Tommy the trucker gets fruity

If you were asked to name a job associated with healthy living, chances are lorry driving wouldn't be one of the first you would choose. Jeremy Davies on an innovative new scheme that offers lorry drivers at Liverpool docks the choice of fruit rather than fatty foods.

The stereotype of the big-bellied, chain-smoking trucker is a powerful one, and not entirely without foundation, as a team at Sefton Health Improvement Support Service were very aware when they launched Tommy the Trucker — a healthy-living campaign for lorry drivers who work at the Port of Liverpool.

Long-distance lorry driving is stressful and hazardous, according to the research literature. It is associated with fatigue and physical strain, poor diet, high levels of tobacco smoking, inactivity and prolonged exposure to vehicle exhaust fumes — all factors which may contribute to higher levels of fatality through road traffic accidents, respiratory problems, cancers, spinal disorders and heart disease.

A lifestyle survey of 170 lorry drivers, conducted as background to the Tommy the Trucker initiative, found that lorry drivers ate less fruit and vegetables than a general cross-section of men from the Sefton area. They also ate more fat, did less exercise and smoked more.

A massive 37% of the lorry driver sample were obese or morbidly obese, with a BMI greater than 30, as compared with 12% of Sefton's male population. And 71% never took vigorous exercise, as compared with 34% of Sefton men.

According to the support service's senior health promotion specialist Jo McCullough [pictured], who launched the campaign after running a sexual health project called Seafarer Sam for mariners, the nature of lorry drivers' work means it can be very difficult for them to make healthy choices.

'As well as being an essentially sedentary job, it's a unisex profession where the men have prolonged absences from home and family — often they leave on a Monday morning and don't get back till Friday night. It can be really hard for them to access lifestyle information, health and leisure services, maintain a healthy diet and participate in regular physical activity,' she says.

Eating a healthy diet can be a particular challenge. The survey showed that nearly a third (29%) of the drivers totally excluded fruit and vegetables from their diets.

Drivers claimed a major factor behind this low intake was the unavailability of fresh fruit and vegetables while out on the road. 'People don't realise that most of the time lorry drivers can't even nip to a supermarket to stock up on food, because there's nowhere for them to park. They're stuck with motorway service stations and other roadside outlets, where fruit is often unavailable, expensive or of poor quality,' says Jo.

One of the results of the initiative has been that more fresh fruit is available. A new vending machine has been installed at Seaforth Container Terminal as part of the Eat 5 A Day the Sefton Way project, supported by South Sefton Primary Care Trust and the Big Lottery Fund.

Baskets with fruit costing just 20p per piece are now available, subsidised by the project, at the port café; and the primary care trust has bought a baked potato machine and has run healthy eating cookery demonstrations for catering staff, who now offer at least one healthy option every day.

The project has not just been about healthy eating, though. One of the big challenges when working with lorry drivers, in common with many other 'masculine' professions, is the prevailing macho culture.

Back problems are common among lorry drivers because they tend to jump, rather than step, out of their cabs, for example, says the service's men's health nurse Gareth Lewis — because that is how 'real men' are supposed to do it.

Nearly half the drivers (48%) described themselves as worried about their health — with their weight and lack of exercise being the most commonly cited concerns. But other issues mentioned included everything from back pain to coronary heart disease risk, psoriasis and diabetes.

'These guys really do have a lot to cope with. They're away from home and in stressful jobs, having to get to places in time, being stuck in traffic jams, sleeping in the cab, the office radioing them all the time — and in between all that, they have a lot of time on their own, to worry about things like their health,' says Jo.

'If they do think they've got something wrong with them, when do they get to see a GP, if they're travelling round the country all the time?'

In recognition of this sense of isolation, the Tommy the Trucker team produced a 12-page A5 booklet of healthy lifestyle advice for lorry drivers, and distributed it to 12,000 drivers passing through the port. The booklet, written in a jokey, accessible style, covered everything from healthy eating and exercise to stress, smoking cessation, alcohol, safer sex and testicular and prostate cancer, providing straightforward advice and helpline numbers.

Jo stresses that, despite some initial reluctance, the men were surprisingly keen to talk about their health concerns when approached by the survey team: 'At first some of them thought we were selling insurance or something, but actually they were very forthcoming and seemed to really value the opportunity.'

Mark Edwards, group transport manager at Widnes haulage company O'Connor and Sons, says initiatives like Tommy the Trucker have helped raise the drivers' self esteem, which has traditionally been low because 'they've been treated like second-class citizens'.

'Our drivers are more aware of how to look after themselves and what they should be avoiding, and that can only be a good thing,' he says.

Hopefully attitudes like that expressed by one driver — who told the team that 'everyone would think I'm a pouf if I had a salad in the port café' — are now changing. And next on the agenda, says Jo, is to set up a gym facility at the port, and to persuade haulage companies to buy the drivers cool boxes so they can keep food fresher for longer.

'It's so important for projects to take their lead from what the men themselves want, and if we can get the necessary agreements and funding we should be able to make an even bigger impact on their long-term health.'

• For further details contact: Gareth.Lewis@southsefton-pct.nhs.uk or call him on 07879415453.
• This article first appeared in MHF Magazine.