Drowsy Driving Fatal Crashes: 10 Occupations with the Highest Risk [2021 Study]

On average, employees in America work 35 hours a week. However, the 10 occupations with the highest risk of drowsy driving average 48-hour workweeks. These long days and workweeks place employees at risk of driving home exhausted and injuring themselves or others. Since drowsy driving causes hundreds of deaths each year, workers need to know how to prevent drowsy driving by learning to recognize the warning signs and effects of drowsy driving and act accordingly.

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Rachel Bodine graduated from college with a BA in English. She has since worked as a Feature Writer in the insurance industry and gained a deep knowledge of state and countrywide insurance laws and rates. Her research and writing focus on helping readers understand their insurance coverage and how to find savings. Her expert advice on insurance has been featured on sites like PhotoEnforced, All...

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Sara Routhier, Managing Editor and Outreach Director, has professional experience as an educator, SEO specialist, and content marketer. She has over five years of experience in the insurance industry. As a researcher, data nerd, writer, and editor she strives to curate educational, enlightening articles that provide you with the must-know facts and best-kept secrets within the overwhelming world o...

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Reviewed by Sara Routhier
Director of Outreach Sara Routhier

UPDATED: Mar 29, 2022

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Can't-Miss Facts

  • The 10 occupations most at risk for drowsy driving make up nearly 5% of the U.S. workforce
  • These 10 worst occupations for drowsy driving average 13 hours longer per workweek
  • Pulling over and resting is the safest option for exhausted, overworked individuals

Have you ever caught yourself yawning while driving home after a long day of work? Drowsy driving is something most drivers have experienced. While blasting music and chugging coffee may be a quick fix for some people, constant fatigue can take a dangerous toll on drivers, especially if drivers work in the occupations with the highest risk of drowsy driving.

If you have a job that requires long hours or night shifts, you may find yourself fighting drowsiness more than other workers.

Driving drowsy puts drivers at an increased risk of crashing, which is why it’s important to recognize the signs of drowsy driving and take steps to avoid it. You should also make sure you have good automobile insurance in case of an accident from drowsy driving.

If you’re worried about high auto insurance rates, know that there are many ways to save. One of the best is to compare live auto insurance quotes from different companies. Enter your ZIP code into our free online quote comparison tool to do just that and start saving today.

For workers who have jobs in any of the 10 occupations most at risk of crashing from driving drowsy, we cover why these occupations are most at risk in our breakdown of the rankings. We will also cover the following important topics:

  • Dangers of Drowsy Driving
  • Advice from the Experts
  • Frequently Asked Questions

Read on to see if your occupation is on the list.

10 Occupations Most at Risk for Driving Drowsy

Drivers who work long hours at work are more likely to struggle with chronic fatigue, leading to drowsy driving. Our team collected the latest data from the U.S. Census Bureau to find the 10 occupations that are most at risk of driving drowsy after a long day of work. Using the U.S. Census Bureau’s dataset tool, our team gathered data on reported average hours worked over a 12-month period for occupations in America.

Our researchers also collected data from the Bureau of Labor Statistics to see how each occupation’s hours compared to the industry average and to calculate each occupation’s percentage of the workforce.

The results? Look at the graphic below to see the rankings for the occupations most at risk of drowsy driving.

occupations most at risk for drowsy driving

The tiebreaker between 8th and 9th place is the percentage of the workforce, as there will be more military tactical operations and air/weapon specialists driving tired than first-line military supervisors.

Now that you have the basic idea of the rankings for each occupation, let’s dive a little deeper into each occupation on the list.

#10 – Firefighter Supervisors and Prevention Workers

  • Weekly Hours Worked: 45
  • Industry Weekly Hours: 31
  • Portion of U.S. Workforce: 0.04%

Firefighter supervisors and prevention workers work some of the longest workweeks in America. This is no surprise, considering they tirelessly work to prevent and eradicate fires. Both of these jobs require making assessments of disasters, training firefighters, and much more.

Since firefighter supervisors and prevention workers have such long hours every week, some at night, they are more at risk of driving when tired.  Whether it’s driving home at the end of a long day or driving home after a long week, workers in these occupations must recognize the signs of drowsiness when driving.

