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Past Issues

March 2005

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It was ten years ago - in August 1995 - that FleetWatch linked hands with Engen and the SA Optometric Association (SAOA) to screen the eyesight of truck drivers on our roads. It was a first for the industry and the results were frightening. Has anything changed since then - especially since the PrDP which requires a medical has been in place for eight years? That is what FleetWatch, Engen and the SAOA set out to determine when they embarked on a similar but enhanced exercise towards the end of last year. Read on...

To say that anyone driving a truck should have good eyesight is rhetorical. When truckers have their driving skills tested to acquire a Professional Driver Permit (PrDP), they also have their vision tested. On the surface, this process looks sufficient to ensure that all our professional drivers have good eyesight. Look under the surface, however, and a different picture emerges.

In August 1995 - some 18 months before the introduction of the PrDP system - FleetWatch, Engen and the SAOA conducted the first "Eye-Care Week Trucker Tests" where truckers voluntarily had their eyesight screened at several Engen truck stops around the country. Over a period of three days, a total of 422 drivers were tested. Of these, 6.4% failed outright with one driver having only 5% vision in his left eye and no peripheral vision in the right eye at all. As we pointed out at the time, this would have meant that the driver had no vision on the left-hand side of the road beyond the right-hand bridge of his nose. He would have had to move his head to the left to see the curb. Scary stuff!

The results of this exercise opened debate as to the effectiveness of eye tests conducted by the driver testing stations. Trevor Skinner, SAOA president, states the bottom line: "It was obvious that more rigorous eye testing needed to be implemented at driver testing stations. It's all about road safety and society as a whole owes it to itself to ensure professional drivers, be they truck or bus drivers, have proper vision correction."

In reaction to the results, the Department of Transport issued a statement to FleetWatch at the time stating that once the PrDP came into operation, proof of good health and an eye test would be compulsory to qualify for a PrDP. (This system was introduced to replace and extend the former public driving permit system).

The statement went on to say that: "The PrDP will be renewable every two years. The regulations that will control this still have to be negotiated with the role players but it is envisaged that everyone will accept the importance of good heath and proper eye sight particularly for drivers responsible for the conveyance of passengers and freight on a commercial basis."

Via its statement, the DoT was pointing to the PrDP as being the solution to the problem highlighted by our research results. That was nine years ago and, as mentioned, the PrDP system has since been implemented so things should have improved. Why do we say this? Simply because one of the 
stipulations for renewal is that the driver must have passed a medical. In fact, a completed medical certificate (form MC) must accompany the application for renewal. On this certificate, the medical examiner must, among others, confirm that the applicant's ability to drive is not affected by any of the "Disabilities Disqualifying Driving" - one of which is "defective vision". Another is "uncontrolled diabetes mellitus". (Section 15 (1) (f)).

With such control measures in place, surely then a repeat of our eye screening project would show vast improvements. To check this out, the three organisations got together once again to undertake a follow-up "Eye-care Week Trucker Test". This time round, we added blood pressure and diabetes testing to the process - and for good reasons.

According to The Careways Group which performed the blood pressure and diabetes testing, high blood pressure increases the risk of cardiovascular disease and stroke and although a once-off measurement of blood pressure may not indicate a risk, if it is elevated it is important to have blood pressure measured over time in order to assess hypertension.

Adding diabetes testing was an obvious enhancement as there is a definite link between long term diminished visual acuity and diabetes. This was highlighted in You and Your Driver, a book published by FleetWatch and partnered by Engen and Mercedes Benz, where a story was told of a reliable driver who had blotted his good record with two accidents both occurring in a short space of time. When committed to an eye test, it was found that this driver suffered from diabetes which, in turn, was taking a toll on his vision. The link is a definite one.

 

Also, as mentioned above, one of the "Disabilities Disqualifying Driving" is "uncontrolled diabetes mellitus". According to The Careways Group, diabetes mellitus is a worldwide disease which has serious medical and financial implications for the patient, community and funders. In clinical terms, Diabetes Mellitus can be defined as a metabolic disease involving: The inability of the body to secrete insulin or use insulin, resulting in sustained high blood glucose levels and is usually a chronic disease often accompanied by other clinical and biochemical disorders.

