What's Taking Professional Drivers Even Before They Can Collect Social Security

By Rodolfo Giacoman, Fatigue Management Specialist, Commercial Vehicle Safety Alliance 
Originally published in the 2026 Third Quarter Guardian, Pages 34 - 35

• What if the greatest threats to a professional driver’s career are the ones no one can see? Two silent killers—cardiovascular disease and fatigue—may be undermining driver health, safety and long-term business sustainability.
• Discover what the new 2026 guidelines mean for drivers and motor carriers, and why protecting driver health is becoming an operational imperative.

Estimated Reading Time: 8–9 minutes.

About 21 years ago, Sean Doherty, my professional mentor, the smartest and most generous person I had the privilege of working alongside, died at the age I am today. He was 56. A philosopher, a businessman and a remarkable human being, he was taken far too soon. The reason was simple: He did not take care of his health. He did not get enough sleep, exercise or basic nutrients. He smoked and relegated his relationships and his own peace of mind to prioritize working around the clock.

Like him, industry health analyses have frequently reported that the average life expectancy of long-haul truck drivers is approximately 61 years, although precise estimates vary depending on the population studied and methodology used. If those estimates are accurate, many drivers may not live long enough to fully benefit from the retirement years they spent decades working toward.

Unfortunately, that is the story of so many careers spent empowering an economy that often forgets to empower the people who keep it moving. That is why earlier this year, I conducted a two-part webinar series titled Top Two Commercial Motor Vehicle (CMV) Driver Mortality Causes: 2026 Guidelines and Prevention. The recordings of both parts are available at www.nafmp.org/webinars. 

Two Killers, One Workforce 

In North America, atherosclerotic cardiovascular disease, or ASCVD, claims more professional drivers than any other condition. ASCVD is the type of cardiovascular disease in which arteries gradually narrow and become obstructed by plaque buildup. ASCVD, together with closely related metabolic disorders such as diabetes and chronic kidney disease, contributes to more than 1.6 million deaths across North America each year, an average of 4,500 every day.

Then there is the occupational threat: fatigue-related crashes. The National Transportation Safety Board suggests fatigue may be involved in approximately one-third of crashes that are fatal to the driver. Because fatigue is difficult to confirm without video or sensor data, the problem is almost certainly undercounted in official statistics.

What makes fatigue particularly dangerous is that it not only causes crashes but also amplifies ASCVD. Poor sleep and chronic fatigue drive systemic inflammation, elevate blood pressure, impair insulin sensitivity and increase oxidative stress, all of which accelerate the same arterial damage that leads to heart attacks and strokes. The two killers are not separate. They reinforce each other.

What Happens Inside the Arteries

The process behind most heart attacks is slow, quiet and starts long before any symptom appears. Healthy arteries are smooth, flexible pathways. Over time, several factors damage the inner lining, called the endothelium, making it sticky:

• High blood pressure
• Tobacco use
• Diabetes
• Chronic inflammation
• Oxidative stress
• Age

Once that lining gets sticky, cholesterol, other fats and calcium begin to accumulate. That buildup is called plaque. Some plaque calcifies into stable deposits. But unstable plaque can rupture after it accumulates. When it does, the body responds by forming a clot. In an already-narrowed artery, that clot can block blood flow entirely. When a coronary artery closes, part of the heart muscle stops receiving oxygenated blood. Muscle tissue begins to die. That is what leads to a heart attack. 

Studies suggest that sudden cardiac death is the first recognized manifestation of coronary artery disease in a substantial proportion of cases. There is no chest pain to recognize.  No shortness of breath to prompt a call for help. That reality is precisely why monitoring biomarkers – measurable, objective indicators of what is happening inside the body – matters far more than waiting for symptoms.

An Aging Workforce at a Critical Threshold

Research from the American Transportation Research Institute shows that the CMV driver population is aging. Over 40% of all CMV drivers are 50 or older. That is precisely the window when ASCVD risk rises sharply, especially for men, who face elevated risk starting around age 40. Women's cardiovascular risk rises substantially after menopause and gradually approaches that of men. When a profession's average life expectancy is 61, and most of its workforce is approaching that age, there is a compounding problem. It is a workforce health crisis caused by two silent, slow-moving killers.

New 2026 Guidelines: Earlier Intervention

In March 2026, the American College of Cardiology, American Heart Association and nine other major medical associations issued updated guidelines for managing ASCVD. These guidelines update how medical professionals should assess and treat ASCVD risk, and they move in one clear direction: earlier, more deliberate intervention.

The 2026 guidelines recommend that doctors use a tool called the PREVENT online calculator. It factors in a broader set of biomarkers to estimate both 10-year and 30-year cardiovascular risk. The calculator accounts for: 

• Sex and age
• Systolic blood pressure
• Total and HDL cholesterol
• Estimated glomerular filtration rate (a kidney function measure)
• Body mass index (BMI)
• Diabetes and smoking status
• Medications to lower lipids and blood pressure

The calculator is free and available online at www.professional.heart.org/en/guidelinesand-statements/prevent-calculator.

