The Australian National Standard for rail workers five years on

Abstract

BACKGROUND: Following the introduction of the National Standard for Health Assessment of Rail Safety Workers, RailCorp train drivers were found to have levels of obesity and hypertension greater than the Australian population prevalence. Cardiovascular risk factors and conditions were the most prevalent health issue and had the greatest impact on fitness for duty. AIMS: To determine whether there has been a change in the prevalence of health conditions in train drivers 5 years after the introduction of the Standard. METHODS: A file review was conducted of all RailCorp drivers and driver recruits assessed between 1 February 2009 and 31 January 2010. RESULTS: The files of 1094 subjects were reviewed. The proportions of drivers with systolic blood pressure ≥140 mmHg (35% in 2004/05; 22% in 2009/10, P < 0.001), total cholesterol ≥5.5 mmol/L (39%; 32%, P < 0.001) and who smoked (25%; 20%, P < 0.01) all decreased significantly. The proportions of drivers who were obese (40% in 2004/05; 47% in 2009/10, P < 0.001) and who had diabetes (7%; 11%, P < 0.01) and pre-diabetes (2%; 5%, P < 0.001) all increased significantly. CONCLUSIONS: The rate of increase of obesity in drivers is similar to the general population and is also observed in recruits. Increases in the prevalence of diabetes and pre-diabetes are likely to reflect the increased prevalence of obesity and the impact of regular screening. These were offset by improvements in systolic blood pressure, total cholesterol and smoking status, with a neutral overall effect on cardiac risk score.