for occupational health and safety measures becomes increasingly urgent.

One 2012 quasi-experimental study examined the effect of urban bus driving on musculoskeletal problems and blood pressure. Researchers noted high levels of stress consistently associated with poor health outcomes. The study found that bus drivers continually endure long work hours that contribute to higher rates of high blood pressure than in other jobs, as well as higher instances of musculoskeletal problems associated with sustained driving in the same position (Johansson et al., 2012).

The researchers determined that bus driving in an urban setting coupled with long work hours can lead to potentially toxic psychosocial and physical problems, manifesting as high stress, high blood pressure, and musculoskeletal disorders. "The findings provide evidence for a positive association between the number of hours of bus driving and blood pressure and musculoskeletal problems" (Johansson et al., 2012, p. 89). This is just one of many studies noting the effects that a high-stress job like bus driving has on a person's health and the need to re-evaluate how bus drivers work, especially during long shifts. Another study analyzed work disability among bus drivers resulting from the constant physical and mental stress they endure while on duty.

A 2016 study stated that bus drivers, compared to workers in other occupations, suffer much higher rates of health problems, work absences, and permanent disability. "In comparison with other jobs, public transport drivers show an increased risk in job-related health problems. The consequences are frequent and long absences from work as well as temporary and permanent disabilities for driving services" (Bockelmann, Arlinghaus and Nachreiner, 2016, p. 1). The increased number of absences and rates of permanent disability create problems not only for the bus driver, but also for the bus company, as both parties lose income from the lack of driver availability.

The study also addressed interventions. "While no substantial evidence was found for the long-term effectiveness of person-oriented interventions, interventions addressing the work load of the drivers directly by improving their working conditions seem to be more effective, supporting the importance of structural prevention over behavioral prevention" (Bockelmann, Arlinghaus and Nachreiner, 2016, p. 1). They found that person-oriented interventions are less effective in the long term than directly addressing workload through improvements to working conditions. If, for example, a bus company makes bus cabins more spacious, easier to exit, and more comfortable, bus drivers will experience fewer health problems.

Another 2013 study considered what specifically causes high stress for bus drivers, leading to high levels of absenteeism, health problems, and turnover. "Results indicated bus drivers experienced considerably lower stress levels under a new control strategy that shifts the performance objective from schedule adherence to service regularity. Higher stress levels were recorded during extreme weather conditions and peak hours and among inexperienced drivers" (Hlotova, Cats and Meijer, 2014, p. 13). To alleviate driver stress, bus companies need to focus on promoting service regularity rather than strict schedule adherence. A potential gap in the literature is determining whether bus companies train drivers to handle poor weather conditions and whether such training reduces stress.

Stress also creates higher levels of employee turnover and contributes to a higher rate of short, unscheduled absences. A 2014 study covering bus driver absenteeism identified several contributing factors, including higher-than-desired scheduled work days, shift transfers, work interruptions during busy periods, holidays, and lack of monetary incentive. The model results suggested that bus companies avoid scheduling interruptions — such as training activities or business meetings — on Thursdays, Fridays, and Mondays, while allowing them on Tuesdays and Wednesdays. The study also recommended minimizing scheduled interruptions during October, November, and December, reducing the number of drivers who work spare shifts, decreasing garage-to-garage shift transfers, reducing scheduled work weeks to no more than five days, and providing financial incentives to reduce absences among drivers working early morning and late morning assignments (Diab, Wasfi and El-Geneidy, 2014, p. 36). Bus companies can reduce stressors and increase the use of monetary incentives to encourage lower absenteeism and reduced employee turnover.

Bus drivers face several limitations within their workplace. They must adhere to set schedules, avoid accidents, and restrain themselves when dealing with unruly passengers. These constraints take a toll on bus drivers, leading to higher employee turnover and an influx of younger, less experienced drivers. A 2016 study observed key characteristics of bus drivers linked to an increased rate of traffic and vehicle accidents. Those characteristics were age, education, and experience. "…age, education, and experiences were found to be statistically significant predictors. Since these three variables can be influenced using appropriate hiring policies and implementation of best practices, this report should be of particular importance to standards development, recruitment, and driver training" (Wen, Li and Liu, 2016, p. 43).