#9 – First-Line Military Supervisors

  • Weekly Hours Worked: 46
  • Industry Weekly Hours: 43
  • Portion of U.S. Workforce: 0.05%

Anyone who has ever been in a position of leadership knows how hard it can be. First-line military supervisors work some of the longest hours, whether they are supervising Air Force crew or new Army members.

In addition to training and overseeing, first-line military supervisors may also work alongside the crew. For first-line supervisors who don’t live on base, driving home after a long day of work may become risky if they are tired. If you are a military member who has a crash or two on your record, make sure you take advantage of military auto insurance to find cheaper insurance.

#8 – Military Tactical Operations and Air/Weapon Specialists

  • Weekly Hours Worked: 46
  • Industry Weekly Hours: 43
  • Portion of U.S. Workforce: 0.27%

Military tactical operations and air/weapon specialists are 8th on our list, with an average of 46 hours worked per week. Military tactical operations are highly specialized workers: planning military tactics, directing members during a mission, and working long or odd hours to get it all done.

Military air and weapon specialists can work in different job fields, but usually, all the related job fields require long hours. Since they are responsible for testing and maintaining weaponry, specialists may work longer hours to keep things in order and get things up and running again.

#7 – Ship and Boat Operators

  • Weekly Hours Worked: 47
  • Industry Weekly Hours: 43
  • Portion of U.S. Workforce: 0.03%

No. 7 is ship and boat operators, as they work an average of 47 hours a week. Transporting people, equipment, or supplies across the water takes time.

So if ship and boat operators drive home after a long day or two of being on the water, they may struggle with fatigue. In addition, if ship and boat operators are working long weeks on the water without being on land, this fatigue may be even more pronounced.

#6 – Extraction Workers

  • Weekly Hours Worked: 47
  • Industry Weekly Hours: 42
  • Portion of U.S. Workforce: 0.01%

Extraction workers work in various fields, from oil rig crews in the ocean to miners underground. One thing extraction workers all have in common is that they work extremely long hours, an average of 47 a week.

The long work hours may also be combined with a long commute to the extraction site every day, contributing further to workers’ drowsiness when driving.

#5 – Physicians

  • Weekly Hours Worked: 47
  • Industry Weekly Hours: 36
  • Portion of U.S. Workforce: 3.72%

It’s no surprise that physicians made it onto the list at No. 5, as doctors work some of the longest shifts and weeks. Many physicians spend long hours seeing patients, performing diagnostics, creating treatment plans, performing surgeries, and much more.

While “physician” is a broad term covering a wide range of doctors from general care practitioners to obstetricians and gynecologists, anyone in the medical field can expect to work long and odd hours. The bad news is this can lead to drowsy driving on the way home from work.

#4 – Sailors, Marine Oilers, and Ship Engineers

  • Weekly Hours Worked: 49
  • Industry Weekly Hours: 43
  • Portion of U.S. Workforce: 0.02%

Sailor/marine oilers and ship engineers come in at No. 4, with an average of 49 hours worked per week. Both of these occupations involve keeping the ship running. Oilers make sure the machinery is running smoothly, assist in refueling, and more.

Engineers are also heavily involved in the ship’s machinery, as they maintain and fix important parts of the ship. From the engine to the generator, ship engineers make everything goes smoothly. Since ship engineers and oilers may end up doing a majority of the work on land when ships are docked, they are at risk of driving drowsy.

#3 – Firefighters

  • Weekly Hours Worked: 49
  • Industry Weekly Hours: 31
  • Portion of U.S. Workforce: 0.21%

Fires are unpredictable, and as such, so are firefighters’ overtime hours. On average, firefighters work 49 hours a week, earning them the 3rd spot on our list. In addition to putting out fires, usually a grueling and risky task, firefighters also work to prevent fires and provide emergency medical care until the arrival of EMS.

The long hours that firefighters put into their jobs means that when it’s time to go home, they may be at increased risk of driving while tired.

#2 – Surgeons

  • Weekly Hours Worked: 51
  • Industry Weekly Hours: 36
  • Portion of U.S. Workforce: 0.02%

Surgeons work some of the longest hours in America — an average of 51 a week. This shouldn’t come as a surprise, as surgeons may perform multiple surgeries a day, especially if they are in high demand in their field.

Complex procedures like open-heart surgery may last for hours, meaning a surgeon must have the utmost concentration for anywhere from 3 to 6 hours or longer. As such, a surgeon driving home after a long day of intense surgeries or multiple may have to frequently battle drowsiness while driving.

