Occupational stress and psychological distress among railway loco pilots in Bengaluru, India: A mixed-methods study

Abstract Objective Occupational stress and mental health conditions are increasingly prevalent among transport workers, especially railway loco pilots operating under prolonged, irregular, and high-pressure schedules. Methods This mixed-methods study assessed work-related stress and symptoms of mental disorder among 287 loco pilots in Bengaluru, India, using the Kessler Psychological Distress Scale (K10) and the Tool to Assess and Classify Work Stress (TAWS-16), along with thematic analysis of qualitative interviews. Results Mild to severe work stress was reported by 34.2% of participants, while 50.9% screened positive for psychological distress. Younger age and Assistant Loco Pilot status were associated with higher occupational stress in unadjusted analyses; after adjustment, Assistant Loco Pilot status remained significantly associated with occupational stress. While working hours and shift types showed no strong associations, regression analysis revealed how rank and age influence vulnerability. After adjustment, Assistant Loco Pilot status was significantly associated with occupational stress (AOR = 2.11, 95% CI: 1.09–4.09, p = 0.028) ,whereas age showed a non-significant association (AOR 1.70, 95% CI 0.92–3.12, p=0.089) Qualitative findings revealed four dominant themes: perceived causes of stress, coping strategies, organizational support, and suggestions for system-level improvement. Stressors included emotional strain, disrupted sleep, family-related guilt, and inadequate support. Coping strategies ranged from self-care to internalized stress management. Conclusion Findings indicate that existing wellness initiatives are not sufficiently tailored to this workforce. The need for role-specific, age-sensitive workplace mental health interventions and ergonomic reforms in railway operations to reduce long-term occupational health risks need to be prioritized.