The review on psychoactive substance use among truck drivers by Girotto et al1 is important from the occupational health perspective, but also has consequences from the broader public health perspective. After commenting on the review's methodology related to its findings, this commentary pays attention to both perspectives.

Relevant papers for inclusion in the review were searched systematically and results of the included studies were synthesised independently by two researchers. The authors wisely decided to stratify the results from studies relying on self-reported information and those using biological samples. Still, the observed prevalence of intake of psychoactive substances showed a very large range in both strata. For example, self-reported alcohol intake varied from 9.9% (‘while driving’, Pakistan) up to 91.0% (‘current’, Brazil), and the use of amphetamines analysed from biological samples ranged from 0.2% (Norway) to 82.5% (Thailand). Apart from empirical variation across different truck driver populations (differences actually present), the authors correctly state that these …