Alcohol and other drug use by Brazilian truck drivers: a cause for concern?

Road traffic injuries remain an important public health issue worldwide. More than 1.2 million people die each year due to road fatalities, and 20 to 50 million are estimated to be injured. Moreover, this health burden with epidemic proportions can be considered an increasing problem, particularly in developing countries.1 Alcohol and other drug use is one of the main contributors to the occurrence of traffic accidents. In Brazil, the road traffic fatality rate is 18.3 per 100,000 inhabitants1 (the second major cause of death by injuries), and generates an economic loss of approximately US$13 billion annually.2 Among motor vehicles, trucks are the second most prevalent in terms of total accidents and related costs.2 In this scenario, alcohol and other drug use among truck drivers are a special cause of concern. In a truck driver survey conducted in Brazil, 9.6% reported having drank alcoholic beverages on the day of the interview, with 4.9% of them presenting a positive blood-alcohol concentration (BAC).3 In another study in which truck drivers provided urine samples for toxicological analysis, 9.3% had used illicit drugs, with 61.9% presenting positive results for amphetamines, 23.8% for cocaine, and 11.9% for cannabis.4 Remarkably, it has been reported that alcohol and other drugs have been purposefully used as a means to overcome the life stressors that truck drivers routinely face (e.g., long working days, few sleeping hours, shift work, psychological pressure to meet deadlines, and being away from home); however, these substances are used in such a way that the occupational activity becomes dangerous, with potential negative consequences to the Brazilian public health, judiciary, and social security systems, in addition to society as a whole. Letter to the Editors