Health perception and physical activity level profile of bus drivers of urban public transportation in Chapecó-SC

Introduction Urban public transportation workers are of great social importance in cities. Working conditions can negatively affect the workers’ health, causing illness and loss of quality of life. Objectives To analyze the perception of health and level of physical activity of bus drivers in urban public transportation in Chapecó, state of Santa Catarina. Methods This study was characterized as descriptive, cross-sectional and field. It was carried out with 46 bus drivers, both genders, aged between 21 and 59 years. An anamnesis form was applied to characterize the participants and to assess the level of physical activity, the reduced International Physical Activity Questionnaire version VIII was used. The research took place in August and September 2021. Data analysis was performed descriptively, using means, standard deviation, relative and absolute frequency. Results There was a prevalence of 91.30% of practitioners of physical activity The perception of health considered good was 71.74%, being associated with the absence of chronic diseases. The predominant level of physical activity was physically active (63.05%). Conclusions The vast majority of bus drivers presented a good perception of health, practiced physical activity, considered their work activities to be good and mentioned not taking medication for the treatment of chronic diseases.


INTRODUCTION
Public transport has become increasingly important socially and economically as urbanization grows continuously, transporting millions of passengers who depend on it to meet their basic needs. 1 It is of significant importance that operators behave in a way that enables them to perform this essential service to the population.Some poorly executed actions in this work can endanger not only the drivers' lives, but also the lives of many people. 2he transportation of passengers accounts for around 70% of motorized transport in Brazilian cities, and buses are almost exclusively responsible for commuting. 3Workers in this industry have both a macro-and a micro-workplace, namely the traffic and the bus.Given these particular features, no other professional is subjected to the pressures of the road environment as much as bus drivers. 4n addition, bus drivers are bound to an unhealthy working routine, with long working hours, requiring constant attention, irregular meal times, the risk of accidents, sedentary lifestyles, repetitive movements, altered vision, emotional stress, among others. 5,6Therefore, drivers' lifestyle and working conditions have been a cause for concern among employers because, in addition to factors within the organization, they need to think about their health, that is, their diet, exercise, and well-being, as these are determinants of their quality of life inside and outside their workplace. 5,7owever, advances in technology have allowed people to have easier access to machines and material goods, placing exercise on a secondary level, in addition to a variety of eating habits with a higher intake of saturated fats and sugars. 8hese conditions therefore lead to the emergence of chronic noncommunicable diseases such as hypercholesterolemia, type-2 diabetes mellitus, obesity, cardiovascular diseases, and hypertension. 9his raises questions about the quality of life of bus drivers, yet only a few studies are referenced in the literature, especially when it comes to the health and lifestyle of this group of professionals. 10 For these reasons, this study aimed to analyze the perception of health and the level of exercise of urban public transport bus drivers in the municipality of Chapecó, SC, Brazil.This study included 46 bus drivers of either sex, between 21 and 59 years old, out of 161 bus drivers from an urban public transport company in Chapecó (Figure 1).These drivers filled in an anamnesis form to assess their overall health and rest conditions.

METHODS
The International Physical Activity Questionnaire (IPAQ) short form 8, validated by Matsudo et al. 11 was used to assess the level of exercise.It includes 5 classification criteria on the level of exercise, namely sedentary, insufficiently active A, insufficiently active B, active, and very active. 12rior to data collection, a video introducing the investigators was sent to the study group to explain the objectives and justify the importance of carrying out this study.The anamnesis and IPAQ were then applied using a Google Forms ® form, which was provided through the company's social networks for communication with their employees, or printed out for each participant.The investigators contacted the study group through a social network (WhatsApp ® ), which was administered by the company's human resources department.The questionnaire was collected during August and September 2021.
The data were analyzed descriptively, using mean, standard deviation (SD), and relative and absolute frequencies.All data were analyzed using Excel ® for Windows, version 365.

