Survival and Prosperity
by Ned Einstein

The Extraordinary Percentage of Drivers Who Are Obese

In early May, I was contacted by a local TV/radio station covering Rockland and Orange counties in New York State, to be interviewed about public transportation.

The concern of the station, and the interviewer, was his or their recent revelation about the extraordinary percentage of drivers who are obese. I agreed to the interview, and it took place on May 5.

While I agreed with this premise (for which I doubt any statistics exist), I took this opportunity to explain some of the reasons for it and to propose solutions. This is not exactly like me explaining this to the new fealty reps that run USDOT. Instead, a few thousand radio listeners with no connection to any entity with the power to make change got to hear a small burst of reality, and then continued to move on and go about their business.

For the main reason suggested, I suspect these services are safe for the moment. As I reminded National Bus Trader readers again and again for the past 25 years, public transit almost died in the late 1950s and early 1960s. Reduced to a skeleton of their former selves, public transit was rescued by former President Johnson in 1964 when the “Model Cities Program” within the Department of Housing and Urban Development paid for 80 percent of all new buses (and other capital expenditures). Three years later, when the Urban Mass Transportation Administration (now the Federal Transit Administration) was moved into the newly-created U.S. Department of Transportation (in 1967), UMTA also provided “operating assistance” to these transit agencies or municipalities.

Mismanagement quickly put them at risk: By 1977, a mere decade later, passenger fares covered only 50 percent of these services’ operating costs (as most of the Federal operating subsidies were translated into salary increases – which at that time were not remotely as depressed with respect to the cost of living as drivers’ salaries are now). That was only 1977. By 2018, two years before COVID-19 decimated transit service, and transit ridership was declining by about 10 percent a year, nationwide, New York City’s transit system recovered 35 percent of its operating costs from farebox revenue – the nation’s highest. After its first three subway lines put Los Angeles County $7 billion in debt – before a single train began operating – that County’s combined subway and bus fares were covering only nine percent of their operating costs. By comparison, Tokyo’s transit system recovers 160 percent of its operating costs from farebox revenue. If one wonders why, part of it is the fact that the cost of living in Japan is half as much as it is in the United States. Might the efficiency of its public transportation services – and presumably many public services like it – be part of the answer?

Fat Employees in Sedentary Jobs

I began my radio interview by pointing out a handful of points. First, 42 percent of the entire U.S. population is obese. This is not overweight. Those overweight have a body mass indicator (BMI) of between 25 and 30. The BMI of those considered obese lies between 30 and 35. (Above that level are those classified as morbidly obese.) When it comes to Americans, more than four-tenths of them are not merely overweight. They are obese. (Our military personnel do better: A recent New York Times article found that more than 40 percent were merely overweight, while only 21 percent were obese.) How secure do these figures make National Bus Trader readers feel?

Obesity for most individuals is different than obesity for operators of public transportation vehicles – and those carrying scores of passengers (on transit, some might be standing – although not nearly as many now that ridership has shrunk). I feel no need to argue or prove that someone obese is more likely to be less alert than someone merely overweight – much less someone not overweight at all – much less someone who exercises regularly and is in decent physical shape. If obese, even when not more sleepy than a healthy person, an obese employee sitting at his or her desk can daydream for five minutes without causing any damage other than a dollop of lost productivity. The same is not true for bus or coach drivers. At 60 m.p.h., during a single second when the driver drifts off – yawning or daydreaming – his or her vehicle has traveled 88 feet.

What this analysis misses is that the nation’s average of 42 percent obese factors in a lot of individuals performing physical work – not a demanding, mundane or boring job performed in a comfortable chair behind a desk and a computer. The percentage of these individuals must be significantly higher than those performing physical work.

A professional driver is not mired in a boring, sedentary job. He or she operates in a tense environment that demands alertness and the rigorous application of training, at every moment the vehicle is in motion. He or she must gaze regularly out the windshield, at windows on both sides of the vehicle, and at five mirrors.

