Impact of the new national health standard for rail safety workers on ischaemic heart disease risk factors in train drivers

Background: In 2004, a compulsory National Standard for the Australian rail industry was introduced outlining health standards that drivers must meet to be deemed fit to drive. Aim: To examine the trend in ischaemic heart disease (IHD) risk factors in train drivers between 2004 and 2009, following the introduction of a National Standard. Methods: A retrospective analysis of IHD risk factors of drivers (n = 386) of an Australian train company, who underwent health assessments between February 2004 and November 2009, was performed. The Framingham Score for 10-year risk of coronary artery disease, body mass index (BMI), cigarette smoking, diabetes, systolic and diastolic blood pressure, high-density lipoprotein (HDL), low-density lipoprotein and total cholesterol were compared with that of controls at these two time periods. Results: There were significant reductions in the rates of 10-year coronary heart disease risk/year (OR = 0.47; 95% CI 0.19, 0.75) in the train drivers compared with the control population. This was driven by a reduction in the rate of cigarette smoking (OR = 0.87; 95% CI 0.79, 0.96) and total cholesterol (OR = -0.05; 95% CI -0.09, 0.003) and an increase in HDL cholesterol levels (OR = 0.02; 95% CI 0.006, 0.03) between groups over time. This was despite an increase in BMI (OR = 0.10; 95% CI 0.01, 0.19). Conclusion: Following the introduction of a National Standard for drivers in Australia, there has been a significant improvement in the health of drivers. Such a programme may have a significant impact in this group of safety critical workers.