Excessive Daytime Sleepiness and Safety Performance: Comparing Proactive and Reactive Approaches

BACKGROUND: Sleep disorders and excessive daytime sleepiness negatively affect employees' safety performance. OBJECTIVE: To investigate the relationship between excessive daytime sleepiness with obstructive sleep apnea and safety performance at an oil construction company in Iran. METHODS: 661 employees consented to participate in this study. Excessive daytime sleepiness was measured with the STOP-BANG questionnaire and Epworth Sleepiness Scale (ESS). To determine how sleepiness would affect the studied occupational incidents, accidents causing injury and near misses, both reactive data and proactive safety performance indices were measured. Demographic and predictor variables were analyzed with hierarchical multiple linear regression. RESULTS: Employees who met the criteria of excessive daytime sleepiness and obstructive sleep apnea had significantly poorer safety performance indicators. STOP-BANG and ESS were significant predictors of safety compliance (β 0.228 and 0.370, respectively), safety participation (β 0.210 and 0.144, respectively), and overall safety behavior (β 0.332 and 0.213, respectively). Further, occupational incidents were 2.5 times higher in workers with indicators of excessive daytime sleepiness and 2 times higher in those with obstructive sleep apnea compared with those without. CONCLUSION: These findings confirmed that excessive daytime sleepiness is a serious safety hazard, and that both reactive and proactive measures are important to understand the relative contribution of predictor variables.