Association of active/passive smoking and urinary 1-hydroxypyrene with poor sleep quality: A cross-sectional survey among Chinese male enterprise workers
Bo Zhou 1
Yifei Ma 2, 3
Fu Wei 2
Li'e Zhang 2
Xiaohong Chen 4
Suwan Peng 2
Feng Xiong 2
Xiaowu Peng 5
Bushra NiZam 2
Yunfeng Zou 2  
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Research Center for Regenerative Medicine, Guangxi Medical University, Nanning, China
Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, China
AIDS Prevention and Control Institute, Liuzhou Center for Disease Control and Prevention, Liuzhou, China
Department of Physical Examination, Guangxi Institute of Occupational Disease Prevention and Treatment, Nanning, China
Center for Environmental Health Research, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, China
Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning, China
Yunfeng Zou   

Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning 530021, China
Kaiyong Huang   

Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning 530021, China
Publish date: 2018-05-22
Tob. Induc. Dis. 2018;16(May):23
Tobacco use has been implicated as an important factor for poor sleep quality. However, in most studies, the sleep quality of smokers was only assessed though a self-reported questionnaire, without measuring any internal biomarkers that reflect the levels of tobacco exposure. We examined the association of active and passive smoking with sleep quality, assessed smoking exposure using urinary 1-hydroxypyrene (1-HOP) as an internal biomarker, and further explored the relationship between 1-HOP and sleep quality.

A cross-sectional survey was conducted in Liuzhou city, Guangxi, China. A total of 1787 male enterprise workers were enrolled. The smoking attribute data were collected by self-reported questionnaire, and individual sleep quality was evaluated through the Pittsburgh Sleep Quality Index (PSQI). The concentration of urinary 1-HOP was measured by highperformance liquid chromatography.

Compared with non-smoking, active smoking and passive smoking were significantly associated with long sleep latency (odds ratio, OR=1.84, 95% confidence interval, CI=1.28–2.64; 1.45, 1.00–2.11, respectively), short sleep duration (OR=2.72, 95% CI=1.45–5.09; 1.94, 1.01–3.71, respectively), daytime dysfunction (OR=1.54, 95% CI=1.10–2.17; 1.44, 1.02–2.03, respectively), and overall poor sleep quality with PSQI total score >5 (OR=1.41, 95% CI=1.05–1.88; 1.34, 1.00–1.79, respectively). Compared with non-smokers, active smokers had higher urinary 1-OHP concentrations that were significant (p=0.004), while passive smokers had no significant difference in urinary 1-OHP concentration (p=0.344). The high concentration group was significantly associated with daytime dysfunction and overall poor sleep quality with PSQI total score >5 (OR = 1.73, 95% CI=1.06–2.81; 1.76, 1.18–2.63, respectively).

Both active smoking and passive smoking are risk factors for poor sleep quality among Chinese male enterprise workers. Active smokers had significantly higher levels of urinary 1-OHP than non-smokers, and high concentration of 1-OHP was associated with daytime dysfunction and overall poor sleep quality.

