Guseva Canu Irina, Remy Viviane Fiona Mathilde
Department of Occupational and Environmental Health, Unisanté, University of Lausanne.
Environ Health Prev Med. 2025;30:57. doi: 10.1265/ehpm.25-00127.
Only prospective cohort studies can capture changes in work conditions and their effects on health. Such studies are rare in bus drivers, despite their high rates of injuries and diseases. The three existing cohorts have limited exposure data, collected at baseline and thus uninformative on exposure and exposure-effect dynamics. Therefore, we aimed to develop the Swiss Transport Personnel Health Cohort (TRAPHEAC) and to anticipate and prevent potential bias.
To set up the study protocol, we first organized the stakeholder consultation and available data inventory. Second, we mapped the exposure-outcomes pairs to list the most prevalent occupational hazards, and conducted exposure measurement campaigns. Third, we built the Swiss Bus-Exposure Matrix for physical-chemical hazards and Bus-Ergonomics Matrix for visual and biomechanical constrains. These matrices contain 705 bus models operated in Switzerland since 1980 and enable assessing current and past exposure when merged with bus drivers' work histories.
We opted for an original study design combining prospective cohort part starting at 2024 and a retrospective part with nested case-control studies. Bus drivers will be invited through three complementary channels: unions, companies, and social media. The eligibility screening, information, and consent form signature and registration will be conducted using the study web-site modules. Registered bus drivers will first receive a comprehensive inclusion questionnaire, then a yearly follow-up questionnaire to assess and update the drivers' work histories. Validated self-reported questionnaires will be used for assessing additional health outcomes (e.g., stress, sleep problems, musculoskeletal disorders, burnout) and individual, occupational and live-style related factors (e.g., personality, ICT use, physical activity). Hospital records (with diagnosed diseases, diagnosis dates and treatments) centralized since 2000 by the Swiss Federal Statics Office will be used for assessing disease prevalence, incidence and case-control status. Advanced statistical analysis will be conducted to address etiological and methodological questions (e.g., individual and joint causal effects of multiple exposures and exposure components; time-varying exposure and outcome variables and confounders mixtures).
The yearly assessment of both exposure and health outcomes should enable capturing changes in work conditions and their effects on bus drivers' health and well-being over time and facilitate the tailoring, implementation and evaluation of preventive interventions.
只有前瞻性队列研究才能捕捉工作条件的变化及其对健康的影响。尽管公交车司机的受伤和疾病发生率很高，但此类研究在公交车司机中却很少见。现有的三个队列研究的暴露数据有限，这些数据是在基线时收集的，因此对于暴露及暴露-效应动态变化情况并无参考价值。因此，我们旨在建立瑞士运输人员健康队列（TRAPHEAC），并预测和预防潜在偏倚。
为制定研究方案，我们首先组织了利益相关者咨询和现有数据清查。其次，我们梳理了暴露-结局对，列出最常见的职业危害，并开展了暴露测量活动。第三，我们构建了物理化学危害的瑞士公交车暴露矩阵以及视觉和生物力学限制的公交车工效学矩阵。这些矩阵包含自1980年以来在瑞士运营的705种公交车车型，与公交车司机的工作经历相结合时，能够评估当前和过去的暴露情况。
我们选择了一种原创性的研究设计，结合从2024年开始的前瞻性队列部分和带有巢式病例对照研究的回顾性部分。将通过工会、公司和社交媒体这三个互补渠道邀请公交车司机。资格筛选、信息提供、同意书签署和登记将使用研究网站模块进行。注册的公交车司机首先将收到一份全面的纳入调查问卷，然后是一份年度随访调查问卷以评估和更新司机的工作经历。经过验证的自我报告问卷将用于评估其他健康结局（如压力、睡眠问题、肌肉骨骼疾病、职业倦怠）以及个人、职业和生活方式相关因素（如性格、信息通信技术使用情况、体育活动）。自2000年以来由瑞士联邦统计局集中整理的医院记录（包括确诊疾病、诊断日期和治疗情况）将用于评估疾病患病率、发病率和病例对照状态。将进行高级统计分析以解决病因学和方法学问题（如多种暴露和暴露成分的个体和联合因果效应；随时间变化的暴露和结局变量以及混杂因素组合）。
对暴露和健康结局的年度评估应能够捕捉工作条件的变化及其随时间对公交车司机健康和福祉的影响，并有助于预防干预措施的定制、实施和评估。
