title: The effects of urban bus driving on blood pressure and musculoskeletal problems: a quasi-experimental study.
abstract: OBJECTIVE
  Work settings with high levels of stress are consistently associated with poor health outcomes. This study examines the longitudinal relationships between the number of hours of driving a bus in a city and blood pressure and musculoskeletal problems.
  
  
  METHODS
  A prospective longitudinal design coupled with multilevel random coefficient modeling was used to examine the relationship among exposure to a job with high level of stress, urban bus driving, blood pressure, and musculoskeletal problems. Baseline blood pressure and musculoskeletal symptoms of men and women (n = 88) were assessed before they began driving a bus in central Stockholm. The number of hours of driving per week, blood pressure, and musculoskeletal symptoms were tracked for a period of 5 years. Multilevel random coefficient modeling techniques were used to model how individual trajectories of health effects were affected by the number of hours of driving, after statistically controlling for baseline preworking health measures.
  
  
  RESULTS
  Controlling for sex and baseline health outcomes, the average number of hours of bus driving per week predicted higher diastolic blood pressure (B = 0.069, standard error = 0.034, p = .042) and more frequent musculoskeletal symptoms (B = 0.013, standard error = 0.003, p < .001).
  
  
  CONCLUSIONS
  The findings provide evidence for a positive association between the number of hours of bus driving and blood pressure and musculoskeletal problems. These findings are discussed in exposures to potentially toxic physical and psychosocial work-related factors.
authors.affiliation: Department of Psychology, Stockholm University, SE-106 91 Stockholm, Sweden. gj@psychology.su.se
authors.forename: Gunn
authors.initials: G
authors.lastname: Johansson
authors.forename: Gary W
authors.initials: GW
authors.lastname: Evans
authors.forename: Caroline
authors.initials: C
authors.lastname: Cederström
authors.forename: Leif W
authors.initials: LW
authors.lastname: Rydstedt
authors.forename: Thomas
authors.initials: T
authors.lastname: Fuller-Rowell
authors.forename: Anthony D
authors.initials: AD
authors.lastname: Ong
mesh_terms: D000328:Adult; D001334:Automobile Driving; D001794:Blood Pressure / Q000502:physiology; D001795:Blood Pressure Determination; D002947:Cities; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008297:Male; D015233:Models, Statistical; D018986:Motor Vehicles; D055361:Multilevel Analysis; D009140:Musculoskeletal Diseases / Q000453:epidemiology* / Q000209:etiology; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology; D011446:Prospective Studies; D012307:Risk Factors; D013315:Stress, Psychological / Q000453:epidemiology* / Q000209:etiology; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D014505:Urban Population; D014940:Work Schedule Tolerance / Q000502:physiology / Q000523:psychology; D055815:Young Adult