#1 – Crane/Drill Operators and Oil/Gas Laborers

  • Weekly Hours Worked: 52
  • Industry Weekly Hours: 42
  • Portion of U.S. Workforce: 0.05%

No. 1 on our list is crane/drill operators and oil/gas laborers. These occupations average 52 hours a week, which is an incredibly long and exhausting work week.

Since both of these occupations have to work on-site, which for crane and drill operators may change regularly if they work in the housing industry building foundations, long commutes might also be part of the job. The result? These occupations are most at risk of driving drowsy after a long day or week of work.

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Employees Most Likely to Fall Asleep While Driving Home

Before we dive into the various dangers of driving drowsy, we want to take a closer look at the 10 occupations most at risk of drowsy driving. Since these occupations are most at risk on the road after a long day of work, take a look at the table below to see just how many people are working in these occupations.

View as image

Physicians have the highest number of employed workers, outnumbering the military tactical operations and air/weapon specialist workers in second place by almost 6 million.

You can also see projected employment for each occupation is expected to increase for every occupation except surgeons and ship/boat operators. This means that more people will be entering occupations where drowsy driving may become a part of their daily routine, putting both themselves and others at risk.

Dangers of Drowsy Driving

Drowsy driving can be just as dangerous as driving drunk or high. If you have an accident from drowsy driving on your record, it will make it harder to find cheap auto insurance rates. However, most drivers aren’t attuned to the signs that warn drivers when they are getting too tired to drive and should pull off the road immediately.

So what are the warning signs of drowsy driving? Take a look below to see some of the main warning signs a driver is too tired to drive and is at risk of causing an accident.

Warning Signs of Fatigue While Driving

If you experience any of the above warning signs, you should pull off and rest.

It’s better to lose 20 minutes of your time napping on the side of the road than to lose your life.

In addition, not getting enough sleep can contribute to more than just the risk of crashing. According to the Centers for Disease Control and Prevention (CDC), the health consequences of not getting enough sleep include increased risk of:

  • Cardiovascular disease
  • Depression
  • Diabetes
  • Obesity

The CDC states that adults 18 to 60 years old need at least seven hours of sleep a night. So if you aren’t getting enough uninterrupted sleep or work odd hours in the night, chances are you will be both driving drowsy and risking your health. Read on to see what advice the experts have for you about drowsy driving.

Tips to Avoid Drowsy Driving

Now that we’ve covered the risks of drowsy driving, you probably want to know how to prevent drowsy driving. We’ve collected advice from automotive experts, travelers, truck drivers, and more to see what they have to say about the dangers of drowsy driving and the best tips for preventing drowsy driving.

Experts around the world

“The sad truth is that tiredness and its effect on drivers are rarely taken seriously. Most people, even if they’re severely tired, won’t think twice about getting in their car and driving to their destination. But this is dangerous.

It’s dangerous to the point where people can fall asleep on major roads traveling at speeds of 70 mph and over. This can not only be seen as driving without due care and attention but also dangerous driving/reckless driving and, if the situation calls for it, even manslaughter.

Avoiding all of this is really easy; all it takes is for you not to get in the vehicle and drive if you think you’re too tired to do so. But the trouble arises when judging whether or not you’re too tired.

Some people have different ideas of what it means to be too tired to drive, which is why it can be tricky.

With that in mind, there are a few things that you can do to gauge your level of exhaustion before getting into your vehicle so that you can protect not only yourself but other people out on the roads and even your loved ones in the car with you.

If you’re in the middle of a road trip or you’re already out on the road, a quick test you can do is to think about the last 10 minutes of your journey: how easily can you remember it? Similarly, try to remember the last few turns that you’ve made.

If you can’t picture or remember them, it might be time to pull over and rest, get energized, or even have a light snack to help increase your energy levels (but a heavy meal might make your drowsiness worse, so decide carefully!).

There are a few more obvious signs to look out for, such as tired eyes, regular/constant yawning, and a foggy mind. These are all easy to spot and can help indicate when you should take a break from driving or even let someone else drive for a while.

Taking turns to continue driving is something that can work well because as one person drives, the other can try to sleep or rest.

One sign of tiredness that is very often overlooked is frequent blinking and squinting.