This study helps explain why constraints stress bus drivers. Bus drivers are often young, inexperienced, and lack proper training to handle the demands placed on them at work. Their long work hours mean they face a multitude of potential problems on a daily basis, compounding an already serious problem. Constraints must be evaluated to understand the kinds of difficulties bus drivers face while on duty.

One of the biggest constraints bus drivers face is scheduling — both adhering to bus route schedules and managing shift schedules. A 2013 study sought an effective solution strategy for scheduling problems within the urban bus transportation industry. Their solution involved an algorithm that promoted flexibility and partial shift changes; however, the problem of driver rostering was not fully resolved. "The constraints of driver rostering generally correspond to the constraints of other typical applications such as nurse rostering, crew rostering, or operator rostering in call centers" (Toth and Kresz, 2013, p. 3).

Another major constraint is avoiding accidents while driving. Considering that bus drivers work long hours at a time, this is a significant concern. A 2014 study analyzed possible problems bus drivers face while working and proposed assigning shorter bus routes or newer, shorter buses to less experienced drivers. "Results were indicative of possible confined road-space issues that bus drivers face along routes with roadside traffic friction and point to the provision of exclusive right of way for buses as a possible way to address this. Results also suggest benefits in assigning routes comprising mainly divided roads as well as newer and shorter buses to less experienced drivers" (Goh et al., 2014, p. 20). Although this is a sensible recommendation, it is difficult to implement given the prevalence of inexperienced drivers resulting from high turnover.

Time is another important constraint in bus driving. Bus drivers must be on time to keep customers satisfied and maintain company profits. A 2013 study examined bus dwell time, defining it as the time spent at or near a bus stop, including passenger boarding and alighting along with opening and closing the doors (Meng and Qu, 2013). The researchers proposed that more accurate estimation of bus dwell time could help ease the time constraints bus drivers face, even though the study did not account for traffic variability or potential accidents.

More accurate dwell time estimates enable better performance and may also support more effective placement of bus stops. "…curbside stops are easy and inexpensive to install, easy to relocate, and provide easy access for bus drivers causing minimal delays to buses. However, they may potentially impede car flows and encourage drivers to make unsafe lane changes" (Meng and Qu, 2013, p. 3). A potential gap in the literature is determining traffic times and incorporating such estimates into bus schedules to further reduce scheduling stress for bus drivers during long shifts.

Ergonomic evaluation is an important component of any solution to occupational health and safety challenges for bus drivers. Bus driver cabins are the spaces in which drivers sit and operate vehicles for hours at a time, and they must be ergonomically designed to relieve the stress of sustained sitting and static posture. Tools and software that monitor or assess the bus driver's cabin for ergonomic adequacy could substantially relieve the burdens bus drivers experience while performing their duties.

A 2016 article discussed the use of a computer-based expert system named SONEX, created to identify ergonomic risks for work-related musculoskeletal disorders (WRMSDs) in occupations like bus driving. The system provides expert prevention advice using a rule-based approach and six knowledge base modules, including: "two main knowledge base modules (symptoms, engaged body part) with four supplementary knowledge base modules (work environment, work chair, work tools, organization factors)" (Pavlovic-Veselinovic, Hedge and Veselinovic, 2016, p. 130). As users input information, the system generates recommendations to help alleviate discomfort. The researchers noted that "SONEX relates ergonomic shortcomings in the job with worker's subjective symptoms; it predicts possible WRMSDs; and it offers preventive suggestions for ergonomic improvements to the job" (Pavlovic-Veselinovic, Hedge and Veselinovic, 2016, p. 130). A key advantage is that it is fast and accessible, and can be used by workers, other professionals, or dedicated ergonomists, without requiring a specialist visit.

Ergonomics is integral to any occupation involving long hours of repetitive movements such as driving, sitting, and opening and closing doors. One article stressed the importance of ergonomics and the need to implement preventive and corrective measures as part of ergonomic evaluation. "…using tools of ergonomics and engineering, such as interventions based on anthropometry, organization of working time, changes in the working methods, reorganization of production layout and equipment introduction aid to the implementation of tasks" (Coelho et al., 2016, p. 1). If bus companies in the UK and Europe were to organize working time for bus drivers more effectively, this would represent one dimension of ergonomic evaluation. Changes in working methods represent another. Together, these approaches may produce a more manageable workload for bus drivers.

