Truckers' health focus of Mayo doctor's study

Dr. Clayton Cowl
Dr. Clayton Cowl talks about the trucker lifestyle Tuesday, Oct. 9, 2012. New federal rules will require truckers to get medical clearance from doctors who have been certified to do their occupational exams. Cowl, a doctor at Mayo Clinic, decided to get his trucking license so he have a better idea of what his patients' needs are.
Alex Kolyer for MPR News

When many people think of truck drivers and their lifestyle, they likely envision someone who sits a lot, eats loads of unhealthy food and consumes too many soft drinks.

They'd be right. Too often, grabbing a quick bite on the road often means eating high calorie, salt- and sugar-laden food at a truck stop, fast food chain or convenience store. On top of that, for too many truckers, hours of driving leave little time for exercise.

As a result, some drivers suffer medical emergencies on the road, including heart attacks and excessive drowsiness. To reduce trucking accidents such emergencies cause, new rules from the Federal Motor Carrier Safety Administration will soon require commercial drivers to undergo medical exams from health professionals it has certified to perform physicals designed to identify conditions that could pose a hazard while driving.

A 2007 study by the Journal of the American Dietetic Association found that 86 percent of truckers were overweight; of those, 66 percent were obese.

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Research suggests that health problems, a poor diet and a lack of physical activity can contribute to accidents.

The new rules, which take effect in 2014, aim to reduce medical emergencies on the road by making health evaluations more rigorous. For some truckers with serious health problems, however, the new rules could make it tough to renew their licenses.

But the regulations are also an opportunity to help truckers make healthier lifestyle choices, said Dr. Clayton Cowl, who has an occupational medicine practice at the Mayo Clinic in Rochester, Minn. His patients include unhealthy truck and bus drivers, some of whom struggle with obesity, high blood pressure, diabetes and other dangerous conditions related to their lifestyle.

Dr. Clayton Cowl
Dr. Clayton Cowl reviews the health record of trucker Tom Gilbertson, 57, of Byron, during an exam on Nov. 15, 2012. In an attempt to reduce trucking accidents, new federal rules will soon require commercial drivers to get their medical exams from certified health care providers.
MPR photo/Lorna Benson

"With excessive weight comes things like sleep-related disordered breathing such as obstructive sleep apnea which then can cause excessive sleepiness during the day," Cowl said.

The new rules will require commercial drivers to receive thorough exams every two years from health professionals like Cowl, who practices in Mayo's Division of Preventive and Occupational Medicine and Internal Medicine. Truckers would undergo the exams every two years or more frequently if they have health problems.

Under the new rule, providers will have to report every trucker exam they perform to a federal database, to discourage truckers from doctor shopping.

Cowl hopes the new regulations will revolutionize the trucking profession by giving truckers an incentive to take better care of themselves and leading truck stops and other businesses that cater to truckers to offer healthier food and more exercise opportunities.

Dr. Clayton Cowl
Dr. Clayton Cowl checks the hoses on a truck before he drives it Tues. Oct. 9, 2012. New federal rules will require truckers to get medical clearance from doctors who have been certified to do their occupational exams. Cowl, a doctor at Mayo Clinic, decided to get his trucking license to have a better idea of what his patients' needs are.
Alex Kolyer for MPR News

The changes could also encourage doctors to help patients who drive trucks develop strategies that will allow them to live healthier lives on the road, said Cowl, who teaches doctors how to comply with federal medical requirements for truck drivers. That's important said Cowl, who holds a commercial truck driver's license.

"Before I tell someone how to do their job I want to be able to physically walk the talk and have some street credibility," he said recently from behind the wheel of a borrowed semi-tractor trailer.

Cowl is the first to admit that his truck driving skills need more practice and that sometimes his shifting isn't smooth.

But he thinks his time on the highway has paid off in his medical practice.

"When I talk to my patients now that drive you know I don't just say, 'Do you drive a truck?' I say 'Oh, do you drive a reefer van or dry van? Are you a tanker yanker?' And all of a sudden there's a bond there," he said. "They go, 'Wow, this guy actually knows something about what I do.'"

At his clinic office in downtown Rochester, Cowl trades in his work gloves for a stethoscope to examine patients like 57-year-old Tom Gilbertson of Byron, Minn., who has been driving truck for more than three decades.

After years of long-haul work early in his career, Gilbertson now drives a cement truck, which allows him to go home to his family every night. Unlike a lot of truckers, Gilbertson is not overweight and he appears to be in good health. He has suffered from an irregular heart beat and sleep apnea in the past. But both conditions have been treated and are under control, so Cowl approves Gilbertson's medical report for another two years.

Some truckers could find the extra health scrutiny troubling since their livelihood is on the line, but Gilbertson isn't bothered by it.

"There ain't nothing wrong with it," he said of the rule. "I guess whatever it takes to keep us safe on the highway, that's the main thing and keep us from crazy people out there."