Felipe Pereira Rocha1; Frida Marina Fischer2; Claudia Roberta de Castro Moreno1,3
The organization of truck drivers’ work underwent considerable changes in recent years, with outsourcing, irregular shifts and extended working hours as some of its characteristics. Poor work organization has serious consequences for the health of workers, as shown by several scientific studies. In this essay we discuss the consequences of recent transformations in the organization of work, particularly the laws that regulate the activity of truck drivers in Brazil. We also point to the need for an intersectoral policy able to articulate the various public policies for the protection of this significant professional category.
Keywords: occupational health; intersectoral collaboration; outsourced services; public policy.
A organização do trabalho de motoristas de caminhão tem se modificado intensamente nos últimos anos. Vêm sendo observados a terceirização das atividades de trabalho, o uso de escalas irregulares e longas jornadas de trabalho. As consequências da má organização de trabalho à saúde dos trabalhadores são severas, conforme demonstram diversas pesquisas científicas. Neste ensaio, discutem-se as consequências das recentes transformações ocorridas na organização de trabalho, particularmente na legislação que regulamenta as atividades de motoristas de caminhão em território nacional e a necessidade de uma política intersetorial capaz de articular as diversas políticas públicas voltadas para a proteção dessa importante categoria profissional.
Palavras-chave: saúde do trabalhador; colaboração intersetorial; serviços terceirizados; política pública.
OUTSOURCING IN THE CONTEMPORARY WORLD
In the contemporary world, occupational health is strong influenced by various conjunctural aspects, among which considerable transformations in the organization of work. The ideals of the neoliberal economic model made significant advances, especially during the 1990s, as a function of globalization, resulting in the strengthening of intercontinental capitalist relationships between central and peripheral countries1-4. Within this context, neoliberal policies had negative impact on public health. At the population level, for instance, some studies reported greater inequities in health, which account for the increase in social inequality and of the poverty indices. The same is the case of occupational health, as shown by the proliferation of insalubrious work environments, work accidents and diseases and extended working hours, among others2-5.
The greater precariousness of the labor relations, partially resulting from production restructuring, led to the loss of labor rights, such as the thirteenth salary and vacation pay. These factors contribute to increase the exposure to environmental hazards and occurrence of work accidents. Outsourcing made the situation even worse, by aggravating the precariousness of work and its consequences4,6-8.
Outsourcing is a form of subcontracting derived from changes in the labor relations. It serves the interests of the hirer via reduction of employee benefits and effective manpower and transfer of responsibility, mainly for the prevention of environmental hazards, to smaller companies6. In Brazil, outsourcing is not restricted to non-essential activities (cleaning, food) but has begun to extend to the ones considered to be essential to the production process. In this regard, the National Congress recently passed a new labor reform, which made outsourcing of the main activity of companies legal. This decision puts the physical integrity of workers at risk, as concerns work accidents and disease, in the short and medium run7-9.
The consequences of the transformation of the organization of work resulting from neoliberal policies, the greater precariousness of labor relations, and outsourcing in particular, are evident among many different labor categories. Truck drivers are one example. Several publications evidenced the consequences of many months and years of work for the health of professional freight drivers10-12.
Outsourcing in this category leads to a variety of employment relationships within one and the same company, as shown by Silva et al.12. In their study, these authors identified four different types of employment relationship: permanent employees, contractors, outsourced and fourth-party service providers. Outsourced drivers are hired by a company that provides services to a shipping company and do not have any formal relationship with the latter. Fourth-party are self-employed workers who provide services with no employment relationship whatsoever. Contractors are self-employed drivers enrolled with a shipping company, without any employment relationship with the latter. In this modality, drivers who own their own truck agree to provide services exclusively to the hirer. As a result, the trailer is property of the company and the tractor of the driver. Shortly, the various types of employment relationship have both advantages and disadvantages, which directly influence the working conditions, ability to meet deadlines, autonomy to choose the best routes and monthly pay, among other aspects.