For buses specifically, benefits from space-saving technology brought on through ergonomic evaluation could include an increase in general bus driver cabin space, or a reduction in the overall length and weight of the vehicle that may help in urban traffic situations. Research also suggests that an elevated seat posture may lessen the strain on drivers during work hours, as it approximates a standing posture more closely than a conventional seat does (Antonelli et al., 2013). The essential purpose of a bus driver's seat and cabin is to be safe and comfortable for the occupant, while facilitating effective vehicle operation. Research states that a seat needs both dynamic and good static properties to aid in overall seat comfort (Antonelli et al., 2013), and comfortable body angles identified by studies of driving postures can guide the development of seating that promotes occupational safety and health.

Some within the European bus industry have sought to implement broader system-level changes. A five-year project called the European Bus System of the Future, commissioned and backed by the European Commission, was funded to develop a new generation of bus systems that could improve the attractiveness and image of buses. Seven European cities were selected to test innovative measures: "Bremerhaven, Germany; Brunoy, France; Budapest, Hungary; Gothenburg, Sweden; Madrid, Spain; Rome; and Rouen, France" (Musso and Corazza, 2015, p. 109). The results provided the basis for evaluating barriers that might hinder or endorse transferability of measures across cities.

In summary, this literature review has demonstrated the need for bus improvements due to the various stresses and health problems endured by bus drivers. Bus drivers suffer from high blood pressure and musculoskeletal problems that frequently contribute to high employee turnover. By applying ergonomic evaluation to the bus driver cabin — through changes to seating, scheduling, and bus stop placement — bus companies can provide a better and more manageable workplace environment. The next section explores the current working conditions of three UK bus companies, using interviews with bus drivers and managers to provide a clearer picture that can be compared with the findings from the literature review.

Methodology

Three UK bus companies were contacted and recruited for participation in this study. Pseudonyms were used to maintain privacy. All three companies reside in the United Kingdom.

Short semi-structured interviews lasting approximately 15 minutes each were carried out with nine drivers, three from each bus company. The interviews enabled exploration of firsthand bus driver experience. All participants were male, aged 30–45, with an average age of 37. The average length of service for participants was 10 years, with some participants having worked as bus drivers for up to 22 years. Participants were recruited based on availability.

Interviews were also conducted with three managers, one per bus company, to discuss their specific roles and organizational policies. Procedures and policies were obtained for one of the three companies (Localbus). Five questions were asked per driver and per manager, relating to sickness absence, accident rates, job satisfaction, staff turnover, and potential for improvement. Questions were delivered via telephone, with managers providing answers via email.

The informal interviews were supplemented with research data and observations collected from the bus companies. No physical site visits were carried out due to limited availability of bus drivers and managers. The study period was one week. All participants' information was kept private, with participants having the option of not providing their name; the only discernible information recorded was age, gender, and race. The intention of the interviews was to collect and compare outcome data such as staff turnover, health problems, and sickness-related absences, and to determine whether these problems were widespread across companies or confined to particular ones.

The five questions asked to the nine bus drivers were as follows:

Modified questions were used for bus managers:

These questions provided sufficient information from which to guide the review of supplemental literature. Literature was identified using multiple academic search engines, including Ingentaconnect, JSTOR, and SpringerLink. Articles used had to be published in or after 2012, be peer-reviewed, and provide information pertaining to bus drivers and the work environment. The research method used for this study was qualitative.

The qualitative method encompasses "participant observation, in-depth interviewing, and others, that yield descriptive data" (Taylor, Devault, & Bogdan, 2015, p. 4). Data collection using this method relied primarily on interviews. Twelve participants — all male, as they were the only ones available at the time — were needed for qualitative information gathering. The goal was to formulate general, open-ended questions to allow potential for richer conversational responses.

The focus was on ergonomic evaluation in the supplemental literature and on the bus driver work environment in the interviews. Due to the delivery format of the interview questions, answers were transcribed during phone calls or collected as written email responses. Brief notes were made during phone interviews noting the tone and inflection of respondents. Observation notes and interview transcripts were imported and coded into NVivo. A framework of main work aspects was derived from the ergonomic evaluation literature and used to establish initial coding, with additional revision made to account for incoming interview responses.