# Morbidity burden and sleep disorder risk among occupational radiation-exposed workers: a cross-sectional study of 1,089 participants in southern China

## TL;DR

This study finds that radiation workers with more health issues are more likely to have sleep disorders, especially women and biomedical engineers.

## Contribution

The study identifies a dose-response relationship between cumulative morbidity and sleep disorders in radiation-exposed workers, highlighting high-risk subgroups.

## Key findings

- Workers with ≥3 morbidities had a 3.81-fold higher risk of sleep disorders compared to those without comorbidities.
- Biomedical engineers had a 5.75-fold higher risk of sleep disorders after adjusting for confounders.
- Women and workers with ≤15 years of service showed significantly stronger associations between morbidity and sleep disorders.

## Abstract

Occupational radiation exposure poses unique health challenges, with emerging evidence suggesting links between chronic low-dose exposure, multisystem morbidity, and sleep disturbances. This study examines the relationship between cumulative morbidity burden and the risk of sleep disorders among radiation-exposed workers in southern China.

A cross-sectional investigation was conducted from January to December 2024 at Guangzhou Twelfth People’s Hospital. Morbidity burden was assessed through physician-diagnosed conditions classified by ICD-10 codes across seven disease categories. Sleep disorders were identified via a study-specific questionnaire. Multivariable logistic regression models, adjusted for demographic, occupational, and lifestyle confounders, were used to quantify associations between morbidity and sleep disorders. Subgroup analyses evaluated effect modification by sex, service duration, and profession.

A consecutive sample of 1,089 radiation workers underwent comprehensive health evaluations. Sleep disorders affected 33.0% of participants. A graded dose–response relationship was observed: workers with one morbidity exhibited 2.28-fold higher risk of sleep disorders (95%CI:1.68–3.10) compared to those without comorbidities. Risk increased to OR = 2.89 (1.97–4.25) for two morbidities and OR = 3.81 (2.42–6.01) for ≥3 morbidities after full adjustment. Subgroup analyses revealed significantly stronger associations in women (OR = 3.97, 1.94–8.42), workers with ≤15 years of service (OR = 4.24, 1.97–9.38), and biomedical engineers (OR = 5.75, 2.38–14.33). Thyroid, respiratory, cardiovascular, and lens opacity prevalence differed substantially between workers with sleep disorders and those without.

Accumulating morbidity burden is robustly associated with sleep disorder risk among radiation workers, with occupational factors influencing the strength of this association. Biomedical engineers, women, and early-career personnel represent high-risk subgroups that warrant targeted screening and preventive interventions.