Truck driving is one of the country's most dangerous jobs, with tens of thousands of injuries and hundreds of deaths each year.

Shirley James says husband Lonnie Cutberth was constantly being called back out onto the road. He died of a massive heart attack while driving in April 2001. 'The coroner said it was a miracle he got that truck off the highway without killing somebody,' Mrs. James said.

Nearly 1,000 U.S. truck drivers died on the job last year – one-sixth of all worker deaths, according to federal statistics.

It isn't the deadliest job – professional fishermen and logging workers die at much higher rates. But for every 100,000 truckers on the road, 29 die. That compares with four out of 100,000 for all workers.

The toll doesn't count drivers who, in a high-pressure, physically taxing job, work themselves to early deaths from heart attacks, strokes and other health problems. And the mechanisms in place to ease that pressure, some experts say, fail to protect truckers – and in turn, the drivers with whom they share the road.

"I believe that the stress on the body of running a 24-7 operation with chaotic schedules that never become routine is the major contributor to all this disease," said John Siebert, project manager for the Owner-Operators Independent Drivers Association Foundation. "Truckers will say they learn to live with it, but it's actually killing them a little at a time, and they are dying at a tragically younger age than the rest of society."

Deadly profession

Shirley James of Lewisville said she can't count the number of times her trucker husband would "barely walk in the door before the company he contracted with would be calling to tell him they had another load."

Her husband, Lonnie Cutberth, promised the company that he could haul one more load to Little Rock in April 2001. They were counting on him, Mrs. James remembered him saying, even though he did not feel well.

Despite his wife's urging to stay home and rest, Mr. Cutberth delivered the load on schedule and headed back home. Calling from the road, he told his wife he didn't feel well. In his last call, he said he was going to pull over and rest. He signed off with the usual "I love you."

Minutes later, Mr. Cutberth had a massive heart attack. He managed to pull the truck into a weigh station outside Hope, Ark.

"The coroner said it was a miracle he got that truck off the highway without killing somebody," Mrs. James said.

Mr. Cutberth's death, six weeks before his 62nd birthday, was the second among a group of four truckers – friends since they started driving together more than 30 years earlier. Within five years, three had died.

Wayne Phillips is the only one left.

A decal on his truck memorialized his friends. "I used to say all three of them were driving with me."

Mr. Phillips did not escape health problems either. He survived two heart attacks, although neither occurred on the road. And after more than 40 years of driving and a recent bout of health problems, he sold his truck last summer. He still works occasionally as a substitute driver.

"I can't get away from it. I've been doing it too long," said Mr. Phillips, 69.

His losses over the years go beyond his closest friends, he said. Other colleagues have died as well, many from heart attacks.

"You don't sleep right. You don't eat right. And you're always under stress to get from here to there," Mr. Phillips said.

Illness, fatigue

That, experts say, can be detrimental not just to the driver but also to others on the road.

A federal study released in March found that truck driver illness was at least one of the causes in accidents involving a truck and a passenger vehicle about 12 percent of the time. And those figures don't include accidents where the driver was fatigued.

Computing the true toll of sleepy drivers is tricky, said Dr. Michael Belzer, a professor of industrial relations at Wayne State University who led a 2003 international conference on truck driver health. "Unless you find a fatigue-o-meter, it's not so easy to monitor."

Long hours and erratic schedules don't just result in sleepy drivers. Chronic sleep deprivation can lead to increased risk of obesity and diabetes.

Chaotic schedules can throw normal hormonal production into total disarray, said Mr. Siebert of the owner-operators association. "By disrupting that, you're throwing big wrenches, not just little handfuls of sand, into the gears of your body."

Erratic schedules prevent many truck drivers from getting regular medical care. And truckers, who spend long periods away from home, have higher-than-normal rates of depression and suicide.

A review by the owner-operator association of records on 1,200 deceased members found that the average age at death was 55, about 20 years earlier than the typical American.

The National Institute for Occupational Safety and Health is expanding that study to about 5,000 deceased members of the owner-operator association. NIOSH ramped up its study of transportation workers' health after Dr. Belzer's 2003 conference. And he hopes that such research will shed light on the cost-benefits of healthier drivers.

When experienced drivers have to quit at age 50 because of health problems, he said, "all that human capital invested, all the capacity it provides, is lost."

If they don't have health insurance, it puts the burden on the taxpayers, he said. "And no one is paying for the fact that these drivers die young. No one is paying for the loss to the families."

Prior research on trucker health prompted government agencies and trade groups to launch wellness programs.

Under a 1998 program backed by the American Trucking Associations and what was then the Federal Highway Administration, 500 truckers received free memberships to a chain of truck-stop gyms. No study results were published, and it's not clear how many truckers took advantage of the program.

Another federal information campaign makes videos, workbooks and training materials on healthy living available to truck drivers, insurance companies and trucking organizations.

But it's difficult for workers who are already pushing themselves to take the time to exercise, said Dr. Belzer, who spent 10 years as a trucker before attending graduate school.

Those programs are good, but real reforms need to come through policy and economic change, he said.

The years of undercutting the competition to improve the bottom line, brought on by the deregulation of the 1980s, has meant that truck drivers are paid less and pushed harder.

Whistleblowers

Truckers fired for refusing to break the law by falsifying their logbooks or driving too many hours may file a complaint with the U.S. Department of Labor. The 1982 Surface Transportation Assistance Act protects them from retaliation by their employer for reporting safety problems.

Truck driver Ron Stauffer filed such a complaint in 1999 when he was fired after 11 years as a driver for Wal-Mart. He had refused to wait at a loading dock where he was told he could sleep during a two-hour delay before dropping off his trailer and picking up another. He argued that he would be too tired to change trailers and that driving after interrupted sleep would be dangerous.

The administrative law judge dismissed the case, saying that Mr. Stauffer did not provide evidence that he would be too tired to shuttle the trailers.

Mr. Stauffer said that he had already put in at least a 14-hour day and that an interruption would mean he would be driving tired the next day.

"You don't have the sleep foundation you need," he said in an interview. "And that leads to truck driver heart attacks."

About two-thirds of the 1,115 complaints filed under the program over the last five years were dismissed. Others were settled or withdrawn; 33 resulted in litigation.

The Federal Motor Carrier Safety Administration in 1998 established a safety violation hotline for employees of transportation companies. The complaints that come in – 7,148 in 2005 – are forwarded to field offices near the carriers, which investigate the complaints.

But reporting their employer is just too risky for some drivers.

"What kind of whistleblower protection can you have in an industry that already has more than 100 percent turnover?" Mr. Siebert asked.

Dr. Belzer said that better pay for drivers would not only improve trucker health – because drivers wouldn't have to kill themselves just to get by – but it would increase road safety. His research shows that increased driver pay improves companies' safety records.

The real change needed, said Mr. Siebert of the owner-operators association, is to revamp how truck drivers are paid. Currently, many drivers are paid by the mile.

"If we could pay drivers by the hour ... they would be safer because they wouldn't be under the pressure to get the miles in. They're rushing, and they're stressed," he said. "We don't pay doctors by the stitch."

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