Obstructive sleep apnea syndrome and sleep disorders in individuals with occupational injuries

Estimated prevalence of obstructive sleep apnea by occupation and industry in England: a descriptive study

Study Objectives

Obstructive sleep apnea (OSA) can induce excessive sleepiness, causing work-related injuries and low productivity. Most individuals with OSA in the United Kingdom are undiagnosed, and thus, theoretically, workplace screening, might by identifying these individuals improve both their individual health and overall productivity. However, the prevalence of OSA in different workplaces is unclear. This study aimed to estimate the prevalence of OSA by industries and occupations in England.

Methods

The Health Survey for England 2019 dataset was combined with Sleep Heart Health Study dataset. We applied multiple imputation for the combined dataset to estimate OSA in the English population aged 40-64. We estimated the pooled prevalence of OSA by both industry and occupation by separating samples by Standard Industry Classification and Standard Occupation Classification.

Results

The overall OSA prevalence estimated by imputation for ages 40-64 was 17.8% (95% CI = 15.9% to 19.9%). Separating those samples into industrial/occupational groups, the estimated prevalence of OSA varied widely by industry/occupation. Descriptive analysis revealed that the estimated prevalence of OSA was relatively higher in the Accommodation and food, Public administration and defence; compulsory social security, Construction industries, and Protective service occupations, health and social care associate professionals, and skilled construction and building trades occupations.

Conclusions

In England in 2019, Accommodation and food, Public administration and defence; compulsory social security, Construction industries, and Protective service occupations, health and social care associate professionals, and skilled construction and building trades occupations showed a relatively higher prevalence of OSA indicating that they may be target populations for workplace screening.

Sleep disturbances and disability following work-related injury and illness: Examining longitudinal relationships across three follow-up waves

Despite the high burden of sleep disturbances among the general population, there is limited information on prevalence and impact of poor sleep among injured workers. This study: (a) estimated the prevalence of sleep disturbance following work-related injury; and (b) examined the longitudinal association between sleep disturbances and disability/functioning, accounting for reciprocal relationships and mental illness. Longitudinal survey data were collected from workers' compensation claimants with a time-loss claim in Victoria, Australia (N = 700). Surveys were conducted at baseline, 6 months and 12 months. Sleep disturbance was measured using the Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaire. Disability/functioning was based on self-reported activity limitations, participation restrictions and emotional functioning. Path models examined the association between disability/functioning and sleep. Mean sleep disturbance T-scores were 55.2 (SD 11.4) at 6 months, with 36.4% of the sample having a T-score of 60+. Longitudinal relationships were observed between disability (specifically, emotional functioning) and sleep disturbances across successive follow-up waves. For example, each unit increase in T2 emotional functioning (five-point scale) was associated with a 1.1 unit increase in T3 sleep disturbance (approximately 29-76 scale). Cross-lagged path models found evidence of a reciprocal relationship between disability and sleep, although adjustment for mental illness attenuated the estimates to the null. In conclusion, sleep disturbances are common among workers' compensation claimants with work injuries/illnesses. Given the links between some dimensions of disability, mental health and sleep disturbances, the findings have implications for the development of interventions that target the high prevalence of sleep problems among working populations.

Excessive Daytime Sleepiness and Safety Performance: Comparing Proactive and Reactive Approaches

BACKGROUND

Sleep disorders and excessive daytime sleepiness negatively affect employees' safety performance.

OBJECTIVE

To investigate the relationship between excessive daytime sleepiness with obstructive sleep apnea and safety performance at an oil construction company in Iran.

METHODS

661 employees consented to participate in this study. Excessive daytime sleepiness was measured with the STOP-BANG questionnaire and Epworth Sleepiness Scale (ESS). To determine how sleepiness would affect the studied occupational incidents, accidents causing injury and near misses, both reactive data and proactive safety performance indices were measured. Demographic and predictor variables were analyzed with hierarchical multiple linear regression.

RESULTS

Employees who met the criteria of excessive daytime sleepiness and obstructive sleep apnea had significantly poorer safety performance indicators. STOP-BANG and ESS were significant predictors of safety compliance (β 0.228 and 0.370, respectively), safety participation (β 0.210 and 0.144, respectively), and overall safety behavior (β 0.332 and 0.213, respectively). Further, occupational incidents were 2.5 times higher in workers with indicators of excessive daytime sleepiness and 2 times higher in those with obstructive sleep apnea compared with those without.

CONCLUSION

These findings confirmed that excessive daytime sleepiness is a serious safety hazard, and that both reactive and proactive measures are important to understand the relative contribution of predictor variables.