With all this as background, the tests went ahead. Under the direction and guidance of the SAOA, optometric students from colleges and technikons around the country carried out the eye screenings while qualified medical personnel from The Careways Group performed the blood pressure and diabetes testing. The screenings were once again voluntary and truckers were invited to take part at five Engen One-Stops: Grasmere, Sydney Road, Kranskop, Harrismith and Highveld. 

No change 
Let's look at the results of the vision screening first. Out of a total 365 truckers who had their vision screened, 6% failed the visual acuity test (ability to judge distance) while fields tests (peripheral/side vision) saw a 7% failure rate. At the Sydney Road 1-Stop, 61 drivers were screened and an alarming 10 failed the visual acuity test. At the Highveld 1-Stop, one driver had a mere 30 degrees peripheral vision. The legally required figure is 115 degrees!

What this tells us is that that the PrDP system which, among others, was intended to ensure all professional drivers have acceptable vision, is not doing its job. PrDPs are being issued to drivers who do not have the necessary physical capabilities to pilot a rig. Poor vision is a potential killer and professional drivers should be as stringently tested as airline pilots. Given the results of these tests, we believe the DoT should rework its driver-testing process to include more comprehensive eye tests. We will be feeding these results through to the NDoT for their reaction and will report back to our readers on the response.

In the meantime, as we did back in 1996, we urge all operators to impose a self-regulatory mechanism whereby, without prompting from legislation, the operator will ensure all his drivers undergo regular vision screening. Don't rely on the PrDP to act as your driver's screening physician.

Blood pressure and diabetes 
As regards the blood pressure and diabetes testing, a total of 301 drivers were tested by qualified medical officers from The Careways Group. The results are equally disturbing. As an extra, participants were also asked to fill in a questionnaire to help assess how many smoked and took regular exercise. This is the analysis of the results as handed to FleetWatch.

The majority (31%) of the drivers were aged 40 to 49 years with 30% aged 30 to 39 years. Only 2% of the drivers were older than 60 years. Ninety three percent (93%) of the people participating in the screening were male and 7% were female. On average, 37% smoke and 12% of the participants previously smoked but have quitted. The majority of participants (55%) do not exercise regularly.

The blood pressure results of the participants are concerning with 33.2% recording a high systolic blood pressure, 26% a high diastolic blood pressure (more serious than the former) and 20.5% with high systolic and diastolic pressures. This essentially means that only 20% of the participants had a completely normal blood pressure (110-140 over 70-90. At Sydney Road, two drivers were recorded at 180 over 120.) Forty percent (40%) of the participants received education regarding their blood pressure and 25% were referred to their doctors for further monitoring and/or management.

As regards diabetes, 6.3% of the people tested had elevated glucose results of which 3.3 percent were referred for further measuring and possible treatment of their glucose results. Three percent (3%) percent of the participants are on chronic medication for diabetes.

From the results, it is clear that the screening of blood pressures and blood glucose levels was a very valuable exercise as the majority of drivers had abnormal blood pressures and 6.3 percent of the drivers had abnormal glucose results.

Early identification, appropriate education and timeous referral where necessary are key to the success of managing both hypertension and diabetes risk, both of which may potentially expose the driver to increased risk of accidents and impaired vision.

The Message
If anyone out there does not sit up and take notice of these results, then you are blind to the realities. Based on this research, it is obvious that the health of this country's truck drivers is in a sorry state and needs urgent attention. It is also obvious that the medial requirements of the PrDP are not working.

I am not sure how to extrapolate the results accurately so as to encompass the total driver population of South Africa but it should be noted that whereas the old public driving permit applied only to drivers of public carrier vehicles, the PrDP is needed whether or not the vehicle is carrying for reward and drivers of public carrier vehicles are not exempt.

As the Fleet Management Digest points out: "Previously exempt, drivers employed by local authorities are affected and ambulance drivers too, if used to carry paying passengers. The requirement also applies to a truck salesman, diesel mechanic or anyone else, even if he is merely delivering a vehicle or taking it on a test drive. A truck or bus driving instructor also needs one. A PrDP is also needed to drive any vehicle which is carrying 12 or more people at the time. This would include a truck carrying workers in the back - and even a bakkie."

