Association of Obstructive Sleep Apnea Risk with Occupational Accidents in Rotating Night Shift Textile Workers

Abstract

Obstructive Sleep Apnea (OSA) represents a critical yet often underdiagnosed contributor to occupational morbidity, given its established links to impaired vigilance, neurocognitive dysfunction, and accident proneness. This cross-sectional study evaluated the prevalence of OSA risk and its relationship with occupational accidents among rotating shift workers. Between April and June 2024, 217 textile workers underwent assessment using the STOP-BANG questionnaire (score ≥3 indicating OSA risk) alongside the Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, and Insomnia Severity Index. Compared with their counterparts, those at risk were older, had higher body mass index, larger neck and waist circumferences, longer employment duration, more comorbidities, and higher daytime sleepiness scores (ESS: 4 [0–11] vs. 5 [0–16];p = 0.007), while subjective sleep time and sleep quality indices were comparable. In total, 36.4% of workers reported an occupational accident in the past year. Accident prevalence was higher in those with OSA risk (50.0% vs. 28.1%), and OSA risk remained an independent predictor of accidents (adjusted OR = 2.55; 95% CI: 1.44–4.53;p = 0.001) in the fully adjusted model. These findings highlight OSA as a prevalent, underrecognized determinant of occupational safety among shift workers. Integrating systematic OSA screening into workplace health surveillance and implementing targeted preventive measures could mitigate accident risk, improve productivity, and contribute to a closer alignment between sleep medicine and occupational health practice.

Keywords

obstructive sleep apnea / occupational accident / daytime sleepiness / sleep apnea screening / STOP-BANG

Author Contributions

R.C.U.: Data curation, field investigation, writing—original draft preparation; O.K.K.: Data curation, investigation, writing—original draft preparation; Z.N.T.: Conceptualization, methodology, formal analysis, interpretation of data, supervision, writing—review and editing; Ö.K.B.: Conceptualization, methodology, supervision, validation, writing—review and editing. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Institutional Ethics Committee of the Faculty of Medicine, Ege University (approval number: 24-2T/27 and date of approval: 8 February 2024).

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

The dataset generated and analyzed in this study contains sensitive personal and health-related information and cannot be made publicly available due to ethical and legal restrictions. Data may be obtained from the corresponding author upon reasonable request, and only with approval from the Ege University Medical Research Ethics Committee. All data will be retained and made accessible to qualified researchers for at least 10 years after publication, in accordance with institutional and journal policies.

Acknowledgments

We gratefully acknowledge the support of the factory administration and the workers who participated in the study, whose contributions were essential for conducting this research. The authors also thank Timur Köse, Ege University Faculty of Medicine, Department of Biostatistics and Medical Informatics, for statistical assistance.

Conflicts of Interest

The authors declare no conflict of interest.

Use of AI and AI-Assisted Technologies

During the preparation of this work, the authors used an AI-assisted language tool (ChatGPT, OpenAI) to improve language clarity and readability. After using this tool/service, the authors reviewed and edited the content as needed and take full responsibility for the content of the published article.

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