番茄社区

SEATTLE -- Individuals with sleep apnea appeared to have a greater rate of on-the-job injuries when compared with workers who did not have sleep-related breathing disorders, researchers said here.

In the univariate analysis, people with obstructive sleep apnea were nearly twice as likely to be hurt on the job [OR 1.929 (95% CI 1.062-3.504, P=0.031)] than co-workers who did not have sleep apnea, said a research associate at the University of British Columbia, Vancouver.

At the annual meeting of the Associated Professional Sleep Societies, Hirsch Allen said that a trend for excess injuries in the sleep apnea workers (P=0.075) persisted when multivariate confounders -- sex, body mass index, alcohol use and/or work in a blue-collar industry -- were factored into the equation.

"Screening and treatment of workers with obstructive sleep apnea may reduce rates of injury," Hirsch Allen told 番茄社区 at his poster presentation.

When he and his colleagues analyzed on-the-job injuries that were associated with sleepiness, the pattern was similar, but not statistically significant.

Individuals who tested positive for obstructive sleep apnea were nearly 2.5 times more likely to have an injury related to reduced vigilance, such as falls or motor vehicle accidents [OR 2.42 (95% CI 0.847-6.295, P=0.099)] and that trend was also seen when confounders were put into the equation [OR 2.42 (95% CI 0.85-6.93, P=0.099)], he said.

For the study, Hirsch Allen and colleagues recruited 1,236 patients, about 70% of whom were men. Their median age was 49 and their median apnea-hypopnea index (AHI) was 15, indicating mild to moderate sleep apnea. About 80% of the patients were diagnosed with some level of sleep apnea, a score greater than 5 on the index. Of the total group of patients, 111 experienced at least one occupational injury.

In performing the study, the researchers focused on blue-collar workers, but the responses required some interpretation, Hirsch Allen said. "A man might say he was in construction, but that didn't really mean he was a blue-collar worker because he could have been an executive with a desk job," he explained. But by reviewing data on how the injuries occurred he was able to determine whether the individuals were blue-collar workers or white-collar workers. "There aren't too many people injured in falls while sitting at their desks," he noted.

The subjects in the study were referred to the University of British Columbia Hospital Sleep Laboratory between May 2003 and July 2011. The patients filled out questionnaires and underwent polysomnography to objectively identify obstructive sleep apnea, according to the AHI. Rates and validated occupational injury that caused at least 1 day of disability in the 5 years prior to polysomnography were calculated by linking the patients' sleep data to claim data from the Workers Compensation Board using PopData BC. Adult patients who reported at least 10 hours work per week were included in the study.

"We sought to improve on previous studies in the literature by using both a large sample size and objective criteria to identify both occupational injuries and obstructive sleep apnea to determine whether patients with sleep apnea were at an increased risk of occupational injury," Hirsch Allen said. "This is the largest study of its kind."

In commenting on the study, a past president of the American Academy of Sleep Medicine and professor of medicine at Wayne State University, Detroit, told 番茄社区 he was not surprised by the results of the study.

"The large number of patients in the study is one of its strengths," he said. "This is a naturalistic experiment. This is what is happening in real life. We know that persons with obstructive sleep apnea are 7 to 8 times more likely to be involved in a motor vehicle accident either because of sleepiness or loss of vigilance or they distract themselves to stay awake. This study now extends this to occupational injury."

Badr said that most sleep specialists advise patients about the hazards of sleepiness on the job and "now we have real data that obstructive sleep apnea puts workers at higher risk for occupational injury. This means effort should be developed to identify these individuals. We don't want you to be drowsy because you could injure yourself or others.

"This work strengthens the case for identifying and treating these patients," he said. Badr suggested that such a program might actually end up being cost saving.

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