[Association of Polycyclic Aromatic Hydrocarbons exposure with sleep quality among coking plant workers].

Objective: To explore the relationship between polycyclic aromatic hydrocarbons (PAHs) exposure and sleep quality in workers from a coking plant. Methods: From April to June 2019. Selected 632 employed workers in the coking plant of a large state-owned enterprise in Shanxi Province as the exposed group, and 477 employed workers in the water-pump plant belonged to the same enterprise as the control group. We used self-designed questionnaires to collect the basic information of subjects. We measured the concentrations of 12 PAHs in the peripheral blood of workers using gas chromatography-mass spectrometry (GC-MS) ; Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep quality of workers; The relationship between plasma PAHs concentration and sleep quality was analyzed using multiple linear regression model, restricted cubic spline (RCS) regression and logistic regression. Results: The concentration of 12 polycyclic aromatic hydrocarbons in the peripheral blood of the exposure group was (2.36±1.46) ng/ml, which was significantly higher than that of the control group (2.19±1.21) ng/ml. The detection rate of sleep disorder in the exposure group (18.0%) was higher than that in the control group (16.8%) , which was manifested by the significantly increased scores in subjective sleep quality, sleep latency, sleep disorders, daytime dysfunction, and PSQI. Multiple linear regression analysis showed that the PSQI score of workers in the high exposure group decreased by 0.80 (95% CI: -1.40~-0.19) points compared with the low exposure group, with a statistically significant difference (P<0.05) . RCS analysis showed a non-linear dose-response relationship of PSQI score with PAHs cumulative exposure (plasma PAHs concentration multiplied by length of service) . The results of logistic regression showed that compared with the low level group, the risk of somnipathy in the middle level group of PAHs cumulative exposure decreased by 44%, among which the risk of sleep disorder in the drinkers decreased by 40%, while the risk of somnipathy in the high level group increased by 96% compared with the low level group. Stratified analysis of alcohol drinking habit showed non-significant difference in PSQI score with low, medium, and high levels of PAHs cumulative exposure in non-drinkers (P>0.05) , and that the PSQI score was significantly increased in alcohol drinkers with high level of PAHs cumulative exposure compared to those with low and medium levels of PAHs cumulative exposure. Conclusion: The workers in the coking plant had high levels of PAHs in plasma and poor sleep quality, Higher level of PAHs cumulative exposure (>1396.56ng/ml) is a risk factor of poor sleep quality.目的： 探讨某焦化厂工人多环芳烃（PAHs）暴露与睡眠质量的关系。 方法： 于2019年4至6月，选取山西省某大型国有企业焦化厂632名工人为暴露组，以该企业下设能动厂477名工人为对照组，问卷调查收集工人基本资料。利用气相色谱-质谱联用（GC-MS）法检测工人外周血中12种PAHs的浓度；用《匹兹堡睡眠质量指数量表》（PSQI）评估工人睡眠质量；采用多元线性回归模型、限制性立方样条（RCS）回归以及logistic回归分析工人PAHs暴露与睡眠质量之间的关系。 结果： 暴露组外周血中12种多环芳烃的浓度为（2.36±1.46）ng/ml，明显高于对照组（2.19±1.21）ng/ml（P<0.05），暴露组睡眠障碍的检出率（18.0%）高于对照组（16.8%），主要体现为主观睡眠质量、睡眠潜伏期、睡眠紊乱、白天功能紊乱以及PSQI得分均明显增高（P<0.05）。多元线性回归分析发现，与低暴露组比较，高暴露组工人PSQI得分减少0.80（95%CI：-1.40~-0.19）分，差异有统计学意义（P<0.05）。RCS分析发现，PAHs累积暴露量（PAHs浓度×作业工龄）与睡眠质量存在非线性剂量反应关系，logistic回归结果显示，与PAHs累积暴露量低水平组比较，中水平组工人发生睡眠障碍的风险降低44%，其中饮酒者发生睡眠障碍的风险降低40%，而高水平组工人发生睡眠障碍的风险增加96%。按照饮酒与否进行分层分析，发现在不饮酒人群中，低、中、高水平组工人的PSQI得分差异无统计学意义（P>0.05），饮酒人群中，高水平组PSQI得分明显高于低、中水平组，睡眠质量明显降低（P<0.05）。 结论： 该焦化厂工人外周血中PAHs水平较高，睡眠质量较差，PAHs累积暴露量较高（>1 396.56 ng/ml）是睡眠质量差的危险因素。.