1. Davila EP, Lee DJ, Fleming LE, et al. Sleep disorders and secondhand smoke exposure in the U.S. population. Nicotine Tob Res. 2010;12(3):294-299. doi:10.1093/ntr/ntp193
2. Consensus Conference Panel, Watson NF, Badr MB, et al. Joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society on the recommended amount of sleep for a healthy adult: methodology and discussion. J Clin Sleep Med. 2015;11:931-952. doi:10.5664/jcsm.4950
3. Liu Y, Wheaton AG, Chapman DP, Croft JB. Sleep duration and chronic diseases among U.S. adults age 45 years and older: evidence from the 2010 Behavioral Risk Factor Surveillance System. Sleep. 2013;36:1421-1427. doi:10.5665/sleep.3028
4. Tang J, Liao Y, Kelly BC, et al. Gender and Regional Differences in Sleep Quality and Insomnia: A General Population-based Study in Hunan Province of China. Sci Rep. 2017;7:43690. doi:10.1038/srep43690
5. Strine TW, Chapman DP. Associations of frequent sleep insufficiency with health-related quality of life and health behaviors. Sleep Med. 2005;6(1):23-27. doi:10.1016/j.sleep.2004.06.003
6. Nakata A, Takahashi M, Haratani T, et al. Association of Active and Passive Smoking with Sleep Disturbances and Short Sleep Duration among Japanese Working Population. Int J Behav Med. 2008;15(2):81-91. doi:10.1080/10705500801929577
7. Lallukka T, Podlipskytė A, Sivertsen B, et al. Insomnia symptoms and mortality: a register-linked study among women and men from Finland, Norway and Lithuania. J Sleep Res. 2016;25(1):96-103. doi:10.1111/jsr.12343
8. Vgontzas AN, Liao D, Pejovic S, et al. Insomnia with short sleep duration and mortality: the Penn State cohort. Sleep. 2010;33(9):1159-1164. doi:10.1093/sleep/33.9.1159
9. Liu JT, Lee IH, Wang CH, Chen KC, Lee CI, Yang YK. Cigarette smoking might impair memory and sleep quality. J Formos Med Assoc. 2013;112(5):287-290. doi:10.1016/j.jfma.2011.12.006
10. Chen H, Bo QG, Jia CX, Liu X. Sleep Problems in Relation to Smoking and Alcohol Use in Chinese Adolescents. J Nerv Ment Dis. 2017;205(5):353-360. doi:10.1097/NMD.0000000000000661
11. Stafford M, Bendayan R, Tymoszuk U, Kuh D. Social support from the closest person and sleep quality in later life: Evidence from a British birth cohort study. J Psychosom Res. 2017;98:1-9. doi:10.1016/j.jpsychores.2017.04.014
12. Lexcen FJ, Hicks RA. Does cigarette smoking increase sleep problems? Percept Mot Skills. 1993;77(1):16-18. doi:10.2466/pms.1993.77.1.16
13. Deleanu OC, Pocora D, Mihălcuţă S, Ulmeanu R, Zaharie AM, Mihălţan FD. Influence of smoking on sleep and obstructive sleep apnea syndrome. Pneumologia. 2016;65(1):28-35.
14. Riedel BW, Durrence HH, Lichstein KL, Taylor DJ, Bush AJ. The relation between smoking and sleep: the influence of smoking level, health, and psychological variables. Behav Sleep Med. 2004;2(1):63-78. doi:10.1207/s15402010bsm0201_6
15. Kaneita Y, Ohida T, Takemura S, et al. Relation of smoking and drinking to sleep disturbances among Japanese pregnant women. Prev Med. 2005;41(5-6):877-882. doi:10.1016/j.ypmed.2005.08.009
16. Fabsitz RR, Sholinsky P, Goldberg J. Correlates of sleep problems among men: the Vietnam Era Twin Registry. J Sleep Res. 1997;6(1):50-56. doi:10.1046/j.1365-2869.1997.00026.x
17. Tu X, Cai H, Gao YT, et al. Sleep duration and its correlates in middle-aged and elderly Chinese women: the Shanghai Women's Health Study. Sleep Med. 2012;13(9):1138-1145. doi:10.1016/j.sleep.2012.06.014