RESULTS
The study included 46 urban public transport bus drivers in the city of Chapecó, SC, Brazil.The average age was 37.1 years (SD 10.0), and the mean time working as a bus driver was 89.2 months (SD 107.1).The drivers' perception of their exercise levels was 91.30%, who reported having exercise routines, as shown in Table 1.
Table 2 shows the results of the drivers' quality of life, showing that 91.30% of the participants had no chronic illnesses, their current health perception was considered good (71.74%) and their stress level was considered moderate (67.39%).
Table 3 shows the results of exercise levels and sedentary behavior, which 36.96% of participants were considered as active.This result is similar to stratification per sex, which shows that 50.00% of women and 36.36% of men are considered active.

DISCUSSION
This study analyzed the perception of health and exercise levels of urban public transport bus drivers in the municipality of Chapecó, SC, Brazil, and found that the participants had a good perception of their health and work activities, had a moderate level of stress, had no chronic diseases, and were considered physically active.
Similarly, Garbaccio & Pereira 13 assessed the self-perception of health of urban bus drivers and corroborated the findings of this study concerning chronic diseases, finding that of the 324 bus drivers analyzed, 80.3% reported having no chronic diseases.In addition, 72.8% of these drivers defined their health as good, thus similar to our findings.
In this respect, Prado 14 found that 55% of 322 drivers from Aracajú, SE, Brazil, were also happy with their health.Equally, Moura-Neto & Silva 15 found that 54.1% of 225 drivers assessed in Pelotas, RS, Brazil, reported good health.
A total of 76.09% of drivers rated their work activities as good.It corroborated the findings of Moura-Neto & Silva, 15 who investigated the diagnosis of working conditions, health, and lifestyle indicators of public transport workers in Pelotas, RS, Brazil, which 92.80% of drivers responded positively when asked if they were happy with their jobs.Compared to the findings of this study, Garbaccio & Pereira 13 found that 95.10% of drivers were happy with their jobs and were satisfied with all aspects investigated (management; their jobs; colleagues; passengers).
The data obtained in this study showed that 67.39% of drivers reported a moderate level of stress symptoms.Thus, urban bus drivers are among the most stressful occupations in Brazil, due to a number of traffic-related and customer support issues. 16lmeida 17 evaluated 20 private drivers, 20 taxi drivers, and 20 bus drivers in Recife, PE, Brazil, and found that 36.90% of bus drivers had the highest stress levels.Similarly, Tavares 18 found that 34.3% of the 134 drivers in Uberlândia, MG, Brazil, had symptoms of stress.Finally, of the 322 bus drivers studied in Aracajú, SE, Brazil, 46.89% showed some level of stress. 19s for the level of exercise, this study found that 36.96% of respondents reported to be physically active.However, Prado 14 found that 77% of the drivers assessed did not meet the recommended levels of exercise.Garbaccio & Pereira 13 also found that 50.60% of the 324 drivers were completely sedentary on weekdays.This can be explained on the grounds that there is a negative correlation between exercise and stress, indicating that the lower the exercise level, the more likely bus drivers are to experience stress peaks. 19hile drivers in Chapecó are physically active, they also experience a moderate level of stress, differently from what has been observed in other regions.
We had limitations during the course of the study.One of these was the pandemic, during which it was not possible to collect the answers via a printed form due to the guidelines for fighting against COVID-19, which required the answers to be collected online.Also, some employees showed no interest in answering the questionnaire, some claimed they had difficulty to understand the questionnaire because it was online and some claimed they had no time to fill in the form because of their short breaks.Furthermore, it is possible that respondents who chose not to complete the questionnaire had worse health conditions and exercised less.However, this does not mean that the sample is unrepresentative of the population of bus drivers in Chapecó, nor does it exclude judiciousness in the choice of assessment instruments, their application, and analysis.
Further studies should be conducted to explore aspects aimed at health promotion for these workers, encouraging changes in their habits and behavior, and introducing exercise programs to improve the quality of life of bus drivers.

Table 1 .
Profile of public transport bus drivers in Chapecó, SC, Brazil SD = standard deviation; M = mean; n = absolute frequency; np = number of participants.

Table 2 .
Quality of life of urban transport bus drivers in Chapecó, SC, Brazil SD = standard deviation; M = mean; n = absolute frequency; np = number of participants.

Table 3 .
Data on the exercise levels and sedentary behavior of urban transport bus drivers in Chapecó, SC, Brazil SD = standard deviation; M = mean; n = absolute frequency; np = number of participants.