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长三角地区机车乘务员幸福感和睡眠质量与职业紧张的关联OA北大核心CSTPCD

Associations of well-being and sleep quality with occupational stress among locomotive engi-neers in the Yangtze River Delta region

中文摘要英文摘要

[背景]职业紧张是影响职业人群健康的重要因素,幸福感是近年来关注较多的话题,睡眠质量和幸福感对职业紧张有一定的影响. [目的]了解长三角地区机车乘务员职业紧张的现状,探讨幸福感和睡眠质量对职业紧张的影响,为今后制定机车乘务员职业紧张的干预措施提供理论依据. [方法]2022年 10-12月,采用分层随机抽样的方法进行抽样.采用基于工作要求-自主模型(JDC模型)简明职业紧张问卷中文版、WHO-5幸福感指数量表(WHO-5)、匹兹堡睡眠质量指数(PSQI)量表对机车乘务员职业紧张、幸福感、睡眠质量进行调查.采用多因素logistic回归分析睡眠质量和幸福感对职业紧张的影响,采用相加和相乘交互作用模型分析幸福感和睡眠质量对职业紧张的影响. [结果]共抽取了5个机车车辆单位8243名在职机车乘务员进行问卷调查,最终纳入分析的问卷有7976份.长三角地区机车乘务员中职业紧张者为4633人(58.09%),幸福感低者为4949人(62.05%),睡眠质量差者为 4129人(51.77%).不同年龄、工龄、地区、技术级别、车辆性质、学历、家庭人均月收入、婚姻状况、吸烟、饮酒、每周运动次数、睡眠质量、工作班制、通勤时长的分组,职业紧张分布差异有统计学意义(P<0.01).多因素logistic回归分析显示,家庭人均月收入大于 11000元(OR=0.795,95%CI:0.656~0.964)、幸福感高(OR=0.477,95%CI:0.430~0.528)、睡眠质量好(OR=0.588,95%CI:0.531~0.651)的研究对象发生职业紧张的风险降低;夜班次数越多发生职业紧张的风险越高,夜班 1次及以下(OR=1.707,95%CI:1.312~2.221)、夜班 2~3次(OR=2.649,95%CI:2.111~3.325)、夜班 4次及以上(OR=2.804,95%CI:2.202~3.571);通勤时间60 min及以上(OR=1.353,95%CI:1.111~1.646)发生职业紧张的风险增加.睡眠质量差与幸福感低对职业紧张的相加交互作用显示,相对超额危险度比(RERI)、归因危险度(API)和交互作用指数(SI)分别为 1.451(1.059~1.844)、0.417(0.327~0.507)、2.407(1.787~3.241),相乘交互作用的结果为(OR=1.546,95%CI:1.262~1.893). [结论]长三角地区机车乘务员职业紧张发生率与其他行业相比较总体处于中等水平.机车乘务员睡眠质量好对于降低职业紧张发生风险的程度大于幸福感高降低职业紧张发生风险的程度,睡眠质量差和幸福感低产生交互作用时,可进一步增加职业紧张发生的风险.

[Background]Occupational stress is an important factor affecting the health of working popula-tion,wellness is a topic that has received much attention in recent years,and sleep quality and wellness have a certain impact on occupational stress. [Objective]To understand the current situation of occupational stress among locomotive engineers in in the Yangtze River Delta,explore the influence of well-being and sleep quality on occupational stress,and provide a theoretical basis for occupational stress intervention among locomotive engineers. [Methods]Sampling was conducted from October to December 2022 using stratified random sampling.The Chinese version of the Brief Occupational Tension Questionnaire based on the Job Demand-Control Model(JDC model),the World Health Organization 5-item Well-Being Index(WHO-5),and the Pittsburgh Sleep Quality Index(PSQI)scale were used to investigate the occupational stress,well-being,and sleep quality of locomotive engineers.Logistic regression was used to analyze the effects of sleep quality and well-being on occupational stress,and additive and multiplicative interaction models were applied to evaluate the interactive effects of well-being and sleep quality on occupational stress. [Results]A total of 8243 questionnaires were collected from five locomotive companies,and after excluding unqualified questionnaires,a total of 7976 questionnaires were included in the analysis.The number of locomotive engineers in the Yangtze River Delta reporting positive occupational stress was 4633(58.09%),the number of low-level well-being was 4949(62.05%),and the number of poor sleep quality was 4129(51.77%).The distribution of occupational stress varied by age,length of service,region,technical level,nature of vehi-cle,education,per capita monthly family income,marital status,smoking,drinking,number of exercise sessions per week,quality of sleep,work shifts,and length of commute(P<0.01).The results of logistic regression showed that a lower level of occupational stress was associated with>11000 yuan per capita monthly household income(OR=0.795,95%CI:0.656,0.964),high level of well-being(OR=0.477,95%CI:0.430,0.528),and good sleep quality(OR=0.588,95%CI:0.531,0.651);a higher level of occupational stress was associated with night shifts:1 or fewer night shifts(OR=1.707,95%CI:1.312,2.221),2 to 3 night shifts(OR=2.649,95%CI:2.111,3.325),and 4 or more night shifts(OR=2.804,95%CI:2.202,3.571);a higher level of occupational stress was associated with 60 min or more commuting time(OR=1.353,95%CI:1.111,1.646).Regarding interaction between poor sleep quality and low well-being on occupational stress,the relative excess risk ratio(RERI),attributable risk index(API),and synergy index(SI)were 1.451(1.059,1.844),0.417(0.327,0.507),and 2.407(1.787,3.241),respectively,and the result of the multiplicative interaction was an OR of 1.546(95%CI:1.262,1.893). [Conclusion]The prevalence of occupational stress among locomotive engineers in the Yangtze River Delta region is generally at a medium level compared with other industries.Good sleep quality reduces the risk of occupational stress to a greater extent than high well-being,and poor sleep quality and low well-being can interact and further increase the risk of occupational stress.

刘燕;杨凤;靳宇;武会栓;曹雪玲;尹艳

上海市疾病预防控制中心健康危险因素监测与控制所,上海 200336中国铁路上海局集团有限公司上海铁路疾病预防控制所,上海 200071复旦大学,公共卫生学院/公共卫生安全教育部重点实验室,上海 200032

预防医学

长三角地区机车乘务员职业紧张幸福感睡眠质量交互作用

Yangtze River Deltalocomotive engineeroccupational stresswell-beingsleep qualityinteraction effect

《环境与职业医学》 2024 (005)

526-532 / 7

上海市加强公共卫生体系建设三年行动计划(2023-2025年)重点学科项目(GWVI-11.1-37);中国铁路上海局集团有限公司科研计划课题任务项目(2022193)

10.11836/JEOM23435

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