钢铁企业职工睡眠障碍的影响因素  

Influencing factors of sleep disorders of employees of a steel enterprise

作　　者：丁明峰 李改云 骆萌 江丽丽 罗晓蕾 张嘉文 江靖雯 李懿伦 沈燕飞[3] 韩雪梅[1] DING Mingfeng;LI Gaiyun;LUO Meng;JIANG Lili;LUO Xiaolei;ZHANG Jiawen;JIANG Jingwen;LI Yilun;SHEN Yanfei;HAN Xuemei(Institute of Social Medicine and Health Management,School of Public Health,Lanzhou University,Lanzhou,Gansu 730000,China;School of Health and Medical Technology,Chengdu Neusoft University,Chengdu,Sichuan 610000,China;Legal Affairs Office,Gansu Provincial People's Hospital,Lanzhou,Gansu 730000,China)

机构地区：[1]兰州大学公共卫生学院社会医学与卫生事业管理研究所,甘肃兰州730000 [2]成都东软学院健康医疗科技学院,四川成都610000 [3]甘肃省人民医院法律事务办公室,甘肃兰州730000

出　　处：《环境与职业医学》2023年第5期559-564,共6页Journal of Environmental and Occupational Medicine

基　　金：甘肃省自然科学基金项目(18JR3RA054)。

摘　　要：[背景]钢铁企业职工是特殊的职业人群,在工作中容易接触粉尘、噪声和高温等职业有害因素,且经常以轮班方式工作,容易发生睡眠障碍。[目的]探索甘肃省某钢铁企业职工睡眠障碍的影响因素,为降低职工睡眠障碍发生风险提供依据。[方法]于2022年1—3月,使用自制问卷结合《匹兹堡睡眠质量指数量表》(PSQI)调查甘肃省某钢铁企业职工。根据其PSQI得分分为睡眠正常组和睡眠障碍组。采用1∶1倾向性评分匹配法(PSM)平衡两组人群一般人口学变量。利用多因素logistic回归分析睡眠障碍的影响因素,采用限制性立方样条模型(RCS)分析每周工作时长与睡眠障碍之间的剂量-反应关系。[结果]12544名研究对象中,睡眠障碍率为48.06%(6029/12544)。PSM后,成功匹配5847对,两组间的匹配变量分布均衡性较好。多因素logistic回归分析显示,高血压(OR=1.39,95%CI:1.24~1.56)、糖尿病(OR=1.34,95%CI:1.07~1.66)、三班倒(OR=1.26,95%CI:1.12~1.41)、粉尘暴露(OR=1.14,95%CI:1.01~1.29)、噪声暴露(OR=1.23,95%CI:1.09~1.39)、高温暴露(OR=1.16,95%CI:1.04~1.29)、工伤(OR=1.22,95%CI:1.02~1.46)的职工睡眠障碍风险增加,与工龄<10年的工人相比,工龄10~20年(OR=1.31,95%CI:1.19~1.44)、20~30年(OR=1.34,95%CI:1.19~1.52)、≥30年(OR=1.35,95%CI:1.19~1.53)的职工睡眠障碍风险更高;与不锻炼的职工相比,偶尔锻炼(OR=0.61,95%CI:0.56~0.66)、经常锻炼(OR=0.55,95%CI:0.49~0.62)的职工睡眠障碍风险降低。RCS结果显示,钢铁企业职工每周工作时长连续变化与睡眠障碍间呈非线性剂量-反应关系(总趋势P<0.05,非线性P<0.05),每周工作时长与睡眠障碍的关系呈“U”形分布,当每周工作时长超过49 h,睡眠障碍风险呈明显的上升趋势。[结论]钢铁企业职工睡眠障碍的非职业影响因素有高血压、糖尿病、体育锻炼,职业影响因素有工龄、每周工作时长、轮班、粉尘暴露、噪声暴露、高温暴露和工伤[Background]Steel workers are exposed to occupational hazardous factors such as dust,noise,and heat,and often work in shifts,making them prone to sleep disorders.[Objective]To explore potential influencing factors of sleep disorders among workers in a steel enterprise in Gansu Province,and provide a basis for reducing the risk of sleep disorders among them.[Methods]From January to March 2022,a self-made questionnaire combined with the Pittsburgh Sleep Quality Index(PSQI)were used to investigate the employees of a steel enterprise in Gansu Province.According to their PSQI scores,they were divided into a normal sleep group and a sleep disorder group.The general demographic variables of the two groups were balanced by 1∶1 propensity score matching(PSM).Multiple logistic regression was used to analyze the contributing factors of sleep disorders.Restricted cubic spline(RCS)model was used to analyze potential dose-response relationship between weekly working hours and sleep disorders.[Results]The prevalence of sleep disorders in the steel workers was 48.06%(6029/12544).After PSM,5847 pairs were successfully matched,and the distributions of matched variables were well balanced between the two groups.The results of multiple logistic regression showed that hypertension(OR=1.39,95%CI:1.24,1.56),diabetes mellitus(OR=1.34,95%CI:1.07,1.66),three-shift system(OR=1.26,95%CI:1.12,1.41),dust exposure(OR=1.14,95%CI:1.01,1.29),noise exposure(OR=1.23,95%CI:1.09,1.39),heat exposure(OR=1.16,95%CI:1.04,1.29),and work injury(OR=1.22,95%CI:1.02,1.46)increased the risk of sleep disorders.Compared with workers with<10 years of service,those with 10-20 years(OR=1.31,95%CI:1.19,1.44),20-30 years(OR=1.34,95%CI:1.19,1.52),and≥30 years of service(OR=1.35,95%CI:1.19,1.53)had a higher risk of sleep disorders.Compared with non-exercise workers,the risk of developing sleep disorders was lower in workers with occasional exercise(OR=0.61,95%CI:0.56,0.66)and regular exercise(OR=0.55,95%CI:0.49,0.62).The RCS model showed that the weekly working hou

关 键 词：钢铁企业职工 睡眠障碍 每周工作时长 倾向性评分匹配 剂量-反应关系 

分 类 号：R135[医药卫生—劳动卫生]