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Abstract
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To the Editor:
We read “Sleep, Obesity, and Injury Among US Male Career Firefighters” by Kaipust et al1 with great interest. This paper indicated that body composition may serve as the effect modifier for the association between sleep and injury among on-duty male career firefighters. This association is found in obese firefighters, but not for normal or overweight firefighters. Considering the association between obesity and disordered sleep, coupled with an increased likelihood of occupational accidents in the presence of obstructed sleep,2,3 it is of upmost importance to investigate the role of obesity on sleep–injury association. This study successfully addressed the association between body composition and sleep among this population, however, some limitations exist in their methodology and some clarifications are needed to further support their findings.
First, the methodology used to test physical activity and fitness is needed to further address. The non-exercise VO2max model using the Self-Report of Physical Activity (SRPA)4 lacks accuracy for predicting VO2max when it compared with VO2max equation derived from the International Physical Activity Questionnaire (IPAQ).5 The non-exercise VO2max model is not accurate to predict VO2max among highly fit occupation that requires high physical demands.4 Compared with the non-exercise VO2max model, VO2max equation adapted in IPAQ5 is more accurate and widely accepted to predict VO2max among aerobically well-trained individuals, for example, firefighters with high physical demands.6,7 Additionally, both physical activity and fitness measurements are adapted in SRPA questionnaire. However, in model building process, fitness was not included in the mixed effects logistic regression for injury on sleep. Considering that firefighters with vigorous physical activity more than 3 hours per week were more likely to injury ...
Language: en |