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Fatigue. Muscle pain. Depression. Dehydration. Kidney issues.

The ailments of Uber and Lyft drivers have gone up as their pay has plummeted and they spend more hours on the road to make up for those dwindling earnings, according to a new report released Tuesday by Human Impact Partners, a health research advocacy group.

That report was released in partnership with Gig Workers Rising, an advocacy group made up of current and former app-based workers, including Uber and Lyft drivers. It recommends establishing a living wage, requiring ride-hail companies to provide health benefits and creating increased work transparency to help stabilize drivers’ health.

Physical ailments affecting Uber and Lyft drivers have compounded in recent years, the report’s authors found — especially as Uber and Lyft catapulted into initial public offerings, increasing their need to turn a profit.

This new dynamic has even caused some drivers to use the bathroom less to maximize their hours driving.

“Now that they’re pushed to the max, it’s adding to the burden their bodies are feeling,” said Martha Ockenfels-Martinez, a research associate at Human Impact Partners.

“Many said they had very limited access to bathrooms so they don’t drink water,” she added. That dehydration also leads to other health issues.

Human Impact Partners’ research included a wide-reaching literature review on the social and health impacts of ride-hail driving and in related industries, three focus groups with a total of 13 people who drive for Lyft and Uber, analysis of those interviews, and additional interviews with occupational health and economics academics and practitioners.

Various realities of ride-hail driving lead to bad health outcomes, the report’s authors found.

The “unpredictability” of ride-hail driving, including the inability to see the distance a ride may require, leads to chronic stress for drivers. In addition, the inability to speak to real humans about work issues — drivers are required to deal with work through the app itself — leads to isolation that can harm drivers’ health.

But perhaps the chief driver of bad health outcomes was increased sedentary time on the road. Four years ago, when drivers say the take-home pay of drivers was higher, they could afford to work 40 hours a week and take time during their shifts to exercise, walk around a block, or go home and see their children.

Now, full-time drivers spend up to 70 hours a week on the road. They feel their time is so scarce that even taking a walk around the block could make the difference between earning a full day’s pay or not.

The report reflects driving conditions nationally, but some drivers who participated in the focus group work primarily in San Francisco, like Steve Gregg, 51, of Antioch.

Most weeks he drives 60 hours to make ends meet. That’s far different from when he started four years ago, when he could drive 30-40 hours a week to make the same pay. He also now drives 12 hour days. When he started, he drove eight for the same pay.

Gregg said he now feels more “pressure” to drive his whole shift, and takes fewer, if any, breaks to exercise. Like some the report’s authors spoke to, Gregg also cuts down on bathroom trips to maximize his earnings.

“I moderate how much water I drink just so I don’t have to use the restroom as much,” he said. “I wonder about my kidneys.”

Gregg also said the additional hours on the road leads to him seeing his three kids, aged 16, 15 and 13, far less. That takes a toll on his emotional health.

“It’s the most heartbreaking experience I’ve ever had. It’s a loss of connection, a loss of intimacy,” he said.

Gig Workers Rising, which worked in partnership with Human Impact Partners to organize the report, is advocating for the passage of Assembly Bill 5, which would cement what is known as the Dynamex court decision and make some independent contractors employees. The change could give some more work benefits and higher wages.

That includes ride-hail drivers. But Uber and Lyft have pushed back, saying many of their drivers are part-time and would be cut out from flexible work by the passage of AB5.

In a statement, a Lyft spokesperson said the company is doing its best to address driver health.

“Lyft constantly works to improve the driver experience and help drivers earn more. Over the past two years, driver earnings have risen, with drivers nationally now making more than $30 per booked hour on average,” wrote a Lyft spokesperson. “And we’re working with elected officials and labor leaders on a way to modernize labor law so we can provide some of the benefits we know drivers want, without sacrificing the flexibility we know they overwhelmingly value.”

Update 8/13/19 11:00 a.m.: An Uber spokesperson forwarded the following statement after this story went to press: “What we repeatedly hear from drivers is what they value most about Uber is the flexibility to work whenever, wherever, and for whom they choose. We believe that independent, on-demand workers should not have to sacrifice security to enjoy that flexibility. That’s why we’ve been at the table with stakeholders offering a plan that would guarantee drivers an earnings floor tied to minimum wage plus expenses; a robust package of portable benefits they can access no matter which rideshare company they drive for; and meaningful representation that gives them a say on matters affecting their lives and livelihood.”

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