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Meta-Analysis
. 2016 Jun 1;39(6):1211-8.
doi: 10.5665/sleep.5834.

Risk of Occupational Accidents in Workers with Obstructive Sleep Apnea: Systematic Review and Meta-analysis

Sergio Garbarino  1   2   3 , Ottavia Guglielmi  1 , Antonio Sanna  4 , Gian Luigi Mancardi  1 , Nicola Magnavita  5
Affiliations
Meta-Analysis

Risk of Occupational Accidents in Workers with Obstructive Sleep Apnea: Systematic Review and Meta-analysis

Sergio Garbarino et al. Sleep. .

Abstract

Study objectives: Obstructive sleep apnea (OSA) is the single most important preventable medical cause of excessive daytime sleepiness (EDS) and driving accidents. OSA may also adversely affect work performance through a decrease in productivity, and an increase in the injury rate. Nevertheless, no systematic review and meta-analysis of the relationship between OSA and work accidents has been performed thus far.

Methods: PubMed, PsycInfo, Scopus, Web of Science, and Cochrane Library were searched. Out of an initial list of 1,099 papers, 10 studies (12,553 participants) were eligible for our review, and 7 of them were included in the meta-analysis. The overall effects were measured by odds ratios (OR) and 95% confidence intervals (CI). An assessment was made of the methodological quality of the studies. Moderator analysis and funnel plot analysis were used to explore the sources of between-study heterogeneity.

Results: Compared to controls, the odds of work accident was found to be nearly double in workers with OSA (OR = 2.18; 95% CI = 1.53-3.10). Occupational driving was associated with a higher effect size.

Conclusions: OSA is an underdiagnosed nonoccupational disease that has a strong adverse effect on work accidents. The nearly twofold increased odds of work accidents in subjects with OSA calls for workplace screening in selected safety-sensitive occupations.

Commentary: A commentary on this article appears in this issue on page 1171.

Keywords: excessive daytime sleepiness; injury; mean effect size; meta-analysis; obstructive sleep apnea; safety; systematic review; work accident; workplace.

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Figures

Figure 1
Figure 1
Article selection algorithm.
Figure 2
Figure 2
Meta-analysis of the association of self-reported obstructive sleep apnea and workplace accidents (seven studies).
Figure 3
Figure 3
Meta-analysis of the association of instrumentally diagnosed obstructive sleep apnea and workplace accidents. Studies without polygraphy/ PSG were excluded from calculation. CI, confidence interval.
Figure 4
Figure 4
Funnel plot. OR, odds ratio; SE, standard error.
See this image and copyright information in PMC

Comment in

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