Associations of sleep disturbance and emotion regulation with perceived workplace safety and fatigue among male firefighters with prior occupational accidents: A cross-sectional study.

Abstract

Firefighters bear a high burden of sleep disturbance and occupational accidents, yet how their individual health states relate to their own appraisal of workplace safety and fatigue is unclear. This cross-sectional study examined whether sleep disturbance, sleep quality, and emotion-regulation capacity are associated with perceived workplace safety and fatigue-related status in this group. One hundred five active-duty male firefighters from urban brigades in the Marmara region of Türkiye, all with a documented occupational accident history, completed the Basic Scale on Insomnia Complaints and Quality of Sleep, a single-item Sleep Quality Scale, the Emotion Regulation Skills Questionnaire, and the Perceived Workplace Safety/Fatigue Status tool (PWSFS), an exploratory, author-developed composite scored 20 to 100, with higher scores being more favorable (Cronbach α = 0.71 in this sample). Pearson correlations and a multiple linear regression of the PWSFS total score on the 3 predictors, adjusted for age and fire-service experience, were computed. The mean Basic Scale on Insomnia Complaints and Quality of Sleep was 12.2 (standard deviation 5.0), and the mean PWSFS was 73.2 (standard deviation 11.2). Greater sleep disturbance was associated with less favorable perceived safety and fatigue status (r = -.81, 95% confidence interval - .87 to - .74, P < .001), whereas better sleep quality (r = .52, P < .001) and greater emotion-regulation skills (r = .44, P < .001) showed weaker associations. The model accounted for 67% of the variance (F(5, 99) = 39.74, P < .001), and sleep disturbance was the only unique correlate (β = -.81, P < .001); neither sleep quality (P = .46) nor emotion regulation (P = .47) contributed independently. The association persisted in reduced-content analyses but was attenuated when sleep- and fatigue-related items were removed (safety-awareness subset r = -.58, R2 = .38, β = -.77). Among firefighters with prior occupational accidents, sleep disturbance was the measured individual-level variable most strongly associated with perceived workplace safety and fatigue. Because the design was cross-sectional and relied on single-source self-report, and because the outcome was measured with an exploratory, author-developed composite, these associations are provisional and cannot support causal inference. Sleep may nonetheless warrant attention in occupational safety and fatigue-management efforts; longitudinal, multi-source research is needed to confirm these findings.