50 Years of Data Shows Bus Workers Face Higher Death Risks — This Is a Bus Safety Issue

A newly published study analysing more than 50 years of data from Transport for London workers has revealed something that should stop the industry in its tracks: bus workers face significantly higher risks of death from respiratory disease, cardiovascular illness and lung cancer compared with office-based staff.

This is not about isolated incidents.
This is long-term occupational risk.

The study examined a cohort of more than 117,000 transport workers and found that bus and London Underground employees experienced higher all-cause mortality as well as increased respiratory, cardiovascular and cancer deaths when compared with office workers. The findings cover workers employed between 1960 and 2010, with follow-up through to 2021, making it one of the most comprehensive long-term studies of transport workers ever conducted.

The headline figures are stark.

Bus workers were found to have:

• 44% higher respiratory mortality risk
• 30% higher cardiovascular mortality risk
• 2.48 times higher risk of lung cancer mortality

London Underground workers showed even higher figures in some categories, suggesting shared occupational exposures across operational transport roles.

These are not small statistical differences. These are significant occupational health signals.

The study points to likely contributing factors including long-term exposure to traffic-related air pollution, sedentary working conditions, shift work, stress, and the unique operational environment faced by frontline transport staff. Bus drivers in particular spend entire shifts in congested urban traffic, exposed to exhaust emissions, particulates, noise and high levels of responsibility, often with limited opportunity for breaks or recovery.

For decades, bus safety discussions have focused primarily on collisions, assaults, and operational incidents. Those issues are important. But this research highlights something deeper: the job itself may be carrying long-term health risks that are not being systematically monitored, reported, or mitigated.

This is a bus safety issue.

Driver health directly affects passenger safety. Fatigue, stress, cardiovascular illness, respiratory problems and long-term occupational exposure can all affect concentration, alertness and decision-making. A workforce exposed to unmanaged long-term health risks is itself a safety risk. Yet the bus industry has no consistent national framework for monitoring these factors.

This raises serious questions.

Where is the national monitoring of bus driver occupational health?
Where are the exposure standards for drivers in urban traffic?
Where is the national reporting of long-term health outcomes?
Where is the independent safety oversight for buses?

At present, none of this exists in a consistent or structured way across the UK bus industry.

Other transport modes recognise the importance of independent safety oversight and long-term risk monitoring. Rail has the RSSB. Aviation has the AAIB. Maritime has the MAIB. These sectors recognise that safety is not just about incidents, but systemic risk, workforce safety and long-term hazards.

The bus industry has no equivalent national safety body focused specifically on bus safety and occupational risk.

While this research relates to Transport for London, the implications are national. Bus drivers across the country work in similar environments: urban congestion, diesel exposure, shift work, sedentary roles, time pressure, and responsibility for passenger safety. If these risks exist in one major transport authority, it is reasonable to ask whether they exist across the wider industry.

At present, there is no national dataset tracking long-term health outcomes for bus workers. There is no consistent monitoring of air quality exposure for drivers. There is no national reporting framework for occupational health risks. There is no requirement for transport authorities or operators to publish workforce safety data in a consistent way.

This creates a significant gap in bus safety governance.

This new research strengthens the case for a national bus safety framework that includes workforce safety alongside operational safety. That should include national safety standards, occupational health monitoring, exposure assessment, fatigue management, and transparent reporting of safety and health risks.

Bus drivers keep communities moving every day. They operate in challenging environments, under time pressure, with responsibility for passengers, road users and public safety. They should not be exposed to long-term occupational health risks without proper oversight, monitoring and protection.

This study should be a wake-up call.

If we are serious about bus safety, it must include the safety of the workforce. That means understanding long-term risks, monitoring exposure, collecting data, and ensuring independent oversight.

Bus safety isn’t just about preventing collisions.
It’s about preventing long-term harm to the people driving them.

Author

Lee Odams is Branch Secretary of the Nottinghamshire & Derbyshire Bus Branch and a bus driver. He campaigns for improved bus safety governance, transparency, and national oversight of passenger and workforce safety across the UK bus industry.

Tags

Bus Safety, Bus Drivers, Occupational Health, Transport Safety, Public Transport, Bus Industry, Driver Safety, Air Pollution, Transport Workers, UK Buses, Road Safety, Workplace Safety, Bus Safety Standards, Transport Policy, Passenger Safety