The Very Mortal Life of City Bus Drivers

Late last month, a Boston-area man was arrested for allegedly boarding an M.B.T.A. bus and assaulting the driver. According to the Boston Globe's MetroDesk blog, police reports say the suspect got on the bus and confronted the driver about pulling away from a previous stop without letting him board. Witnesses saw the suspect punch the driver until he hit the ground, then kick him while he was down.

The job of city bus driver has long been one of the most stressful and hazardous gigs in town. If staying on schedule or fighting through traffic or remaining in a seated position for hours doesn't get you, then fending off shod foot from some vengeful guy who was late to the stop will. And when a transit authority makes the hard cuts that reduce service, it's the drivers on the front line that feel the sometimes-mucus-filled wrath of the public.

That's not just anecdotal pity talking. Half a century of medical research has determined that the demands of driving a city bus result in a variety of physical (notably heart disease and back pain), mental (anxiety and depression), and behavioral (substance abuse) health problems. A British review [PDF] of this work from a few years ago concluded that "poor well-being in drivers is part and parcel of the job."

The first study to document deteriorating health among city bus drivers was done in the early 1950s. Researchers found higher mortality rates and increased risk of clinical heart disease as a result of the bus driver's sedentary lifestyle. A study from the late '70s [PDF] reported a high lung cancer rate consistent with the amount of smoking done to ease the stress. Ten years later an investigation of roughly 1,500 American city bus drivers found that "exposure to the occupation" was linked to significantly higher rates of hypertension, compared to control populations.

The '90s delivered more bad news. Only one in nine drivers reached retirement age, according to one report, partly because they suffered musculoskeletal or mental health problems before they got there. A small study of 22 assaulted drivers in England nevertheless found that a very high rate — nearly a quarter — went on to develop P.T.S.D. In 2001, researchers attributed the high risk of coronary heart disease among a sample 1,400 drivers in Taiwan [PDF] to elevated blood pressure and obesity. More recent work is no more optimistic.

Some researchers are now targeting preventive measures for bus drivers before the effects of the job overwhelm them. A few early signs are encouraging. At a conference this month in Italy, a group of occupational health researchers from Poland will report that drivers being treated for hypertension maintained significantly lower blood pressure on the job than those who were not (though both groups exceeded normal blood pressure rates).

Such treatment, combined with stress training and conflict resolution, could go a long way toward decreasing the health risks of the job. Hail to the bus driver. Or, at the very least, hale.