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| Name | Class |
|---|---|
| National Institute for Occupational Safety and Health (NIOSH/CDC) | FED |
| Washington State, Department of Labor and Industries | UNKNOWN |
| University of Washington | OTHER |
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The current project is a safety and health intervention focused on sleep and fatigue among truck driver teams (pairs), where one driver sleeps in a moving vehicle while the other partner drives. This study is conducted within the Oregon Healthy Workforce Center (OHWC), a NIOSH Center of Excellence in Total Worker Health. We will evaluate engineering and behavioral interventions to improve sleep, reduce fatigue, and impact Total Worker Health. An enhanced cab intervention will alter whole body vibrations during driving and sleep periods, and includes a therapeutic mattress system and an active suspension seat. The enhanced cab will be evaluated alone and in combination with a behavioral sleep intervention adapted from our effective SHIFT (Safety &Health Involvement For Truckers) program. The interventions prioritize hazard reduction according to the hierarchy of controls, and will be evaluated with a randomized controlled design.
Total Worker Health® (TWH) is defined as policies, programs, and practices that integrate protection from work-related safety and health hazards with promotion of injury and illness prevention efforts to advance worker well-being. Sleep deficiency is a cross-cutting factor for TWH that not only impacts workplace safety, but also generates excess risk for obesity, chronic disease, and early mortality. Long-haul truck drivers average less sleep per night on the road than they do when sleeping at home due to long, irregular work hours and unfavorable sleeping conditions in truck sleeper berths (e.g., low quality mattresses, vibrations, noise, temperature). Sleep deficiency in trucking is a likely contributor to the 69% prevalence of obesity among US drivers, which increases the risk of obstructive sleep apnea and deadly crashes. Despite the severity of these interacting problems, research on engineering controls in commercial truck cabs to improve sleep and reduce fatigue is limited. Behavioral interventions to improve sleep among truck drivers are also limited. We must address these gaps and evaluate the economic cost-utility of interventions to stimulate industry investment in factors that substantially improve drivers' TWH.
The primary goal of this proposal is to evaluate the effects of an enhanced cab intervention on long-haul truck drivers' sleep and TWH with a randomized controlled design. A secondary goal is to evaluate the additive effects of a behavioral sleep intervention. We focus on truck driver teams (pairs), where one driver sleeps in a moving vehicle while the other partner drives, who experience twice as many awakenings as solo drivers. Our enhanced cab intervention will alter whole body vibrations during driving and sleep periods, and includes a therapeutic mattress system with anti-vibration characteristics (Thevorest) and an active suspension seat (BoseRide III). The enhanced cab will be evaluated alone and in combination with a behavioral sleep intervention adapted from our effective SHIFT program. Our preliminary studies show that the therapeutic mattress system alters vibrations and is strongly preferred by drivers, the active suspension seat reduces vibration exposure and fatigue, and that SHIFT produces robust health behavior changes. Our primary hypotheses are that relative to a control group, the enhanced cab intervention will improve objective measures of (a) sleep duration and quality, (b) fatigue, and (c) driver performance. We will also measure impacts on musculoskeletal pain, well-being, and health behaviors (diet, physical activity). We also hypothesize that intervention effects will be larger when combined with a behavioral sleep intervention. Our propensity for success is bolstered by our unique prior accomplishments and strong trucking industry support. To accomplish our goals and test our hypotheses we propose a 5-year project to accomplish 3 specific aims:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention | Experimental | All participants in the intervention arm will receive two interventions: an enhanced cab intervention alone, and then the enhanced cab conditions combined with a behavioral sleep intervention. |