Interestingly, you have capillaries under your eyelid that are responsible for sending oxygen to your eyeballs. They do this when your eyes are closed — for example, when you sleep or blink.

With that in mind, when you’re overly tired, your eyes will do all they can to get the oxygen through to them, including squinting so that you can still see but also absorb the oxygen. This will limit your vision, which means that you’re putting yourself and others at risk still. So, if you’re squinting and blinking a lot, pull over and rest.

According to The National Highway Traffic Safety Administration (NHTSA), there are 56,000 sleep-related road crashes a year in the U.S. These crashes have resulted in 40,000 injuries and over 1,500 fatalities.”

Andy King Headshot

Andy King is an automotive expert with Jamjar.com.
Jamjar is a car-selling comparison site.

What are the main warning signs that a motorist is too drowsy to drive?

“In our experience, the main warning signs that a motorist can show if they are too drowsy to drive include frequent yawning or blinking, having a hard time remembering the past few kilometers that are driven, missing important stops or exits, and drifting from their lane.”

What should drivers do if they experience warning signs of exhaustion?

“They should definitely try their best to take a short break. Drowsy driving is dangerous and hazardous to human life, and so it would really make a difference if drivers who are too fatigued could get a quick power nap so that they can be more alert.

If sleeping is impossible, they could try other means to stay awake such as consuming caffeinated beverages like coffee to perk themselves up. Still, taking a few minutes of rest can help avoid exhaustion-related vehicle accidents.”

What steps should drivers take to avoid drowsy driving (both in road trips and careers with long hours)?

“In order to avoid drowsy driving, it is important to plan ahead how long the journey will take and make it a point to limit driving hours and set time for rest (multiple times of at least once). It’s also best to avoid driving during the most ‘groggy’ parts of the day (midnight to 6 a.m.).

Don’t consume alcohol or sedative drugs, get some quality sleep, and if possible, bring a travel companion who can take over driving while you rest or at least keep you awake while you drive.”

What are some of the common reasons people drive drowsy?

“Some of the reasons why drivers can be drowsy include sleep deprivation, fatigue, severe exhaustion, sleep disorders, consumption of alcohol, medications that can cause grogginess such as sleeping aids, and the time of the day when the driver is driving (e.g., late-night or early dawn).”

Please share an experience you have with drowsy driving.

“I wasn’t the one driving, but our friend was the one who was taking us to a particular place during late hours. He had been staying up late for a few days as he works as a writer for his boss, who’s in a different time zone.

He was frequently yawning, and we almost hit a truck because he closed his eyes for like a moment or two. Luckily, we didn’t get harmed. I took over for him and let him rest in the passenger seat.”

Do you feel your job puts you at risk of falling asleep behind the wheel?

“Yes, if I don’t allow time for adequate rest. I’m a fashion writer, and I tend to pull all-nighters to finish deadlines so I can be at risk for dozing off when driving. But given my experience, I try to avoid driving when tired or groggy just to be safe.”

What should be done to correct this safety issue in the U.S.?

“I live in the U.K., and what’s done here is that the government advises that we mustn’t drive until we’ve shaken off excessive sleepiness that can be due to exhaustion, sleeping disorders, or consumption of drowsiness-inducing drugs.

If we do drive despite having excessive sleepiness, we can be fined up to $1,000. In my opinion, I think having stricter policies and bigger fines can correct this safety issue.”

Do you believe it is dangerous if drivers depend on crash avoidance techs such as drowsy driving apps or self-driving features?

“Yes, because they’re not always reliable. The human element in driving is still important, and so to ensure safety, drivers should be in optimal condition even when relying on crash avoidance technology such as drowsy-driving apps, or self-driving features.”

May Flanagan Headshot

May Flanagan is the founder of Global Green Family.
Her website provides eco-living and wellness advice for families.

“Some of the drowsy warning signs we recommend to watch out for include frequent blinking or trouble keeping your eyes open, not being able to remember the last few miles driven, missing your exit, frequent yawning and eye rubbing, restlessness, and irritation.

More severe symptoms of drowsiness involve lengthy blinking, head nodding, and spacing out. These are all sure signs of driving while drowsy.

Smart drivers who recognize the signs of drowsiness will immediately pull over. If driving with others who can legally drive, then drivers should allow others to take their turn behind the wheel if they feel refreshed and ready. If driving alone, then taking time to rest is key.