The “rule of thumb” (admittedly not always realistic, and often unnecessary to look at all five mirrors or at both side windows) is to scan all five mirrors every five to eight seconds. As far as defensive driving, in scores of the hundreds of depositions of public transportation drivers I have reviewed since 1989, where drivers were asked to recite the five rudimentary principles of defensive driving, plus the “mantra” (“Always expect the unexpected”), only once did a driver recite (not in the most perfect language) four of the five principles. Most often they recited none. If these drivers could not recall one of the most important components of their training while sitting in a chair, and motivated to remain alert since they were being deposed after a serious incident that was usually partly or largely their fault, why would one expect them to remain alert about such things while behind the wheel, with their vehicle in motion, often at high speeds, often surrounded by traffic, with most of it traveling above the speed limit, in an environment where law enforcement on U.S. roadways began to disappear 40 to 50 years ago (while at the same time, speed limits increased)?

Drivers’ Salaries, Tax Rates and the Cost-of-Living

Compounding this problem has been the expansion of extremes in the distribution of wealth. Former Senator Mitt Romney, whose company I assisted as a consultant in 1995 – helping a Russian company, no less – once gloated that his tax rate was only 15 percent while the rate of his secretary was 30 percent. That was a while ago. Today, until our current president reduces it further, and opens up loopholes that many former presidents (including some Republicans) closed, those with terrific squadrons of attorneys and accountants likely get deductions.

This is not a political rant. This article is about drivers. What does one think their tax rate is? Less than a decade ago, as an expert witness, I encountered bus monitors on school buses earning $7.50/hour, with their drivers earning slightly more. Why then should we be surprised that public transportation has experienced a driver shortage since 1980 (and possibly a slight shortage even before then)? This shortage is still so great in the school bus industry, for example, that paying bus monitors several times more than this, hundreds of routes per day in the worst-run systems (e.g., Washington, D.C.) do not have enough personnel for their buses to leave the storage yards?

When I studied this same shortage, as a consultant, in 2002, the District’s bus monitors were paid $19/hour – and they still could not hire enough. In this environment, can we really expect to weed out the obese driver candidates? What about the merely overweight drivers? What about those out-of-shape? Returning again to drivers’ salaries, 40+ years ago, when the drivers of my paratransit system were paid $7.50/hour as a starting salary, that salary for many of my competitors was $4.25/hour. My haughty staff used to joke about the single hiring question our competitors’ drivers had to answer correctly to obtain this demanding and ridiculously-underpaid job: “Can you breathe?”

Sleep and Driver Assignment

Then there is sleep. Many medical authorities consider a good night’s sleep more important than good nutrition. Yet unlike Canada, the European Union, Australia and perhaps a few other nations I am unaware of, the restrictions on “driver assignment” in America are minimal. In the other nations and continents noted, a motorcoach driver cannot begin a shift more than three hours later or earlier than the shift he or she began the night before. Instead, such drivers can operate their vehicle for no more than 10 hours within a 15-hour span of time, and afterwards, must be off-duty for at least eight hours. To our credit, the FMCSA force-fed the requirement for Electronic Drivers’ Logs (EEOCs) through Congress in 2017.

But still. Off duty does not mean eight hours of sound sleep. In a lawsuit I served as an expert on years ago, a driver who had been off duty for four days (during which time she reverted to a normal, daytime sleep/wakefulness cycle) returned to work, and was assigned to a Cleveland to New York City run that began at 11 p.m. – at the end of which she had been awake for roughly 24 hours. Yet she survived. During the eight hours off duty before she had to drive the return trip, she had to ostensibly conduct a post-trip inspection, walk to the large company’s “dormitory,” have a midnight snack, check in and walk to her room, shower, fall asleep – and after someone knocked on her door to awaken her, she had to have breakfast, walk to her coach, conduct a pre-trip inspection, (presumably) spot or help the passengers on board and take off.

