Abstract
Background/Objectives: This study aims to investigate the effects of ethylene oxide (EO) exposure on sleep health, focusing on sleep duration and quality. Methods: The study analyzed data from the NHANES (National Health and Nutrition Examination Survey) 2015-2020 cycles, including 4268 participants aged 20 and older. EO exposure was measured using hemoglobin adducts of EO (HbEO), which serve as a reliable biomarker. Sleep health was assessed through self-reported questionnaires on sleep duration and quality. Participants were categorized based on sleep duration (<6 h, 6-9 h, >9 h) and symptoms of sleep disturbances. Statistical analyses employed survey-weighted logistic regression models to evaluate the associations between HbEO levels and sleep outcomes, adjusting for sociodemographic, health-related, and behavioral factors. Moreover, to examine whether the impact of ethylene oxide exposure on sleep quality and sleep duration varies by sociodemographic characteristics, stratified analyses were conducted based on gender, age, marital status, and employment type. Results: According to the results, higher EO exposure was associated with shorter sleep durations and increased likelihood of sleep disturbances. Moreover, according to sub-group analysis by sex, men with higher exposure to EO, were likely to have short sleep duration, and women with higher exposure to EO had higher risk of daytime sleepiness and sleep problems. Conclusions: The findings suggest that EO exposure may negatively impact sleep health, emphasizing the need for stricter EO exposure regulations and public health interventions to reduce associated risks.