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| Control | No Intervention | Usual practices with regards to cab conditions and access to workplace programs for preventing sleep and fatigue problems. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Enhanced Cab | Other | The enhanced cab intervention includes the introduction of an active suspension seat and a therapeutic mattress system. After a baseline phase, the intervention arm will receive the enhanced cab intervention alone, and then the enhanced cab plus a behavioral sleep program. |
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline in self-reported sleep duration in hours at 2 months | Pittsburgh Sleep Quality Index sleep duration question (more hours is better sleep duration) | Baseline and 2 months (post-enhanced cab) |
| Change from baseline in self-reported sleep duration in hours at 3-4 months | Pittsburgh Sleep Quality Index sleep duration question (more hours is better sleep duration) | Baseline and 3-4 months (post-enhanced cab + behavioral sleep program) |
| Change from baseline in self-reported sleep quality at 2 months | Pittsburgh Sleep Quality Index sleep quality question (0-3, higher is better sleep quality) | Baseline and 2 months (post-enhanced cab) |
| Change from baseline in self-reported sleep quality at 3-4 months | Pittsburgh Sleep Quality Index sleep quality question (0-3, higher is better sleep quality) | Baseline and 3-4 months (post-enhanced cab + behavioral sleep program) |
| Change from baseline in sleep disturbance at 2 months | Sleep Disturbance Scale, Patient-Reported Outcomes Measurement Information System (8-40, higher is worse [greater sleep disturbance]) | Baseline and 2 months (post-enhanced cab) |
| Change from baseline in sleep-related impairment at 2 months | Sleep Disturbance Scale, Patient-Reported Outcomes Measurement Information System (8-40, higher is worse [greater sleep disturbance]) | Baseline and 3-4 months (post-enhanced cab + behavioral sleep program) |
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline in sleep hygiene practices at 2 months | Sleep Hygiene Index (0-48, higher is worse sleep hygiene) | Baseline and 2 months (post-enhanced cab) |
| Change from baseline in sleep hygiene practices at 3-4 months |
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline in body weight at 2 months | Direct measurement via Tanita TBF-310GS Bioelectric Impedance Analyzer (higher weight is worse) | Baseline and 2 months (post-enhanced cab) |
| Change from baseline in body weight at 3-4 months |
Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Oregon Health and Science University | Portland | Oregon | 97239 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 2748771 | Background | Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989 May;28(2):193-213. doi: 10.1016/0165-1781(89)90047-4. | |
| 20685078 | Background | Cella D, Riley W, Stone A, Rothrock N, Reeve B, Yount S, Amtmann D, Bode R, Buysse D, Choi S, Cook K, Devellis R, DeWalt D, Fries JF, Gershon R, Hahn EA, Lai JS, Pilkonis P, Revicki D, Rose M, Weinfurt K, Hays R; PROMIS Cooperative Group. The Patient-Reported Outcomes Measurement Information System (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005-2008. J Clin Epidemiol. 2010 Nov;63(11):1179-94. doi: 10.1016/j.jclinepi.2010.04.011. Epub 2010 Aug 4. |
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Only de-identified data will be shared with researchers outside of the primary research team. De-identified data will be shared only after receiving IRB approval.
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Jul 8, 2026 |
| ID | Term |
|---|---|
| D020447 | Parasomnias |
| D020178 | Sleep Disorders, Circadian Rhythm |
| D001519 | Behavior |
| D015438 | Health Behavior |
| D005221 | Fatigue |
| D009043 | Motor Activity |
| ID | Term |
|---|---|
| D012893 | Sleep Wake Disorders |
| D009422 | Nervous System Diseases |
| D001523 | Mental Disorders |
| D021081 | Chronobiology Disorders |
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In the randomized controlled trial, participants will be randomly assigned to either the control or intervention groups. Following a baseline period, intervention participants will receive the enhanced cab portion of the intervention on its own. Then, for the following intervention phase, intervention participants will participate in the behavioral sleep program in addition to continuing the enhanced cab intervention.