An hour outside the city, she fell completely asleep at the wheel, scraped her coach against a wall and, when it ended, she fell asleep. During this initial hour, when admonished about her wavering, lane-changing operation, she cursed out the passengers in a profanity-filled diatribe that would have made a sailor blush. The attorneys – among the worst for whom I had ever worked – represented 29 of these passengers or their estates (only a small number were killed), and managed to settle the case for something close to $100 million. Needless to say, this driver was described by a few passengers as obese.

Finally, there is Obstructive Sleep Apnea (OSA), a condition that causes individuals with it to experience “mini-sleeps” during the hours when he or she is normally awake. A troubling study of 500 or so truck drivers in Australia during the beginning of the 21st Century found that nearly half of them had OSA. This is a nation whose regulatory structure restricts the hours during which one can drive a commercial vehicle – changes beyond the number of hours during which one would experience “shift inversion” or, as I call it, “bus lag.” Common characteristics of someone with OSA are (a) a thick neck (typically 17 inches or more in circumference) and (b) a body mass indicator (BMI) exceeding 25. If the majority of our professional drivers (trucks as well as buses) are overweight, and many are obese and some morbidly obese, we can be certain that many have Obstructive Sleep Apnea.

Solutions and Dreams

In theory – at least in our society, culture and political arena – there are basic solutions:

– Hire only drivers who are physically fit.
– Pay them a salary enabling them to afford nutritious food and a mortgage on a small house.
– Adapt a driver assignment structure (like that of Canada, the EU and Australia) that prohibits shift inversion (or “bus lag,” as I coined the term in previous National Bus Trader articles more than a decade ago).

These are only starting points. Beyond these minimalist necessities lie a handful of more-unusual approaches or programs, all of which are nearly effortless and/or low-cost amenities:

– Assign drivers according to those hours when they will likely be maximally alert – easy to implement since most drivers will choose these shifts if given a choice – an approach I feel I invented in 1982 (I termed this “bio-sensitive driver assignment”) which I applied throughout the 10 years I directed the operations of my own 70-vehicle paratransit system.
– Outfit the driver’s lounge with exercise equipment, or provide drivers with memberships to fitness centers (membership that will be inexpensive when purchased for a block of members).
– Replace the conventional garbage in any vending machines with more nutritious food (protein bars instead of candy and chips; fruit juice instead of soda). Better still, serve them nutritional food in your cafeteria (practical only for large companies, and at large depots – not necessarily the size of the New York Port Authority Bus Terminal) or pay for their meals at nearby moderate-cost restaurants on the condition that the free-food meal tickets apply only to a select group of foods and drinks – and monitor each restaurant’s compliance with the food selection.
– Particularly where drivers operate on split shifts, provide cots on which they can nap (plus masks to darken the room and shooting-range noise-eliminating headsets).
– Expand the requirements for medical exams to include a determination of whether or not the patient has Obstructive Sleep Apnea, and if so, prescribe and (to the degree possible) monitor the patient’s use of a Sleep Apnea device (including a mask and hose) or, if it works like its recently-introduced TV ad alleges, a less intrusive device named “Inspire.” Also included in this medical examination should be an analysis of any prescription and (less-effective and less-dangerous) over-the-counter sleep medication taken, and guidance as to its usage. Especially important are sleeping pills, which have the unfortunate boomerang that most have long “half-lives” – and as such, the stronger and higher dosage of the medication needed to fall asleep, the more groggy it will leave the patient when he or she is forced to awaken for his or her next shift.
– Provide nutrition advice along with admonitions about when and when not to eat certain things, and when to not eat or drink anything at all. As a rule-of-thumb, eating anything within four hours of retiring not only impedes one’s ability to fall asleep, but fills up one’s bladder during the night as the late-eaten or -drunken food is digested – compromising the quality of sleep, causing the sleeper to arise once or more during the night to relieve his or her bladder, and reducing the amount of deep sleep (known as REM sleep), which occurs at the end of each roughly 90-minute sleep cycle, while the percentage of each successive cycle composed of REM sleep increases. Awakening once or twice during one’s sleep period thus decreases the percentage of total sleep that is composed of Stage IV or REM sleep.

