Background Fatigue driving is an important cause of road traffic accidents in modern society, and the fatigue condition of heavy-duty commercial truck drivers has attracted widespread attention. Research on the fatigue status and influencing factors of heavy-duty commercial truck drivers in China is relatively rare at present.

Objective To analyze the main characteristics of fatigue among heavy-duty commercial truck drivers and the impacts of factors such as working hours, insomnia, and occupational burnout on their fatigue status.

Methods Using cluster sampling method, a cross-sectional study was conducted from July to August 2023, enrolling heavy-duty commercial truck drivers in long-distance freight logistics markets (stations) located in three administrative regions of W City, Xinjiang Uygur Autonomous Region. A self-designed questionnaire was used to collect demographic and occupational characteristics of heavy-duty commercial truck drivers, and the Chinese versions of Fatigue Scale-14 (FS-14), Athens Insomnia Scale (AIS), and Maslach Burnout Inventory General Survey (MBI-GS) were used to evaluate their fatigue, insomnia, and occupational burnout status, respectively. Mann-Whitney U test and Kruskal-Walls H test were used to compare intergroup differences, and Spearman correlation coefficient was used to analyze the correlation between variables. Hierarchical regression models were used to study the impacts of selected variables on fatigue status.

Results This study obtained 311 valid questionnaires, with a valid recovery rate of 88.86% (311/350). The physical fatigue, mental fatigue, and total fatigue scores of the survey subjects in M (P₂₅, P₇₅) were 3.00 (2.00, 4.00), 2.00 (1.00, 3.00), and 5.00 (4.00, 6.00), respectively. The comparison results showed that, except for smoking, there were statistically significant differences in total fatigue scores between different groups of age, marital status, number of children, educational level, service length of freight transportation, average daily working time, and average monthly income (P<0.05). The difference in total fatigue score among the groups without sleep disorders, with suspected insomnia, and with insomnia was statistically significant (P<0.001). The difference in total fatigue score among the groups without occupational burnout, with moderate occupational burnout, and with severe occupational burnout was also statistically significant (P<0.001). Positive correlations were found between insomnia score and scores of physical fatigue (r_s=0.507), mental fatigue (r_s=0.547), and total fatigue (r_s=0.618) (P<0.001). Hierarchical regression models revealed that having more children, extended daily working hours, insomnia, and increased scores of decreased personal accomplishment were negative factors affecting the fatigue status of heavy-duty commercial truck drivers (P<0.05), and the final regression equation was: total fatigue score=7.579+0.581×number of children+0.916×average daily working time+0.434×score of AIS+0.754×score of reduced personal accomplishment.

Conclusion The fatigue status of heavy-duty commercial truck drivers is not optimistic. An increase in the number of children, extended daily working hours, severe insomnia symptoms, and increased scores of decreased personal accomplishment associate with their worse fatigue status.