MENSTRUAL FUNCTION AND PHYSICAL AND MENTAL JOB STRESS

月经周期是女性生育潜力的标志，可以 监测从未尝试或实现怀孕的女性工人，但 其生殖功能和激素相关慢性病的风险可能 尽管如此，还是会受到工作环境的影响。此应用程序请求 调查女工月经功能和研究的资金 工作压力对身体和精神的影响以及与压力相关的行为 像摄入咖啡因一样，对周期特征和卵巢激素的影响 模式。我强调S普遍的职业暴露和一种 有可能被预防或减少。它已被牵连到 月经紊乱，也被认为是一种可能的替代方案 接尘工人不良妊娠结局的解释 代理(例如，VDTS)。对于女性来说，工作压力可能是一个特别的问题， 他为所谓的“第二班”增加的责任并不是 准备好在非工作时间从压力中恢复过来。该项目 因此，我们建议解决两个重要问题：(1)工作压力 女性-暴露对其影响需要进行严格的调查 自己的优点，并帮助将压力效应与其他 工作场所制剂；以及(2)开发生物标志物的必要性 月经功能，以识别和预防与工作相关的疾病 在非怀孕妇女中(就像精液分析用于监测男性 职业暴露)。 我们建议招收100名女护士，从上下级各抽取50名。 纪念斯隆-凯特琳癌症中心(MSKCC)的应力区，为期三天 连续的月经周期。受试者将被要求记录下基本身体 体温，每天收集一小份尿液，并保持 有条理的月经日记。为了评估排卵和黄体功能， 尿样将被分析雌酮-3-葡萄糖醛酸(E1G)， 孕二醇-3-葡萄糖醛酸(PDG)、黄体生成素(LH)和肌酐 (Cr)。护士因职业高而被选为目标人群 压力水平，以及高咖啡因摄入量和顺从意愿 似乎也有可能采用苛刻的养生法；进行了可行性研究 At MSKCC支持这一点。受试者将由护士现场招募 MSKCC现场总监，将确定高压力和低压力单位 档案材料的基础以及与管理人员的讨论。 数据分析将评估与工作相关的关系的强度 应激源、咖啡因摄入和接触抗肿瘤药物，以及 月经功能的几个指标(周期长度、排卵和黄体 阶段充分性)。E1G和PDG的绝对水平和变化率将 也可以与暴露进行比较。最后，为了帮助设计 未来的月经研究，基础体温和 将评估预期确定的月经周期报告， 使用尿液激素数据作为黄金标准。

The menstrual cycle is a marker of female fertility potential and can serve to monitor female workers who never attempt or achieve a pregnancy, but whose reproductive function and risk of hormone-related chronic disease may nonetheless be affected by the work environment. this application requests monies to investigate menstrual function in women workers and to study effects of physical and mental job stress, and stress-related behaviors like caffeine consumption, on cycle characteristics and ovarian hormone patterns. Stress i s pervasive occupational exposure and one that potentially can be prevented or reduced. It has been implicated in menstrual disorders and has also been cited as a possible alternative explanation for adverse pregnancy outcomes among workers exposed to other agents (e.g. VDTs). Job stress may be a particular problem for women, whose added responsibility for the so-called "second shift" does not readily allow for recovery from stress during nonwork hours. the project we are proposing thus addresses two important issues: (1) job stress in females - an exposure whose effect needs rigorous investigation both on its own merits and to help disentangle stress effects from effects of other work place agents; and (2) the need to develop biological markers of menstrual function in order to identify and prevent work-related disorders among non-pregnant women (much as semen analysis has served to monitor male occupational exposures). We propose to enroll 100 female nurses, 50 each drawn from high and low stress areas of Memorial Sloan-Kettering Cancer Center (MSKCC), for three consecutive menstrual cycles. Subjects will be asked to record basal body temperature, collect a small aliquot of urine daily and maintain a structured menstrual diary. To evaluate ovulatory and luteal function, urine samples will be analyzed for estrone-3-glucuronide (E1G), pregnanediol-3-glucuronide (pdG), luteinizing hormone (LH) and creatinine (Cr). Nurses were selected as the target population because of high job stress levels, and because high caffeine intake and willingness to comply with a demanding regimen also seemed likely; a feasibility study conducted at MSKCC supports this. Subjects will be recruited by a nurse-field director on-site at MSKCC who will identify high and low stress units on the basis of archival material and discussions with administrators. Data analyses will evaluate the relations in the intensity of job-related stressors, caffeine consumption, and exposure to antineoplastics, and several measures of menstrual function (cycle length; ovulation; and luteal phase adequacy). Absolute levels and rates of change in E1G and PdG will also be compared in relation to exposure. Finally, to aid in the design of future menstrual studies, the validity of basal body temperature and prospectively ascertained reports of menstrual cycles will be assessed, using the urinary hormone data as a gold standard.