For professional drivers who have deadlines to meet, it’s about preplanning. Build in extra time for your trip to account for construction, accidents, or other causes of a possible delay.

The government put in place driving log books years and years ago to help regulate the number of hours a truck driver can spend driving per day and week.

While some truckers have been known to run double books (highly illegal), it’s becoming mandatory that all tractor-trailers have built-in electronic logs. This, of course, makes it virtually impossible for a driver to drive excessive hours without their company knowing.

The most common reason why people drive drowsy is to reach their destination. Stopping frequently only adds time to a road trip.

It might be that the dad who is road-tripping with multiple children and doesn’t want to spend any more time in the vehicle than he has to. It might be the college kids’ spring break trip and they don’t want to admit they are tired and need a break. It might be that truck driver who is dead tired but only an hour or two away from making their deadline.

Eating healthy and getting the proper amount of sleep each night are two significant factors in staying alert while driving. If you know your body and know that you often get drowsy mid-afternoon, use that specific time to pull over, fuel up, eat a meal, or take a nap.”

Joel Speyers Headshot

Joel Speyers is the co-founder of Prep4Travel.com.
He’s an avid traveler who writes road-trip safety and travel guides.

“I know all too well the consequences of driving while overly tired or fatigued. You see, my husband was working as a field engineer for an overhead crane company in 2019, and he would always work between 70-90 hours every week. Not because they were short-staffed, but because he was really trying to provide an excellent life for our family.

Unfortunately, none of us expected that while he was trying to make a good life for us, his tiredness could cause the loss of life for another. In 2016, he was making the drive home from one of their customers’ sites, and he took part in a horrible accident.

His truck was totaled, and the sole driver of the other vehicle lost their life that evening.

My husband was not at fault for this accident, but he may have been able to easily prevent it if he was in his right mind and not operating while so tired.

The other driver had made a left turn, and he was coming from the adjacent direction through a green light. He hit the side of the other car head-on directly into the driver’s side door.

There are so many signs of fatigue while driving. While most companies limit the hours of those who drive for a living per day and week, his company allowed it because of the nature of his business and because the traveling aspect is not the main description of his job. This was a horrible experience for him during that time, and he has since left that field of work.

He and I both advocate now against driving while fatigued and hope that many other people in similar situations with their jobs can learn from our experience.”

Emma Alda Headshot

Emma Alda is the co-founder of ModestFish.
She is an advocate for safe driving practices.

What are the main warning signs that a motorist is too drowsy to drive?

“If you notice the following signs, then you might be too drowsy to drive:

  • Yawning frequently
  • Dozing off
  • Increased blinking, droopy eyes, or tired eyes
  • Drifting into another lane without noticing
  • Missing an exit or a road sign
  • Having difficulties in maintaining your speed

These signs indicate you may be in danger of causing an accident or even falling asleep at the wheel.”

What should drivers do if they experience warning signs of exhaustion?

“If a driver experiences warning signs of exhaustion, they should:

  • Drink a caffeinated drink such as coffee
  • Take a break every once a while
  • Avoid slouching
  • Let others drive if they have a companion with them.”

What steps should drivers take to avoid drowsy driving?

“Here are the steps you can take to avoid drowsy driving:

  • Limit your driving hours
  • Avoid driving at times when you’re supposed to be asleep
  • Make sure to feel well-rested before driving
  • Avoid drinking any medication or alcoholic beverages
  • Bring a companion if you’re going for a long drive to avoid drowsy driving.”

What are some of the common reasons people drive drowsy?

“The common reasons that people drive while feeling sleepy are:

  • Not having enough sleep
  • Working long shifts or the night shift
  • Driving for commercial purposes
  • Having a sleep disorder

In addition, some medications can make you feel drowsy.”

Please share an experience you have with drowsy driving.

“As a trucker, I often have to drive long trips alone. At times, I feel sleepy while behind the wheel. However, I had to change my bad habit of drowsy driving after one incident.

I was driving late at night, and my eyes closed for one second. And for that split second, my truck almost swerved off the road. That awakened me and made me realize that all it takes is a single moment for me to possibly hurt myself or others. After that time, I no longer drove while feeling drowsy.”

Do you feel your job puts you at risk of falling asleep behind the wheel?