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| Fit4Sleep | Behavioral | The behavioral sleep program includes a friendly dyad-based physical activity competition; self-monitoring and logging of physical activity, sleep hygiene behaviors, and sleep; and individual coaching. The behavioral sleep program includes an optional body weight management component. The intervention arm will receive the behavioral sleep program in combination with the enhanced cab intervention. |
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| Change from baseline in sleep-related impairment at 2 months | Sleep-Related Impairment Scale, Patient-Reported Outcomes Measurement Information System (8-40, higher is worse [greater sleep-related impairment]) | Baseline and 2 months (post-enhanced cab) |
| Change from baseline in sleep-related impairment at 3-4 months | Sleep-Related Impairment Scale, Patient-Reported Outcomes Measurement Information System (8-40, higher is worse [greater sleep-related impairment]) | Baseline and 3-4 months (post-enhanced cab + behavioral sleep program) |
| Change from baseline in self-reported fatigue at 2 months | Swedish Occupational Fatigue Inventory (0-48, higher is worse [more fatigue]) | Baseline and 2 months (post-enhanced cab) |
| Change from baseline in self-reported fatigue at 3-4 months | Swedish Occupational Fatigue Inventory (0-48, higher is worse [more fatigue]) | Baseline and 3-4 months (post-enhanced cab + behavioral sleep program |
| Change from baseline in actigraphic measures of sleep duration in hours at 2 months | Direct measurement via Actigraph GT3x+ BT (more hours is better sleep duration) | One week samples at Baseline and 2 months (post-enhanced cab) |
| Change from baseline in actigraphic measures of sleep duration in hours at 3-4 months | Direct measurement via Actigraph GT3x+ BT (more hours is better sleep duration) | One week samples at Baseline and 3-4 months (post-enhanced cab + behavioral sleep program) |
| Change from baseline in actigraphic measures of sleep efficiency percentage at 2 months | Direct measurement via Actigraph GT3x+ BT (higher percentage is better sleep efficiency) | One week samples at Baseline and 2 months (post-enhanced cab) |
| Change from baseline in actigraphic measures of sleep efficiency percentage at 3-4 months | Direct measurement via Actigraph GT3x+ BT (higher percentage is better sleep efficiency) | One week samples at Baseline and 3-4 months (post-enhanced cab + behavioral sleep program) |
Sleep Hygiene Index (0-48, higher is worse sleep hygiene)
| Baseline and 3-4 months (post-enhanced cab + behavioral sleep program) |
| Change from baseline in self-reported days per week with moderate intensity physical activity at 2 months | International Physical Activity Scale-Short Form moderate intensity physical activity question (0-7 days, more days is better moderate physical activity levels) | Baseline and 2 months (post-enhanced cab) |
| Change from baseline in self-reported moderate intensity physical activity at 3-4 months | International Physical Activity Scale-Short Form moderate intensity physical activity question (0-7 days, more days is better moderate physical activity levels) | Baseline and 3-4 months (post-enhanced cab + behavioral sleep program) |
| Change from baseline in self-reported vigorous intensity physical activity at 2 months | International Physical Activity Scale-Short Form vigorous physical activity question (0-7 days, more days is better vigorous intensity physical activity levels) | Baseline and 2 months (post-enhanced cab) |
| Change from baseline in self-reported vigorous intensity physical activity at 3-4 months | International Physical Activity Scale-Short Form vigorous physical activity question (0-7 days, more days is better vigorous intensity physical activity levels) | Baseline and 3-4 months (post-enhanced cab + behavioral sleep program) |
| Change from baseline in actigraphy measures of minutes per week in physical activity bouts at 2 months | Direct measurement via Actigraph GT3x+ BT (more minutes is better) | One week samples at Baseline and 2 months (post-enhanced cab) |
