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American Journal of Epidemiology Advance Access published online on August 22, 2007

American Journal of Epidemiology, doi:10.1093/aje/kwm205
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American Journal of Epidemiology © The Author 2007. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

Original Contribution

Predictors of Psychostimulant Use by Long-Distance Truck Drivers

Ann Williamson

From the New South Wales Injury Risk Management Research Centre, University of New South Wales, Sydney, NSW, Australia

Correspondence to Dr. Ann Williamson, NSW Injury Risk Management Research Centre, University of New South Wales, Building G2, Western Campus, UNSW Sydney, NSW, Australia, 2052 (e-mail: a.williamson{at}unsw.edu.au).

Received for publication March 19, 2007. Accepted for publication June 8, 2007.

Two national cross-sectional surveys of fatigue and its effects in long-distance road transport in Australia showed that stimulant use was a common feature of this industry. Between one in five and one in three drivers reported using stimulants at least sometimes, and a significant proportion reported stimulant use as a most helpful fatigue management strategy. This study reanalyzed the surveys with the aim of identifying predictors of stimulant drug use by drivers. The surveys were administered in 1991 (n = 970) and 1998 (n = 1,007) by interview and self-administration. Logistic regression analysis conducted separately for each survey showed that stimulant drug use was twice as likely for drivers who had the greatest problem in managing fatigue and was two to three times more likely for drivers paid on a payment-by-results or contingency-payment basis. Younger, less experienced drivers were also more likely to take drugs. This analysis demonstrates the involvement of external factors, especially productivity-based payment systems, in stimulant drug use by truck drivers; findings were confirmed in two separate surveys conducted 7 years apart. Results highlight the important role of economic and organizational factors in occupational health and safety problems.

central nervous system stimulants; fatigue; motor vehicles; salaries and fringe benefits; substance-related disorders


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