Figuratively as well as literally, it was appropriate to title this section “Solutions and Dreams” – literally because sleep was part of the subject matter, and figuratively because the likeliness of these solutions being implemented in this country are what many call a “pipe dream” – a dream one might have in an opium den.

Shams and Shame

The shams are many – well illustrated by the “old wives’ tales” about ways to stay awake while driving when a bout of fatigue seems to come along. The most worthless advice includes listening to the radio, opening the window or stopping the coach and walking a few laps around it. (Clever drivers tell the passengers that the cooling system is about to overflow, and the vehicle must be shut off for a short while until the cooling system begins to leak or compromise the integrity of the engine.)

Other minimally-ineffective advice that may help in the short run includes drinking coffee or energy drinks. The benefits of coffee, in particular, are problematic because it can take 15 to 20 minutes for the caffeine to enter one’s bloodstream. Only until then does the person wake up – although a coffee drinker’s mind can be tricked by the memory of being more awake brought about by the first sip. Further, when what is really needed is sleep, a semi-remedy like caffeine, sugar (which later creates a “trough” that can make one even more tired than normal), energy drinks and protein bars are a quick fix. The best – for example, two cups (or more available now, albeit expensive) two cans of espresso – may help for a few hours at most. Also, these food-and-drink “crutches” may help carry a sleepy user over until his or her normal sleep/wakefulness cycle reaches a point where one’s body will normally be more awake.

One of the problems about fatigue is that many drivers do not know when they are fatigued, or perhaps do not know how fatigued they really are. Some, or perhaps even most drivers, can “fight through it,” and even when feeling tired, can remain awake enough to keep his or her vehicle on the road and, hopefully, in the lane. The reality is that even those drivers who can “manage” a degree of fatigue are clearly not as alert as they would be if not even slightly fatigued. This state slows down one’s reaction time, and irrefutably blunts one’s memory about safe driver practices – such as rules for, and ways to calculate, a safe following distance for a given speed, much less the critical rudiments of defensive driving.

The true irony about these shams is that there actually is an approach that works for many drivers who can take them: A short nap (often referred to as a power nap) is actually easy to obtain for a motorcoach driver, on a long trip, where passenger preferences translate into rest stops every three hours or so. Instead of dining with the passengers – even with some passengers still on board – a driver can whip on his or her shooting gallery headset and eye mask and catch 20 winks. Upon awakening, a few gulps of that extra thermos of hot coffee (or can of espresso) would further help awaken the driver.

This approach will not work for everyone, and those with long sleep/wakefulness cycles can rarely nap, and if they can, they can rarely do so sitting up. For most motorcoach drivers, such a practice can be a great help. Even without the society-altering changes noted above that are, frankly, nothing but pipe dreams in a country like ours, there are some small, effective things professional drivers can do. Drivers operating split shifts can spend part of their off-hours napping in their cars (if they drove to work), or in a colleague’s car if he or she can find one, and the permission to use it for this purpose.

Otherwise, there is no safe food, beverage or chemical that will stimulate a groggy driver to become an alert, wide-awake driver. Some bad and costly chemicals actually will – cocaine being the best example, and one that works much faster, and is much stronger, than caffeine. Apart from the obvious legal and cost problems with such a “solution,” hours later the user experiences a crash (not a vehicle crash, but a crash of his or her body system). Even apart from the legal and cost implications (much less for someone making a driver’s salary), the numerous short- and long-term problems with such “fixes” are dramatic and dangerous, and obviously have serious long-term detrimental effects on their users. I feel confident that no responsible individual, much less the professional driver of a common carrier, would begin to entertain something so wildly dangerous as cocaine to fend off a bout of fatigue.

The point is, when one needs sleep, the only thing that will truly suffice is sleep.

Apart from the “old wives’ tales” (the shams) and the other short-term remedies that can provide marginal or short-term relief (like caffeine), the shame of it all is the litany of societal changes that would imbue our nation with a cadre of safe, healthy and fulfilled drivers. More of the shame is, of course, that all professional drivers of passenger vehicles are “common carriers,” held to the highest standard and duty of care.