| Change from baseline in actigraphy measures of minutes per week in physical activity bouts at 3-4 months | Direct measurement via Actigraph GT3x+ BT (more minutes is better) | One week samples at Baseline and 3-4 months (post-enhanced cab + behavioral sleep program) |
| Change from baseline in actigraphy measures of 10-minute physical activity bouts at 2 months | Direct measurement via Actigraph GT3x+ BT (more bouts is better) | One week samples at Baseline and 2 months (post-enhanced cab) |
| Change from baseline in actigraphy measures of 10-minute physical activity bouts at 3-4 months | Direct measurement via Actigraph GT3x+ BT (more bouts is better) | One week samples at Baseline and 3-4 months (post-enhanced cab + behavioral sleep program) |
| Change from baseline in well-being (physical health) at 2 months | Physical Health Subscale of the Patient-Reported Outcomes Measurement Information System Global Health Scale (4-20, higher is better physical health) | Baseline and 2 months (post-enhanced cab) |
| Change from baseline in well-being (physical health) at 3-4 months | Physical Health Subscale of the Patient-Reported Outcomes Measurement Information System Global Health Scale (4-20, higher is better physical health) | Baseline and 3-4 months (post-enhanced cab + behavioral sleep program) |
| Change from baseline in well-being (mental health) at 2 months | Mental Health Subscale of the Patient-Reported Outcomes Measurement Information System Global Health Scale (4-20, higher is better mental health) | Baseline and 2 months (post-enhanced cab) |
| Change from baseline in well-being (mental health) at 3-4 months | Mental Health Subscale of the Patient-Reported Outcomes Measurement Information System Global Health Scale (4-20, higher is better mental health) | Baseline and 3-4 months (post-enhanced cab + behavioral sleep program) |
Direct measurement via Tanita TBF-310GS Bioelectric Impedance Analyzer (higher weight is worse)
| Baseline and 3-4 months (post-enhanced cab + behavioral sleep program) |
| Change from baseline in body mass index at 2 months | Direct measurement via stadiometer and Tanita TBF-310GS Bioelectric Impedance Analyzer (higher body mass index is worse) | Baseline and 2 months (post-enhanced cab) |
| Change from baseline in body mass index at 3-4 months | Direct measurement via stadiometer and Tanita TBF-310GS Bioelectric Impedance Analyzer (higher body mass index is worse) | Baseline and 3-4 months (post-enhanced cab + behavioral sleep program) |
| Change from baseline in percent body fat at 2 months | Direct measurement via Tanita TBF-310GS Bioelectric Impedance Analyzer (higher percent body fat is worse) | Baseline and 2 months (post-enhanced cab) |
| Change from baseline in percent body fat at 3-4 months | Direct measurement via Tanita TBF-310GS Bioelectric Impedance Analyzer (higher percent body fat is worse) | Baseline and 3-4 months (post-enhanced cab + behavioral sleep program) |
| Change from baseline in systolic blood pressure at 2 months | Direct measurement via Omron HEM-907 automatic blood pressure monitor (higher systolic blood pressure is worse) | Baseline and 2 months (post-enhanced cab) |
| Change from baseline in systolic blood pressure at 3-4 months | Direct measurement via Omron HEM-907 automatic blood pressure monitor (higher systolic blood pressure is worse) | Baseline and 3-4 months (post-enhanced cab + behavioral sleep program) |
| Change from baseline in diastolic blood pressure at 2 months | Direct measurement via Omron HEM-907 automatic blood pressure monitor (higher diastolic blood pressure is worse) | Baseline and 2 months (post-enhanced cab) |
| Change from baseline in diastolic blood pressure at 3-4 months | Direct measurement via Omron HEM-907 automatic blood pressure monitor (higher diastolic blood pressure is worse) | Baseline and 3-4 months (post-enhanced cab + behavioral sleep program) |
| Change from baseline in fruit and vegetable servings per day at 2 months | Single-item on number of fruit and vegetable servings developed by investigators (0-5+, more servings is better) | Baseline and 2 months (post-enhanced cabs) |
