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Original article

Vol. 143 No. 5152 (2013)

Sleep problems and work injury types: a study of 180 patients in a Swiss emergency department

  • Katrin Uehli
  • David Miedinger
  • Roland Bingisser
  • Selina Dürr
  • Edith Holsboer-Trachsler
  • Sabrina Maier
  • Amar Jayant Mehta
  • Roland Müller
  • Christian Schindler
  • Stefanie Zogg
  • Nino Künzli
  • Jörg Daniel Leuppi
Cite this as:
Swiss Med Wkly. 2013;143:w13902


INTRODUCTION: Sleep problems present a risk for work injuries and are a major occupational health concern worldwide. Knowledge about the influence of sleep problems on work injury patterns is limited. Therefore, the aim of this study was to identify potential associations between different types of work injuries and sleep quality, sleep duration, and daytime sleepiness.

METHODS: In this hospital-based study, 180 male and female patients with work injuries were recruited at the Emergency Department of the University Hospital Basel, Switzerland, from December 1st 2009 to June 30th 2011. The data on work injury characteristics, sleep problems, and potential confounders, such as demographic, health, lifestyle, occupational and environmental factors, were collected. Multivariable logistic regression analyses were performed to investigate the relationship between sleep problems and various types of work injury.

RESULTS: Each dimension of sleep problems – sleep quality, sleep duration and daytime sleepiness – was a significant risk factor for at least one type of work injury. The strongest association was found for musculoskeletal injuries and falls with short sleep duration (odds ratio [OR] 5.41, 95% confidence interval [CI] 1.81–16.22). The standardised scores of the Pittsburgh sleep quality index (PSQI) and the Epworth sleepiness scale (ESS) did not discriminate between injury types.

CONCLUSION: Employees with sleep problems were more likely to suffer from certain types of work injuries. This should be considered by employers monitoring work injuries and implementing prevention measures in the company’s health and safety management.