REPERCUSSION OF THE ORGANIZATION OF WORK FOR TRUCK DRIVERS
The work schedule of truck drivers show they are subjected to regular and irregular shifts. Irregular, including night, shifts are harmful to health for causing several disorders, such as disturbs of the circadian rhythm, sleep-related diseases, excessive daytime and night-time sleepiness and larger numbers of road accidents, among other negative consequences for health and performance at work11-13.
Use of both legal and illegal substances during the working hours is a recurrent phenomenon, which harms health as a whole. These substances are used as a function of the need of drivers to remain awake to meet deadlines and thus get a better pay11-13. In this regard, several recent studies reported frequent consumption of amphetamines, crack, alcohol, stimulants and cocaine, among others12,13. In the study by Leopoldo et al.11, performed with 535 truck drivers in the state of São Paulo, 67.3% of the participants reported to have consumed alcohol in the past 30 days. Many reported multiple drug use, most commonly energy drinks, amphetamines, tobacco and cocaine.
Diet imbalance, characterized by calorie-rich foods with little nutritional value, is frequent among truck drivers and contributes to increase the prevalence of overweight and obesity among this professional category14,15. The association of shift work and overweight and obesity is a significant risk factor for development of chronic degenerative metabolic diseases, such as hypertension, diabetes mellitus and dyslipidemia16. A study conducted with 262 truck drivers in the United States found that 66.4% of 115 blood samples exhibited low high-density lipoprotein (HDL) levels and 23.4% the lower desirable limit, which point to high risk of atherosclerosis. The vast majority of the participants, 80%, met two to four criteria for diagnosis of cardiovascular disease (including metabolic syndrome) such as high blood sugar, abnormal (systolic or diastolic) blood pressure, low HDL and elevated low-density lipoprotein (LDL) levels, among others17,18.
Diet imbalance also contributes to an inadequate body mass index, as shown by Moulatlet et al.19 Relative to a sample of 470 drivers, the odds of developing hypertension were 4.2 times higher among the overweight and obese ones. In their study, Marqueze et al.16 found higher systolic and diastolic blood pressure average values among the drivers who worked irregular shifts, as well as higher serum total cholesterol and LDL levels. These findings reinforce the hypothesis that the exposure of truck drivers to irregular shifts along life might contribute to increase their risk for cardiovascular diseases.
Several studies suggest that exposure to precarious road conditions combined with extended working hours has also impact on the psychological health of drivers. In the study by Ulhôa et al.20 with 460 truck drivers, the prevalence of minor psychiatric disorders was 6.1%. The stressors most frequently reported were traffic congestion, tracking control and extended working hours.
Another source of concern for drivers is the safety conditions during the performance of work, as observed by Moreno and Rotenberg10. Drivers reported fear of aggression by robbers and of the truck being stolen. It should be observed that in the latter case, vehicle insurance cannot be collected when the truck is not property of the company, but only for the stolen cargo. The insecurity resulting from this situation probably contributes to increase occupational stress.
The aforementioned study by Ulhôa et al.21 further detected several other factors that might influence occupational stress: low job satisfaction, number of years in the job and short sleep time. All these factors are positively correlated with the stress hormone cortisol. The cortisol levels were found to be elevated on workdays, which denotes positive stress response on these days. Interestingly, irregular daytime and night shifts had negative influence on the blood glucose and cholesterol by comparison to regular shifts.
We also call the attention to the need for adequate quality of rest areas at both company headquarters and on the road. Several studies showed that not all shipping companies provide adequate on-site rest areas, while truck drivers only find improper and unsafe rest, food and toilet facilities on the road12,22,23. These aspects of the organization of truck drivers’ work impair the quality of sleep and increase the occurrence of sleepiness during working hours. In a study conducted with 1,500 truck drivers, 62.3% of the sample exhibited scores indicative of poor sleep quality24. In another study with 335 participants, almost half (48%) of them reported an episode of excessive sleepiness in the past month25.
NEED TO IMPLEMENT AN INTERSECTORAL POLICY FOR TRUCK DRIVERS
Neoliberal policies introduced changes into the organization of work most of which mainly serve the interest of capital at the expense of the interests of workers4-8. Truck drivers fit well within this context, since they have to cope every day with the consequences of the deterioration of their work environment and the loss of rights gained after many years of struggle. In addition to deadlines, drivers must cope with the poor conditions of the state, and especially of the federal highways, high toll rates and unsafety, among other aspects.