| Change from baseline in fruit and vegetable servings per day at 3-4 months | Single-item on number of fruit and vegetable servings developed by investigators (0-5+, more servings is better) | Baseline and 3-4 months (post-enhanced cab + behavioral sleep program) |
| Change from baseline in frequency of meals brought from home at 2 months | single item from prior research by other investigators (0 [Never] to 9 [5 or more times per day], higher is better) | Baseline and 2 months (post-enhanced cab) |
| Change from baseline in frequency of meals brought from home at 3-4 months | single item from prior research by other investigators (0 [Never] to 9 [5 or more times per day], higher is better) | Baseline and 3-4 months (post-enhanced cab + behavioral sleep program) |
| Change from baseline in frequency of consumption of sugary snacks at 2 months | single item from prior research by other investigators (0 [Never] to 9 [5 or more times per day], higher is better) | Baseline and 2 months (post-enhanced cab) |
| Change from baseline in frequency of consumption of sugary snacks at 3-4 months | single item from prior research by other investigators (0 [Never] to 9 [5 or more times per day], higher is better) | Baseline and 3-4 months (post-enhanced cab + behavioral sleep program) |
| Change from baseline in frequency of sugary drink consumption at 2 months | single item from prior research by other investigators (0 [Never] to 9 [5 or more times per day], higher is better) | Baseline and 2 months (post-enhanced cab) |
| Change from baseline in frequency of sugary drink consumption at 3-4 months | single item from prior research by other investigators (0 [Never] to 9 [5 or more times per day], higher is better) | Baseline and 3-4 months (post-enhanced cab + behavioral sleep program |
| Change from baseline in frequency of fast food consumption at 2 months | single item from prior research by other investigators (0 [Never] to 9 [5 or more times per day], higher is better) | Baseline and 2 months (post-enhanced cab) |
| Change from baseline in frequency of fast food consumption at 3-4 months | single item from prior research by other investigators (0 [Never] to 9 [5 or more times per day], higher is better) | Baseline and 3-4 months (post-enhanced cab + behavioral sleep program) |
| Change from baseline in pain interference with home and work activities at 2 months | Adapted Nordic-style questionnaire for musculoskeletal symptoms (5-25, higher is worse [greater pain interference]) | Baseline and 2 months (post-enhanced cab) |
| Change from baseline in pain interference with home and work activities at 3-4 months | Adapted Nordic-style questionnaire for musculoskeletal symptoms (5-25, higher is worse [greater pain interference]) | Baseline and 3-4 months (post-enhanced cab + behavioral sleep program) |
| Change from baseline in pain intensity at 2 months | Adapted Nordic-style questionnaire for musculoskeletal symptoms (0-50, higher is worse pain) | Baseline and 2 months (post-enhanced cab) |
| Change from baseline in pain intensity at 3-4 months | Adapted Nordic-style questionnaire for musculoskeletal symptoms (0-50, higher is worse pain) | Baseline and 3-4 months (post-enhanced cab + behavioral sleep program) |
| Change from baseline in driving vehicle collisions without damage at 2 months | Self-reported vehicle collisions without damage using item created by investigators (0-5+, more is worse) | Baseline and 2 months (post-enhanced cab) |
| Change from baseline in driving vehicle collisions without damage at 3-4 months | Self-reported vehicle collisions without damage using item created by investigators (0-5+, more is worse) | Baseline and 3-4 months (post-enhanced cab + behavioral sleep program) |
| Change from baseline in driving vehicle collisions with damage at 2 months | Self-reported vehicle collisions with damage using two items created by investigators (0-5+, more is worse) | Baseline and 2 months (post-enhanced cab) |
