The trucking industry is the backbone of the global economy, as companies deliver products across vast distances for our convenience. In 2021, 72 percent of goods in America were shipped by trucks, highlighting the economic importance of the trucking industry and its drivers. However, the diesel trucks that power this industry come at a significant cost, emitting harmful emissions that pose serious threats to public health and the environment. Truck drivers bear the brunt of this pollution since they encounter harmful diesel exhaust fumes as a regular part of their daily work routine. Transitioning to zero-emission trucks not only has the potential to improve truck drivers' health but also offers a path toward a more sustainable future. 

Harmful effects of diesel emissions

Diesel emissions release harmful pollutants like nitrogen oxide (NOx) and particulate matter 2.5 (PM2.5) into the atmosphere. NOx belongs to a group of reactive gases produced during activities such as fossil fuel combustion and industrial processes. PM2.5, commonly known as soot, is another harmful component found in diesel exhaust and is associated with respiratory issues. PM2.5 forms a complex aerosol system primarily associated with black smoke from diesel engines, and its ultrafine size of less than 2.5 microns allows it to easily enter the lungs, causing respiratory issues. Regular exposure to PM2.5 has been linked to various respiratory diseases, making it a significant concern for truck drivers, who are frequently exposed to diesel exhaust. PM2.5 can also irritate the nose, throat, lungs, and eyes, leading to cardiovascular illness and premature death. Despite only representing 6 percent of the on-road fleet, heavy-duty trucks generated 59 percent of ozone- and particle-forming NOx emissions, 55 percent of particle pollution, and 26 percent of transportation-based greenhouse gas emissions in 2020, according to research by the American Lung Association.

In-cabin pollution: An overlooked threat

In-cabin pollution poses one of the most significant daily exposures to air pollutants for drivers. Over time, truck cabins can accumulate unhealthy levels of PM2.5 and NOx emissions. The cabin serves as a hotbox for pollutants, leading to drivers inhaling these fumes daily. In-cabin pollution can have detrimental effects on drivers who spend long hours in their trucks, leading to respiratory issues, such as asthma and respiratory infections, while also contributing to cardiovascular problems. According to the American Cancer Society, workers with the heaviest and most prolonged exposures to diesel emissions—such as railroad workers, heavy-equipment operators, miners, and truck drivers—have been found to have higher lung cancer death rates than unexposed workers.

Who is at risk and what are the impacts on health?

There are about 3.5 million truck drivers in the United States, according to the American Trucking Association. Due to the nature of their jobs—long hours, little rest, lack of healthy food options—truck drivers are more at risk for asthma, heart disease, and obesity. This, paired with the fact that the average age of a truck driver is 46 years old, means that in-cabin diesel emissions directly increase the risk of severe, negative health outcomes. Medical research indicates that truck drivers regularly exposed to diesel exhaust face an elevated risk of lung cancer. The International Agency for Research on Cancer classifies diesel exhaust as a Group 1 human carcinogen, meaning there is sufficient evidence linking it to an increased risk of lung cancer. Exposure to diesel particulate matter (DPM) can also lead to respiratory symptoms, decreased lung function, and hospitalizations for heart and lung diseases, including asthma. 

A 2018 study on occupational health disparities among long-haul truck drivers in the United States revealed significant differences in health risks compared to other sample groups. The research highlights that the long-haul truck driver group had higher mean scores for both cardiovascular disease and metabolic disease risk. Additionally, truck drivers exhibited elevated levels of body mass index (BMI) and high blood pressure. Specifically, 43.9 percent of truck drivers had a BMI significantly above the mean of the study's sample, and this trend was consistent. Additionally, 30 percent of truckers observed in the study had higher systolic blood pressure, and 50 percent had elevated diastolic blood pressure. These findings underscore the health disparities and increased risk factors for cardiovascular and metabolic diseases within the truck driver occupation.

Furthermore, truck drivers are less likely to have health insurance coverage compared to other workers (with 15 percent being uninsured versus 10 percent for all workers), which adds to their vulnerability. The health disparities and elevated health risks observed among long-haul truck drivers without health insurance can result in delayed treatment, financial hardships, decreased job performance, and potential long-term health complications. 

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