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J Occup Health year 2007 volume 49 number 6 page 461 - 466
Classification Original
Title Predisposing Factors of Sleep-Disordered Breathing in Japanese Male Workers
Author Kuniyuki Niijima1, Tetsuya Mizoue2, Masatoshi Kawashima3, Kazuhiko Enta1, Shunsuke Sashihara3 and Yasuo Morimoto4
Organization 1Shizuoka Health Care Center, Central Japan Railway Company, 2Department of Epidemiology and International Health Research Institute, International Medical Center of Japan, 3Health Care Center, Central Japan Railway Company and 4Department of Occupational Pneumology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan
Keywords Sleep-disordered breathing, Screening, Hyoid mental distance, Mandibular hypoplasia, Modified Mallampati score, Tonsillar hypertrophy, Pulse oximetry, Occupational health
Correspondence S. Sashihara, Health Care Center, Central Japan Railway Company, 3-7-7 Taikou, Nakamura-ku, Nagoya city, Aichi 453-0801, Japan (e-mail:
Abstract Predisposing Factors of Sleep-Disordered Breathing in Japanese male Workers: Kuniyuki Niijima, et al. Shizuoka Health Care Center, Central Japan Railway Company—The aim of this study was to elucidate the usable predisposing factors of sleep-disordered breathing (SDB) in the workplace. A total of 353 male workers who complained of SDB related symptoms such as witnessed snoring, recurrent awakening from sleep, urination during the night, morning headache, and excessive daytime sleepiness were included in the analysis. We examined hyoid-mental distance (HMD), modified Mallampati score (MMS), and the narrowness of the pharynx with tonsillar hypertrophy as the predisposing physical findings of SDB. We used the number of 3% or more oxygen desaturation events per hour (ODI3) as the indicator of SDB. The mean values (S.D.) of all subjects were 44.3 (8.9) yr (19-66 yr) of age, and 25.9 (3.8) Kg/m2 body mass index (BMI). A significant difference in ODI3 was found between the HMD classes, and also between the subjects with and without tonsillar hypertrophy. Mean ODI3 adjusted for age, BMI, and alcohol consumption on the day of monitoring was high in the group of short HMD and the group of tonsillar hypertrophy (+). For MMS, though ODI3 did not appear to be significantly different, mean ODI3 was high in the MMS-IV. In conclusion, short HMD and tonsillar hypertrophy are the important findings predicting SDB identified by pulse oximetry. These findings would be beneficial in the workplace for selection of subjects who should be encouraged to undergo pulse oximetry for detection of SDB.