| Change from baseline in driving vehicle collisions with damage at 2 and 3-4 months | Self-reported vehicle collisions with damage using two items created by investigators (0-5+, more is worse) | Baseline and 3-4 months (post-enhanced cab + behavioral sleep program) |
| Change from baseline in minor injuries at work at 2 months | Self-reported worker injuries without lost work time using item created by investigators (0-5+, more is worse) | Baseline and 2 months (post-enhanced cab) |
| Change from baseline in minor injuries at work at 3-4 months | Self-reported worker injuries without lost work time using item created by investigators (0-5+, more is worse) | Baseline and 3-4 months (post-enhanced cab + behavioral sleep program) |
| Change from baseline in major injuries at work at 2 months | Self-reported worker injuries resulting in lost work time using item created by investigators (0-5+, more is worse) | Baseline and 2 months (post-enhanced cab) |
| Change from baseline in major injuries at work at 3-4 months | Self-reported worker injuries resulting in lost work time using item created by investigators (0-5+, more is worse) | Baseline and 3-4 months (post-enhanced cab + behavioral sleep program) |
| 22250775 | Background | Yu L, Buysse DJ, Germain A, Moul DE, Stover A, Dodds NE, Johnston KL, Pilkonis PA. Development of short forms from the PROMIS sleep disturbance and Sleep-Related Impairment item banks. Behav Sleep Med. 2011 Dec 28;10(1):6-24. doi: 10.1080/15402002.2012.636266. |
| 11041305 | Background | Ahsberg E. Dimensions of fatigue in different working populations. Scand J Psychol. 2000 Sep;41(3):231-41. doi: 10.1111/1467-9450.00192. |
| 16557353 | Background | Mastin DF, Bryson J, Corwyn R. Assessment of sleep hygiene using the Sleep Hygiene Index. J Behav Med. 2006 Jun;29(3):223-7. doi: 10.1007/s10865-006-9047-6. Epub 2006 Mar 24. |
| 12900694 | Background | Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, Oja P. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003 Aug;35(8):1381-95. doi: 10.1249/01.MSS.0000078924.61453.FB. |
| 22018588 | Background | Lee PH, Macfarlane DJ, Lam TH, Stewart SM. Validity of the International Physical Activity Questionnaire Short Form (IPAQ-SF): a systematic review. Int J Behav Nutr Phys Act. 2011 Oct 21;8:115. doi: 10.1186/1479-5868-8-115. |
| 19543809 | Background | Hays RD, Bjorner JB, Revicki DA, Spritzer KL, Cella D. Development of physical and mental health summary scores from the patient-reported outcomes measurement information system (PROMIS) global items. Qual Life Res. 2009 Sep;18(7):873-80. doi: 10.1007/s11136-009-9496-9. Epub 2009 Jun 19. |
| 19890169 | Background | Buxton OM, Quintiliani LM, Yang MH, Ebbeling CB, Stoddard AM, Pereira LK, Sorensen G. Association of sleep adequacy with more healthful food choices and positive workplace experiences among motor freight workers. Am J Public Health. 2009 Nov;99 Suppl 3(Suppl 3):S636-43. doi: 10.2105/AJPH.2008.158501. |
| 22113975 | Background | Dennerlein JT, Hopcia K, Sembajwe G, Kenwood C, Stoddard AM, Tveito TH, Hashimoto DM, Sorensen G. Ergonomic practices within patient care units are associated with musculoskeletal pain and limitations. Am J Ind Med. 2012 Feb;55(2):107-16. doi: 10.1002/ajim.21036. Epub 2011 Nov 23. |
| 10582503 | Background | Hedge A, Morimoto S, McCrobie D. Effects of keyboard tray geometry on upper body posture and comfort. Ergonomics. 1999 Oct;42(10):1333-49. doi: 10.1080/001401399184983. |
| 15676628 | Background | Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering-Sorensen F, Andersson G, Jorgensen K. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon. 1987 Sep;18(3):233-7. doi: 10.1016/0003-6870(87)90010-x. |
| 37590443 | Result | Olson R, Johnson PW, Shea SA, Marino M, Springer R, Rice SPM, Rimby J, Donovan C. The Tech4Rest Randomized Controlled Trial: Applying the Hierarchy of Controls to Advance the Sleep, Health, and Well-being of Team Truck Drivers. J Occup Environ Med. 2023 Nov 1;65(11):937-948. doi: 10.1097/JOM.0000000000002941. Epub 2023 Aug 12. |
| D020920 |
| Dyssomnias |
| D009784 | Occupational Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |