Background In metro cities, different types of transportation are available for passengers, but public buses play a vital role in Kolkata as the backbone of local transportation for the common man in the city. Bus drivers spend the entire day operating in a hazardous and hectic environment. These kinds of circumstances affect them not just physically but also psychologically, and occasionally they serve as the basis for accidents or near-miss incidents.

Objective The objective of the study is to investigate the association among the work pattern, physiological, psychological, and work environment factors of the drivers and their association with the occurrence of accidents in the city.

Methods The study was undertaken among 185 randomly selected bus drivers from different routes. To assess musculoskeletal disorders (MSD), an accident analysis questionnaire was developed and performed. The associations between individual characteristics and different factors were also examined by a χ2 test, and the associations were described by the odds ratio with a 95% confidence interval.

Results and Discussion Drivers work for 16–18 hours per day with both physical and mental stress throughout the year. Questionnaire analysis reported that 10.9% have developed the MSD. Data also reflected a significant association between accidents with MSD (4.8, 1.1–21), hearing loss (6.9, 1.7–23.9), monotonous work (5.9, 1.9–17.9), prolonged working time (3.3, 1.2–9.1), inadequate rest periods in between the working days (4.1, 1.3–12.1) and monotonous work (2.7, 1.1–7.7), inadequate rest periods during the working day (5.1, 1.3–1.6), poor job satisfaction (5.9, 2.1–17.1), and low job appreciation (3.3, 1.2–9.2) showed a significant effect on the occurrence of accidents. Despite the above fact, the results reveal that the majority of the near misses occur because of the driver’s fault, including competition between buses, failure to maintain a maximum safe distance, and fast overtaking.

Conclusion Bus accidents are related to occupational and psychological stress along with excessive hours, poor road design, and ignorance and violation of traffic rules.