“Yes, as a trucker, I felt that my job was putting me at risk of falling asleep behind the wheel.”

Do you believe it is dangerous if drivers depend on crash avoidance techs such as drowsy driving apps or self-driving features?

“I believe that crash avoidance technology is helpful in preventing crashes due to drowsiness. However, techs such as lane-departure systems and front-crash prevention may experience a glitch at times. As a result, it can be dangerous if drivers become too dependent on them.

It’s still the drivers’ responsibility to be always alert and wary of their surroundings. Crash avoidance techs are only meant to aid the driver but not to replace it.”

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Arnold Chapman headshot

Arnold Chapman is the founder of ELDFocus.com.
After being a truck driver for two decades, he started a fleet site.

Frequently Asked Questions: Drowsy Driving Stats & Risks

Drowsy driving is an important topic to discuss, so if you still have questions about the dangers of drowsy driving and drowsy driving statistics, keep reading. Below are some answers to the most commonly asked questions about drowsy driving and accidents.

#1 – What is drowsy driving?

Drowsy driving can be defined as anytime drivers are impaired by tiredness. So what are the effects of drowsy driving? Drivers’ reaction time is slowed, they may be falling asleep at the wheel, and they have poorer judgment, making them a danger to themselves and others.

#2 – What percentage of crashes involve drowsy drivers?

Just how many crashes in the U.S. involve a drowsy driver? According to the NHTSA’s report, an estimated 2.3 to 2.5 percentage of fatal crashes involved drowsy drivers from 2011 to 2015.

However, because researchers believe the number of fatal drowsy driving accidents is actually higher than reported numbers, this percentage is likely higher. Adding in non-fatal drowsy driving accidents will also raise the percentage.

#3 – What are the high-risk times for driver fatigue?

Whether you are looking at drowsy driving statistics in 2019 or 2020, the numbers all point to the same thing. The high-risk times for driver fatigue, according to the NHTSA, are from midnight to 6 a.m. and in the late afternoon. This is why young drivers with learner’s permits and intermediate licenses are usually banned from driving from midnight to 6 a.m. in most states.

#4 – What age group of adults is most likely to fall asleep at the wheel?

A survey by the NHTSA found that 42 percent of drivers ages 46 to 64 admitted to nodding off at the wheel, which was the highest percentage out of all the age groups. Drivers under the age of 20 were the least likely to fall asleep, most likely due to nighttime driving restrictions.

#5 – Who is most at risk for drowsy driving?

The list is long: people who work odd or long hours, people with sleep disorders, people who take medications, etc. Anyone who has disrupted sleep or is tired is at risk for drowsy driving.

#6 – What is the best thing to do when you feel drowsy while driving?

The best advice is to pull over in a safe spot, such as a rest stop. Take a short nap, get a coffee, or walk around. Taking a break from driving, especially if you are driving long distances, will help break up the monotony and keep you alert.

#7 – Can sleep apnea cause you to fall asleep while driving?

Driving with sleep apnea can put drivers at increased risk of driving drowsy and falling asleep at the wheel. If you suffer from sleep apnea, it is important to talk to a doctor about sleep apnea treatments, such as a CPAP breathing machine. Getting a good night’s sleep will help you stay awake on the road.

Methodology: Determining Drowsy Driving Risks Among Occupations

Our researchers analyzed U.S. Census Bureau data using its dataset research tool to find the 10 occupations that worked the longest hours on average over a 12-month period and therefore were most at risk for drowsy driving. In addition to the data on average hours worked over 12 months for each occupation, our team pulled a second data point on industry average hours from the Bureau of Labor Statistics.

Comparing the two allowed our researchers to see how each occupation’s hours compared to the industry average. In each of the top 10 occupations, employees worked a significant number of hours more than the reported industry hours. These long hours make for tired employees, resulting in an increased risk of drowsy driving.

Our team also found BLS data on how many employees work in each occupation, as a high percentage of employees working in a field prone to drowsy driving means more drowsy drivers on the road. Employers in these fields need to ensure that they are taking steps to combat drowsy driving in their employees, whether it’s offering transportation or having shorter workweeks.

Regardless of what job you have, drowsiness can affect any driver. Make sure to stay off the roads when you are tired to keep both yourself and others safe.

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Drowsy Driving: Highest Risk Occupations
Drowsy Driving: Highest Risk Occupations