Of course, taxi drivers are also included so if we extrapolate the 6% visual acuity and 7% fields test failure rates; the 6.3% elevated glucose levels and the 20.5% high systolic and diastolic blood pressure levels across the entire spectrum of drivers who hold PrDPs in South Africa, we are talking of thousands of drivers out there who are a danger on the road.

The situation is indeed a serious one as confirmed by our sources at the Chris Hani Hospital in Johannesburg where a notable increase in heart attacks - specifically among black taxi drivers - has been recorded. The stress of driving, the many inactive hours behind the wheel and a poor diet are impacting factors contributing to these statistics. We hope operators recognise those three factors as prime lifestyle habits of truck drivers.

In terms of poor diet, drivers will, for example, eat a pie for lunch. Nice treat but unfortunately, it causes the blood sugar level to spike very high and then, within a few hours, to drop very low. As a result, by mid-afternoon the driver is struggling the keep his eyes open! Add this to a driver who suffers from undetected diabetes and who is feeling the usual driver fatigue related to long hours behind the wheel and you have a sure recipe for disaster! Coke is also a big favourite among drivers as far as preferred soft drinks go. But here's the problem: One can of Coke dumps the equivalent of seven teaspoons of sugar into the system. If this is taken without food, there is no fibre for the body to digest so the body needs to rapidly absorb this sugar which places the pancreas under extreme stress.

It is obvious then that the impact a driver's lifestyle habits have on his/her overall health should not be overlooked. It's all linked and while we initially set out to do vision screening, by adding blood pressure and diabetes testing to the project we have opened up a whole new area of thought.

Transporters and fleet managers need to work urgently with their drivers to monitor all these issues. Don't ignore what is presented here. By affecting improvements, you will be acting in the interests of your drivers, your company and the country as a whole. You will also be contributing to improving road safety out there which, as we all know, is as unhealthy as are our truck drivers. All this needs to change - so change it!

 

Halala Engen!!! If there is one organisation which the truck drivers of South Africa can look to with affection as being a company which really cares for them, that organisation is Engen. From the first time FleetWatch contacted Engen back in 1995 with the idea of doing vision screening, the company has shown a firm commitment towards improving the health of this country's truck drivers. Over the years, Engen has partnered us not only in our Eye Care campaigns, but in many other initiatives directed at driver health education and awareness. Together we have produced booklets, information leaflets and posters on all aspects of driver heath.  The latest campaign - which you can see in FleetWatch - is to produce posters for permanent display at truckstops as well as hand-out pamphlets for drivers giving information on malaria, diabetes, eyesight, HIV and STI's, hypertension and TB. Thinking back over the years, Engen was also the main player that put FleetWatch in the position to offer free HIV/AIDS workshops to the industry. It has been a partnership that we value and that has added so much value to the industry. Poster and handouts produced for permanent display at truckstops, info not only on eyesight but diabetes, malaria, HIV hypertension and TB  For all this, plus much more, we lift our hats in tribute to a company which is truly committed to making a difference. Trucks are the lifeblood of our economy and without fit drivers, we're all doomed. Halala Engen! On this eye care campaign, I'd also like to thank the SAOA, The Careways Group, the optometric students and the staff at FleetWatch, for putting together a project which has enabled us to pin down exactly what state our driver's eyes are in and to counsel on how to improve the situation. I'd also like to thank all the Engen Truck- and 1-Stop managers for their enthusiasm and support on the day. A big thank you also goes to Mr JP Venables at Edan Traders for supplying the number plates required for the "distance test".  A special word of thanks must go to Lorinda Stoltz, FleetWatch's enthusiastic project co-ordinator who has a passion for improving the health of our truck drivers. Her drive and dedication to make things happen is so admirable. Well done and thank you Lorinda. Thanks to the good work of all these good people and organisations, we now have results to act on. What actions are you going to take, Mr Operator, to make a difference?  Patrick O'Leary Publisher/Managing Editor