  1. Uehli K, Mehta AJ, Miedinger D, Hug K, Schindler C, Holsboer-Trachsler E, et al. Sleep problems and work injuries: a systematic review and meta-analysis. Sleep Med Rev. Forthcoming 2013.
  2. Dregan A, Armstrong D. Cross-country variation in sleep disturbance among working and older age groups: an analysis based on the European Social Survey. Int Psychogeriatr. 2011:1–8.
  3. Kessler RC, Berglund PA, Coulouvrat C, Hajak G, Roth T, Shahly V, et al. Insomnia and the performance of US workers: results from the America Insomnia Survey. Sleep. 2011;34(9):1161–71.
  4. Chau N, Mur JM, Benamghar L, Siegfried C, Dangelzer JL, Francais M, et al. Relationships between certain individual characteristics and occupational injuries for various jobs in the construction industry: a case-control study. Am J Ind Med. 2004;45:84–92.
  5. Chau N, Gauchard GC, Siegfried C, Benamghar L, Dangelzer JL, Francais M, et al. Relationships of job, age, and life conditions with the causes and severity of occupational injuries in construction workers. Int Arch Occup Environ Health. 2004;77(1):60–6.
  6. Swaen GMH, van Amelsvoort LGPM, Bültmann U, Kant IJ. Fatigue as a risk factor for being injured in an occupational accident: results from the Maastricht Cohort Study. Occup Envrion Med. 2003;60(Suppl I):i88–i92.
  7. Gilboy N, Tanabe P, Travers DA, Rosenau AM, Eitel DR. Emergency Severity Index, version 4: implementation handbook. Rockville, MD: Agency for Healthcare Research and Quality. May 2005. AHRQ Publication No. 05–0046–2.
  8. Grossmann FF, Delport K, Keller DI. Emergency Severity Index: Deutsche Übersetzung eines validen Triageinstruments. Notfall Rettungsmed. 2009;12:290–2. German.
  9. Schweizerische Eidgenossenschaft. Bundesgesetz über die Unfallverhütung (UVG). Landesrecht. 1981; Art. 7. German.
  10. Eurostat. European statistics on accidents at work (ESAW): Summary methodology. Eurostat methodologies & working papers. 2012.
  11. Buysse DJ, Reynolds CF, 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psyciatry Res. 1989;28:193–213.
  12. Riemann D, Backhaus J, editors. Behandlung von Schlafstörungen. Weinheim: Psychologie Verlags Union; 1996. German.
  13. Bloch KE, Schoch OD, Zhang JN, Russi EW. German version of the Epworth sleepiness scale. Respiration. 1999;66:440–7.
  14. Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991;14(6):540–5.
  15. Tomasi D, Wang RL, Telang F, Boronikolas V, Jayne MC, Wang GJ, et al. Impairment of attentional networks after 1 night of sleep deprivation. Cerebral cortex. 2009;19(1):233–40.
  16. Theorell-Haglöw J, Berglund L, Janson C, Lindberg E. Sleep duration and central obesity in woman – differences between short sleepers and long sleepers. Sleep Med. 2012;13(8).
  17. Beccuti G, Pannain S. Sleep and obesity. Curr Opin Clin Nutr Metab Care. 2011;14:402–12.
  18. Corbeil P, Simoneau M, Rancourt D, Tremblay A, Teasdale N. Increased risk for falling associated with obesity: mathematical modeling of postural control. IEEE Trans Neural Syst and Rehabil Eng. 2001;9(2):126–36.
  19. Gauchard GC, Chau N, Touron C, Benamghar L, Dehaene D, Perrin PP, et al. Individual characteristics in occupational accidents due to imbalance: a case-control study of the employees of a railway company. Occup Environ Med. 2003;60:330–5.
  20. Østbye T, Dement JM, Krause KM. Obesity in workers’ compensation. Results from the Duke Health and Safety Surveillance System. Arch Intern Med. 2007;167:766–73.
  21. Pereira CB, Strupp M, Holzleitner T, Brandt T. Smoking and balace: correlation of nicotine-induced nystagmus and postural body sway. Neuroreport. 2001;8:1223–6.
  22. Cronbach LJ. Coefficient alpha and the internal structure of tests. Psychomerika. 1951;16(3):297–334.
  23. Sammelstelle für die Statistik der Unfallversicherung UVG (SSUV). Unfallstatistik UVG 2012. 2012. German.
  24. Schweizerische Unfallversicherungsanstalt (SUVA). Unfallstatistik UVG 2003–2007. 2009. German.
  25. Bundesamt für Statistik. Gesundheitsstatistik 2012. Statistik der Schweiz. 2012;14. German.
  26. Bundesamt für Statistik. Schweizerische Arbeitskräfteerhebung (SAKE). 2011. German.
  27. Statistisches Amt. Beschäftigte nach Geschlecht und Staatsangehörigkeit. Tabelle t03205 [Internet]. 2010 [cited 2013 Mar 26]. Available from:
  28. Statistisches Amt des Kantons Basel-Stadt. Arbeitsmarktmonitoring 2011. Jahresbericht. Basel-Stadt: Präsidialdepartement des Kantons Basel-Stadt. 2011.
  29. Laube I, Seeger R, Russi EW, Bloch KE. Accidents related to sleepiness: review of medical causes and prevention with special reference to Switzerland. Schweiz Med Wochenschr. 1998;128:1487–99.
  30. Frickmann F, Wurm B, Jeger V, Lehmann B, Zimmermann H, Exadaktylos AK. 782 consecutive construction work accidents: who is at risk? Swiss Med Wkly. 2012;142:w13674.
  31. Kunar BM, Bhattacherjee A, Chau N. A machted case-control study of occupational injury in underground coalmine workers. J S Afr Inst Min Metall. 2010;110(1):1–9.
  32. Kling RN, McLeod CB, Koehoorn M. Sleep problems and workplace injuries in Canada. Sleep. 2010;33(5):611–8.
  33. Nakata A, Ikeda T, Takahashi M, Haratani T, Fukui S, Swanson NG, et al. Sleep-related risk of occupational injuries in Japanese small and medium-scale enterprises. Ind Health. 2005;43:89–97.
  34. Salminen S, Oksanen T, Vahtera J, Sallinen M, Härmä M, Salo P, et al. Sleep disturbances as a predictor of occupational injuries among public sector workers. J Sleep Res. 2010;19:207–13.
  35. Ulfberg J, Carter N, Edling C. Sleep-disordered breathing and occupational accidents. Scand J Work Environ Health. 2000;26(3):237–42.
  36. Melamed S, Oksenberg A. Excessive daytime sleepiness and risk of occupational injuries in non-shift daytime workers. Sleep. 2002;25(3):315–21.
  37. World Health Organisation (WHO). BMI classification. Global database on body mass index [Internet]. [cited 2012 Dec 6]. Available from:
  38. World Health Organisation (WHO), editor. Waist circumference and waist-hip ratio: report of a WHO expert consultation. Geneva: WHO Library; 2008.
  39. Institute for Health and Care Research (EMGO+). Quality handbook: guidelines for each research phase. 2010 [cited 2011 Nov 1]. Available from:

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