The 2026 guidelines also significantly lower the risk thresholds that should prompt clinical action. Under the prior 2018 framework, intervention was typically recommended once a person's 10-year cardiovascular risk exceeded 7.5%. The new guidelines now flag anyone above 3% risk as borderline and recommend that clinicians consider lipid-lowering therapy starting at 5% to 10% risk, without waiting for a person to reach the high-risk threshold of above 10%.

Cholesterol targets are also back. The new guidelines return to specific LDL numbers, not just percentage reductions, because LDL cholesterol remains the primary raw material for plaque formation. The lower it goes, the less material is available to accumulate in arteries.

Two biomarkers that do not appear on a standard lipid panel are also getting attention: apolipoprotein B, which measures the actual number of plaque-forming cholesterol – carrying particles in the bloodstream rather than just their weight, as the standard lipid panel measures; and lipoprotein(a), a genetically determined cholesterol type linked specifically to a particularly dangerous form of coronary blockage. 

Seeing What's Already There: The Calcium Score

One of the most actionable tools highlighted in the new guidelines is the coronary artery calcium score, a relatively low-radiation CT scan with exposure levels roughly comparable to those of other common screening imaging studies, such as mammography. It can reveal whether arterial damage has already begun.  For men 40 and older and women 45 and older, this test can substantially reclassify risk, often moving someone from a low-risk calculation result to treatment. 

My cardiologist had been asking me to take this test, and I was sure my score would be zero. After all, I do practice what I preach, following the five keys to wellness (see the next section). But my score came back at 41. While mild, it means that arterial damage is already underway, so I’m now on a statin, the first line of medications to lower lipids. One possible explanation is what some researchers call the "athlete's paradox," a phenomenon in which long-term high-volume endurance exercise may be associated with greater coronary calcification despite otherwise favorable cardiovascular health profiles.

Check out the Part 1 webinar for the specific therapies currently available and those being tested: www.nafmp.org/webinars. 

What Drivers Can Do

Drivers and the rest of us can do a lot to prevent our blood vessels from getting sticky.  Stop smoking and practice the five keys to wellness:

1. Start by practicing mindfulness and lowering mental stress.
2. Warm up your personal relationships by staying connected while on the road and spending quality time when at home.
3. Exercise regularly to improve your body's ability to use oxygen or VO2 max.
4. Be very picky about what you put in your mouth: Get your essential macro- and micronutrients and not too much else.
5. Get enough restorative rest by practicing sleep hygiene.

Check out the Part 2 webinar for details on how to put these keys to wellness into practice, along with other free NAFMP resources: https://nafmp.org/webinars.

What Motor Carriers Can Do

Driver’s health is not only a personal matter. It belongs as part of the safety culture of every organization that puts a driver behind the wheel.  That culture does not take hold unless it starts at the top. If leadership does not treat health as an operational value, drivers will not either.  Education is the foundation, and not only once during onboarding. It should be continuous, woven into the routines of the organization. 

Compensation structures matter too.  Compensation systems that inadvertently reward excessive work hours or discourage adequate rest can undermine wellness efforts.  Sound scheduling, stable enough that a driver's body can align its circadian rhythm and sleep pressure to a consistent pattern, is one of the most direct levers a carrier can control.  Circadian adaptation often requires several days and sometimes longer, depending on the magnitude and direction of the schedule change. Rotating drivers erratically through day and night shifts is the physiological equivalent of being permanently jetlagged.

Carriers should consider wellness incentives, such as:

• Reimbursement for healthy grocery purchases during trips
• Covering exercise program memberships or basic exercise equipment
• Offering access to sleep accessories like eye masks, earplugs and white noise devices
• Working with medical examiners to ensure drivers have access to evidence-based screening and referral pathways for sleep disorders when clinically indicated

Check out NAFMP Module 2 on how to implement an effective safety culture and a fatigue risk management system at http://www.nafmp.org/courses.

The Fiduciary Case for Driver Health

When I talk to drivers about fatigue management and wellness, I often hear some version of this: “All of that sounds right, but I have to pay the rent.” And then I ask, “Are you planning to stop paying the rent next year? In five years? In 20?” As I wrote in the fourth quarter 2025 Guardian, in “The Perils of Not Understanding Your Fiduciary Duty,” motor carriers, drivers and all of us have a responsibility to protect the long-term viability of our businesses, careers and families. The careers that drivers have built and that carriers have invested in are not designed to run for a single quarter or even a year. They are built to support companies and families over a lifetime. Health is not a distraction from that goal. It is the  foundation of it. You cannot drive a truck when you no longer have the years to drive. 

This profession asks a lot from drivers.  Long hours, time away from home, physical isolation, irregular schedules, the pressure of tight deadlines and road conditions that demand constant attention. We owe it to them to take their health as seriously as we take their logs, their inspections and their compliance records.

Invest in your drivers' health with the same intention you bring to maintaining your fleet.  Apply the same discipline. Make it a nonnegotiable value. Not only because it is the right thing to do but also because accepting the possibility that many drivers may not live long enough to enjoy the retirement they worked for is not acceptable and is plain bad business.