In this regard, article 235-C item 4 of the recently passed Law no. 13,103, from 13 March 2015, known as the new truck drivers’ law26, establishes that the rest area for long haul trips (driver more than 24 hours away from headquarters) is within the truck itself or locations with adequate conditions for resting. Examples are lodging facilities provided by employers, hirers, shippers, recipients, etc. Thus the need for adequate rest areas for truck drivers achieved the status of law in Brazil.
However, Law no. 13,103/2015, which replaced Law no. 12,619/2012, also reversed benefits relevant for the health and safety of truck drivers26-28. Among the most significant ones: extension of the daily working hours from 10 to 14 and of the consecutive working hours from 4 to 5,5; when two drivers are present, they must rest on a sleeper cab, with the vehicle in motion instead of parked at a - safe and adequate - place, as established in the previous law; drivers are granted not necessarily consecutive 11 rest hours per 24-hour workday on sleeper cabs, etc.
While Brazil is a signatory to the International Labor Organization Convention C153, the law in force does not comply with its recommendations, which explicitly state that drivers should not be allowed to drive continuously for more than four hours without a break. In turn, ILO Recommendation R161 indicates that the normal hours of work should not exceed eight per day and 40 per week29,30. As can be seen, the Brazilian legislation ignored the scientific evidence for and international recommendations on the health and safety of truck drivers. The organizations responsible for protecting workers’ benefits and rights, such as National Coordination of Workers’ Health and National Workers’ Health Integral Care Network, trade unions and society at large should be listened mainly as concerns the formulation and implementation of intersectoral policies for prevention of accidents and other events affecting the health of workers.
According to Cavalcanti et al.31, intersectorality involves the articulation of several public policies for protection of a given population as concerns its fundamental social needs. Such set of actions seeks to fill gaps left by fragmented isolate public policies and thus optimize solutions to satisfy the social needs of the population.
Junqueira et al.32 observe that public policies are too fragmented and unarticulated. According to these authors, intersectorality seeks to articulate a wide variety of information, perceptions and experiences related to the development of ideas aiming at formulating solutions to social demands which reflect the reality of a given group of people no matter its complexity. The result is holistic and subjective actions centered on minimizing social exclusion. Nascimento33 corroborates this notion upon calling the attention to the potential of intersectorality as a relevant tool for the application of previously inefficient sectoral policies. Thus it provides opportunities to combine the technical knowledge of the various professionals involved.
As concerns truck drivers, there is not yet any efficient intersectoral policy able to preserve cohesion within the work-health-social security triad, as illustrated in Figure 1. Contrariwise, when applied to practice, the public policies in vigor are shown to have an extremely narrow focus and to be alien to the actual needs of truck drivers given the complexity of their job activities.
Truck drivers are essential to the Brazilian economy. This professional category is charged of the transport of a wide diversity of goods all across the country. As such, it deserves more recognition and respect, while the government must ensure dignified working conditions, compatible salaries and adequate working hours. Society at large and workers’ representatives need to mobilize to ensure that their rights are respected and preserved, in addition to the formulation of new public policies targeting the protection and safety of this professional category.
Several Brazilian and international studies point to the need for urgent changes in the organization of these professionals’ work to improve their safety and quality of life. The replacement of Law no. 12,619/2013 by Law 13,103/2015 was a step backward, inasmuch as the latter allows extending the working hours and consecutive working hours and reduced the time for rest, among other changes. Evidently, the available literature was not taken into account, as it recommends not extending the working hours without an adequate number of breaks and rest time.
Mobilization of society at large and its representatives is relevant as concerns the formulation of intersectoral policies for truck drivers. Lack of a nationwide efficacious intersectoral policy hinders the strategic planning of public policies for this category, and thus impairs the articulation of interventions to improve the organization of work. As a result, the working conditions of truck drivers should be seen as a national public health problem.
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27 de Fevereiro de 2018.
Aceito em 14 de Maio de 2018.
Fonte de financiamento: nenhuma
Observação: a coeditora chefe Frida Marina Fischer não teve participação no processo editorial de avaliação do artigo