18. Ohida T, Kaneita Y, Osaki Y, et al. Is passive smoking associated with sleep disturbance among pregnant women? Sleep. 2007;30(9):1155-1161. doi:10.1093/sleep/30.9.1155
19. Schwartz J, Bottorff JL, Richardson CG. Secondhand smoke exposure, restless sleep, and sleep duration in adolescents. Sleep Disord. 2014;2014. doi:10.1155/2014/374732
20. Xu X, Liu D, Zhang Z, Sharma M, Zhao Y. Sleep Duration and Quality in Pregnant Women: A Cross-Sectional Survey in China. Int J Environ Res Public Health. 2017;14(7):E817. doi:10.3390/ijerph14070817
21. Shahsavani S, Dehghani M, Hoseini M, Fararouei M. Biological monitoring of urinary 1‑hydroxypyrene by PAHs exposure among primary school students in Shiraz, Iran. Int Arch Occup Environ Health. 2017;90(2):179-187. doi:10.1007/s00420-016-1184-9
22. Kakimoto K, Toriba A, Ohno T, et al. Direct measurement of the glucuronide conjugate of 1-hydroxypyrene in human urine by using liquid chromatography with tandem mass pectrometry. J Chromatogr B Analyt Technol Biomed Life Sci. 2008;867(2):259-263. doi:10.1016/j.jchromb.2008.04.015
23. Li R, Kameda T, Li Y, et al. Hydrogen peroxide-sodium hydrosulfite chemiluminescence system combined with high-performance liquid chromatography for determination of 1-hydroxypyrene in airborne particulates. Talanta. 2011;85(5):2711-2714. doi:10.1016/j.talanta.2011.08.005
24. Jacob J, Seidel A. Biomonitoring of polycyclic aromatic hydrocarbons in human urine. J Chromatogr B Analyt Technol Biomed Life Sci. 2002;778(1-2):31-47. doi:10.1016/s0378-4347(01)00467-4
25. Feng S, Roethig HJ, Liang Q, et al. Evaluation of urinary 1-hydroxypyrene, S-phenylmercapturic acid, trans, trans-muconic acid, 3-methyladenine, 3-ethyladenine, 8-hydroxy-2'-deoxyguanosine and thioethers as biomarkers of exposure to cigarette smoke. Biomarkers. 2006;11(1):28-52. doi:10.1080/13547500500399730
26. Roethig HJ, Munjal S, Feng S, et al. Population estimates for biomarkers of exposure to cigarette smoke in adult U.S. cigarette smokers. Nicotine Tob Res. 2009;11(10):1216-1225. doi:10.1093/ntr/ntp126
27. Wei F, Nie G, Zhou B, et al. Association between Chinese cooking oil fumes and sleep quality among a middle-aged Chinese population. Environ Pollut. 2017;227:543-551. doi:10.1016/j.envpol.2017.05.018
28. Bureau of Disease Control and Prevention, China's Ministry of Health. Chinese guideline on adult overweight and obesity prevention. Beijing: People's Medical Publishing House; 2006.
29. Sriram TG, Chandrashekar CR, Isaac MK, Shanmugham V. The General Health Questionnaire (GHQ). Comparison of the English version and a translated Indian version. Soc Psychiatry Psychiatric Epidemiol. 1989;24(6):317-320. doi:10.1007/bf01788035
30. Smilkstein G. The family APGAR: a proposal for a family function test and its use by physicians. J Fam Pract. 1978;6(6):1231-1239.
31. Wu YL, Zhao X, Li YF, et al. The risk and protective factors in the development of childhood social anxiety symptoms among Chinese children. Psychiatry Res. 2016;240:103-109. doi:10.1016/j.psychres.2015.08.046
32. Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193-213. doi:10.1016/0165-1781(89)90047-4
33. Li X, Leng S, Guo J, Guan L. An improved high performance liquid chromatography method for determination of 1-hydroxypyrene in urine. Wei Sheng Yan Jiu. 2003;32(6):616-617.
