李小明, 崔诗悦, 宋杨, 武建辉, 王永斌, 王利华, 袁聚祥. 钢铁工人职业紧张与失眠的关系研究[J]. 环境与职业医学, 2019, 36(8): 710-717. DOI: 10.13213/j.cnki.jeom.2019.19092
引用本文: 李小明, 崔诗悦, 宋杨, 武建辉, 王永斌, 王利华, 袁聚祥. 钢铁工人职业紧张与失眠的关系研究[J]. 环境与职业医学, 2019, 36(8): 710-717. DOI: 10.13213/j.cnki.jeom.2019.19092
LI Xiao-ming, CUI Shi-yue, SONG Yang, WU Jian-hui, WANG Yong-bin, WANG Li-hua, YUAN Ju-xiang. Association between occupational stress and insomnia among steel workers[J]. Journal of Environmental and Occupational Medicine, 2019, 36(8): 710-717. DOI: 10.13213/j.cnki.jeom.2019.19092
Citation: LI Xiao-ming, CUI Shi-yue, SONG Yang, WU Jian-hui, WANG Yong-bin, WANG Li-hua, YUAN Ju-xiang. Association between occupational stress and insomnia among steel workers[J]. Journal of Environmental and Occupational Medicine, 2019, 36(8): 710-717. DOI: 10.13213/j.cnki.jeom.2019.19092

钢铁工人职业紧张与失眠的关系研究

Association between occupational stress and insomnia among steel workers

  • 摘要: 背景 职业紧张是职业人群健康的重要影响因素,研究发现职业紧张与不良睡眠质量相关。睡眠不良可增加肥胖、脑卒中、心血管疾病的发生风险。钢铁工人作业环境中存在众多职业性有害因素且长期以轮班的方式工作,导致其容易产生职业紧张和失眠等问题,给钢铁工人的健康造成不良影响。

    目的 探讨钢铁作业工人职业紧张与失眠的关系,为提高钢铁工人睡眠质量,促进其健康提供理论依据。

    方法 选择2017年2月至10月参加某钢铁公司职业健康体检的一线钢铁工人为研究对象,5 769名工人纳入本次调查,由经过统一培训的调查员采用面对面访谈方式进行问卷调查,调查研究对象性别、年龄、文化程度等一般情况,吸烟、饮酒、体力活动等行为习惯和工龄、轮班等工作特征;采用中文版付出-回报失衡问卷进行职业紧张测评;采用阿森斯失眠量表调查失眠情况。采用二元logistc回归分析,探讨排除钢铁工人一般情况、行为习惯和工作特征的影响后,职业紧张与失眠的关系。

    结果 5 769名研究对象中男性工人占91.2%,年龄为(42.9±8.6)岁。钢铁工人总体失眠率为33.8%。单因素分析显示,酒精摄入为13~33.9 g/d组,家庭人均月收入低于2 000元组,正式工或轮班作业的钢铁工人失眠率较高,与其他分组工人的差异有统计学意义(P < 0.05)。职业紧张程度高、付出得分高、回报得分低、内在投入得分高的钢铁工人失眠率较高,差异有统计学意义(P < 0.001)。职业紧张程度和内在投入综合后,四组钢铁工人组间失眠率差异有统计学意义(P < 0.001);高紧张高内在投入组失眠率较高,为46.9%(P < 0.001)。二元logistc回归分析显示,与低职业紧张钢铁工人比较,高职业紧张工人发生失眠的可能性更高,OR为1.68(95% CI:1.45~1.94);与低内在投入工人相比,高内在投入工人发生失眠的可能性高,OR值为1.23(95% CI:1.09~1.38);与低紧张低内在投入工人相比,高紧张高内在投入的钢铁工人发生失眠的可能性更高,OR值为2.11(95% CI:1.80~2.48)。

    结论 职业紧张是钢铁工人失眠的危险因素。宜制定相应的职业紧张缓解策略和措施,以降低钢铁工人失眠率。

     

    Abstract: Background Occupational stress is major health risk factor in occupational population. It is reported to be associated with sleep disturbance. Sleep disorder is associated with increased risks of obesity, stroke, and cardiovascular disease. Many occupational hazards in working environment and long-term shif work lead to occupatonal stress, insomnia, and other adverse health effects of steel workers.

    Objective This cross-sectional study aims to explore the association between occupational stress and insomnia in steel workers, and provide a theoretcal basis for improving health level and sleep quality of steel workers.

    Methods A total of 5 769 steel workers who took part in the annual health examinaton of a steel company from February to October 2017 in Hebei Province were enrolled for this study. Gender, age, educatonal level, smoking, alcohol consumption, physical activity, employment time, shift work, and other demographic, behavioral, or job characteristics were collected using questonnaire interviewed fact-to-face by trained interviewers. The Chinese brief version of Effort-Reward Imbalance (ERI) was used to evaluate occupatonal stress, and the Athens Insomnia Scale (AIS) was used to evaluate insomnia. Logistc regression analysis was used to explore the relatonship between occupatonal stress and insomnia afer excluding the influence of selected demographic factors, behavior indicators, and job characteristcs.

    Results Of the 5 769 partcipants, most were male (91.2%). The mean age of all partcipants was (42.9±8.6) years. The prevalence rate of insomnia in the steel workers was 33.8%. The univariate analysis results showed that the steel workers with alcohol consumpton of 13- 33.9 g/d, monthly family income less than 2 000 yuan, shif work, and regular employment contract had a lower prevalence of insomnia than the others (P < 0.05). The steel workers with high occupatonal stress, high effort, low reward, and high over-commitment had a higher prevalence of insomnia than the others (P < 0.001). Afer combining the subgroups of occupatonal stress and over-commitment, a signifcant difference in the prevalence rate of insomnia was found among the four combinatons (P < 0.001), and the highest rate was 46.9% in the high stress-high over-commitment group. The results of logistc regression analysis demonstrated that the steel workers with high occupatonal stress had a higher risk of insomnia (OR:1.68; 95%CI:1.45-1.94) than those with low occupatonal stress; those with high over-commitment had a higher risk of insomnia (OR:1.23; 95%CI:1.09-1.38) than those with low over-commitment; those with high occupatonal stress and over-commitment had a higher risk of insomnia (OR:2.11; 95%CI:1.80-2.48) than those with low occupatonal stress and over-commitment.

    Conclusion Occupatonal stress is a risk factor of insomnia in the steel workers. Corresponding strategies and measures are required to relieve occupatonal stress and reduce insomnia rate of steel workers.

     

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