The fitness-to-drive of shift-work taxi drivers with obstructive sleep apnea: An investigation of self-reported driver behavior and skill

The aim of this study was to investigate the effects of different work shift types and obstructive sleep apnea (OSA) risks on taxi drivers' driving behavior and driving skill. A total of 178 male professional taxi drivers participated in the study. The participants were asked to complete a questionnaire that included demographic information, the STOP-Bang questionnaire, the Epworth Sleepiness Scale (ESS), the Driver Behavior Questionnaire (DBQ) and the Driver Skill Inventory (DSI). Factor analyses of the DBQ and DSI resulted in four-factor and three-factor solutions, respectively. The factors of the DBQ included 'aggression', 'violations', 'lack of concentration' and 'memory lapse'. The factors of the DSI were 'safety consciousness', 'technical driving skill' and 'risk perception'. To test the differences and interaction effects of shift types and OSA on the behaviors and skills of taxi drivers, Bivariate correlation analysis and Analyses of Covariance were conducted. According to the results, the impacts of OSA on taxi drivers' daily driving behaviors were concentrated in two areas: memory lapse and risk perception. Moreover, the driving skills of OSA high risk drivers were generally worse than OSA low-risk drivers. Among day shift drivers, OSA significantly affected memory lapse and risk perception in daily driving processes, and drivers with high OSA risk exhibited more aggressive driving than drivers with low OSA risk. Moreover, among night shift drivers, OSA high-risk drivers presented fewer aggressive driving behaviors and more episodes of decreased concentration than their low OSA risk counterparts. (C) 2017 Elsevier Ltd. All rights reserved.