34. Zhu P, Bian Z, Xia Y, et al. Relationship between urinary metabolites of polycyclic aromatic hydrocarbons and thyroid hormone levels in Chinese non-occupational exposure adult males. Chemosphere. 2009;77(7):883-888. doi:10.1016/j.chemosphere.2009.08.054
35. Burris JL, Perez C, Evans DR, Carlson CR. A preliminary study of cigarette smoking in female orofacial pain patients. Behav Med. 2013;39(3):73-79. doi:10.1080/08964289.2012.731439
36. Xiang YT, Ma X, Cai ZJ, et al. The prevalence of insomnia, its sociodemographic and clinical correlates, and treatment in rural and urban regions of Beijing, China: a general population-based survey. Sleep. 2008;31(12):1655-1662. doi:10.1093/sleep/31.12.1655
37. Driver HS, Taylor SR. Exercise and sleep. Sleep Med Rev. 2000;4:387-402. doi:10.1053/smrv.2000.0110
38. Peters EN, Fucito LM, Novosad C, Toll BA, O'Malley SS. Effect of night smoking, sleep disturbance, and their co-occurrence on smoking outcomes. Psychol Addict Behav. 2011;25(2):312-319. doi:10.1037/a0023128
39. Jaehne A, Unbehaun T, Feige B, Lutz UC, Batra A, Riemann D. How smoking affects sleep: a polysomnographical analysis. Sleep Med. 2012;13(10):1286-1292. doi:10.1016/j.sleep.2012.06.026
40. McNamara JP, Wang J, Holiday DB, et al. Sleep disturbances associated with cigarette smoking. Psychol Health Med. 2014;19(4):410-419. doi:10.1080/13548506.2013.832782
41. Zhang L, Samet J, Caffo B, Bankman I, Punjabi NM. Power spectral analysis of EEG activity during sleep in cigarette smokers. Chest. 2008;133:427-432. doi:10.1378/chest.07-1190
42. Takahashi M, Tanigawa T, Tachibana N, et al. Modifying effects of perceived adaptation to shift work on health, wellbeing, and alertness on the job among nuclear power plant operators. Ind Health. 2005;43(1):171-178. doi:
43. Bin P, Leng S, Cheng J, et al. Association of aryl hydrocarbon receptor gene polymorphisms and urinary 1-hydroxypyrene in polycyclic aromatic hydrocarbon-exposed workers. Cancer Epidemiol Biomarkers Prev. 2008;17(7):1702-1708. doi:10.1158/1055-9965.EPI-07-2812
44. Pan CH, Chan CC, Huang YL, Wu KY. Urinary 1-hydroxypyrene and malondialdehyde in male workers in Chinese restaurants. Occup Environ Med. 2008;65(11):732-735. doi:10.1136/oem.2007.036970
45. Gunier RB, Reynolds P, Hurley SE, et al. Estimating exposure to polycyclic aromatic hydrocarbons: a comparison of survey, biological monitoring, and geographic information system-based methods. Cancer Epidemiol Biomarkers Prev. 2006;15(7):1376-1381. doi:10.1158/1055-9965.EPI-05-0799
46. Cocco P, Moore PS, Ennas MG, et al. Effect of urban traffic, individual habits, and genetic polymorphisms on background urinary 1-hydroxypyrene excretion. Ann Epidemiol. 2007;17(1):1-8. doi:10.1016/j.annepidem.2005.11.001
47. Zielińska-Danch W, Wardas W, Sobczak A. Determination of urinary cotinine and 1-hydroxypyrene and blood carboxyhemoglobine as the biomarkers of tobacco smoke exposure. Przegl Lek. 2006;63(10):922-925.
48. Yoon HS, Lee KM, Lee KH, Kim S, Choi K, Kang D. Polycyclic aromatic hydrocarbon (1-OHPG and 2-naphthol) and oxidative stress (malondialdehyde) biomarkers in urine among Korean adults and children. Int J Hyg Environ Health. 2012;215(4):458-464. doi:10.1016/j.ijheh.2012.02.007
49. Shiue I. Urinary heavy metals, phthalates and polyaromatic hydrocarbons independent of health events are associated with adult depression: USA NHANES, 2011-2012. Environ Sci Pollut Res Int. 2015;22(21):17095-17103. doi:10.1007/s11356-015-4944-2