Work and family stress is associated with menstrual disorders but not with fibrocystic changes: cross-sectional findings in Chinese working women

The prevalence of menstrual disorders and their association with psychological stress in Syrian students enrolled at health-related schools: A cross-sectional study

OBJECTIVES

Menstrual disorders are among the most prevalent health issues among young female students studying in health science faculties. This study aimed to provide insights into the menstrual patterns among medical faculty students and determine whether stress can be a risk factor for its various disorders.

METHODS

This cross-sectional study was conducted in the Faculties of Medicine, Dentistry, and Pharmacy at the Syrian Private University, Damascus, Syria, between October and November 2022. A total of 980 female students anonymously completed the identification of menstrual problems and the perceived stress scale (PSS) questionnaire. The data were analyzed using SPSS-25.

RESULTS

The mean age of students was 21.52 ± 2.06 years. The most common menstrual disorders in this study were dysmenorrhea (88%), and premenstrual syndrome (87%). A total of 82% had mild to moderate stress, 10% had high stress, and 8% had low stress. Moderate to high perceived stress was associated with an increased risk of PMS (OR = 1.79, P = 0.0037).

CONCLUSION

These findings stress the importance of universities, especially health science faculties, establishing protocols for early detection and intervention in students with stress and menstrual disorders. Implementing stress reduction education and timely counseling, along with preventive measures, is crucial for students' well-being. Further research is needed to refine interventions for this group.

Estimating the joint effect of household solid fuel use and social isolation on depression among middle-aged and older adults in China

BACKGROUND

Household solid fuel use and social isolation are reported to increase the risk of depressive symptoms, but their joint effect has not yet been examined. This study aimed to explore the separate and joint effects of household solid fuel use and social isolation on depression.

METHODS

We used data from the latest four waves (2011-2018) of the China Health and Retirement Longitudinal Study (CHARLS). Depression was defined as a score of ≥12 using the Center for Epidemiologic Studies Depression Scale (CES-D 10). Cox proportional hazards models were applied to explore the separate and joint associations of household solid fuel use and social isolation with incident depression.

RESULTS

During the seven-year follow-up, 2793 (30.25 %) out of the 9232 participants were identified with depressive symptoms. Solid fuel use for household heating or cooking was significantly associated with more hazards of depressive symptoms after adjusting for potential confounders (cooking: HR = 1.280, 95 % CI = 1.175-1.394; heating: HR = 1.142, 95 % CI = 1.054-1.238). High social isolation at baseline was also a significant predictor of incident depressive symptoms (HR = 1.139, 95 % CI = 1.053-1.231). Participants exposed to both solid fuel use and high social isolation were found to have higher hazards of experiencing depressive symptoms than those exposed to none or only one of these two risk factors (heating: HR for 'solid fuel use + high social isolation'=1.308 versus HR for other groups = 1-1.185; cooking: HR for 'solid fuel use + high social isolation' = 1.430 versus HR for other groups = 1-1.255).

CONCLUSION

Household solid fuel use and social isolation were separately and jointly associated with higher risks of incident depression. Appropriate interventions to reduce solid fuel use and social isolation are recommended to improve the psychological health among middle-aged and older adults in China.

Menstrual irregularities associated with COVID-19 vaccines among women in Saudi Arabia: A survey during 2022

Some changes appeared in women's menstrual cycle after receiving the coronavirus disease 2019 (COVID-19) vaccine, but the information about the pattern and characteristics of these symptoms was unclear. This study was conducted to estimate the prevalence of menstruation change and evaluate the association between COVID-19 vaccination and the occurrence of such disturbance. An online web-based survey was conducted during March-April 2022 that targeted 729 COVID-19 vaccinated women aged between 18 and 45 years in the Jazan region of Kingdom of Saudi Arabia. The tool collected demographic information, psychological data, and COVID-19 post-vaccination side effects. The overall prevalence of menstrual change among the women was 60.9% (95% CI 57.3-64.4). 66.3% and 64.1% of women, respectively, in the age group of 25-34 and 35-45 years were more affected. Most of the detected abnormalities were related to delayed menstruation and changes in pain intensity. Menstrual disturbances that occur after immunization are transient and have no long-term implications. Menstrual disorders are prevalent before vaccination, but there is a considerable increase following vaccination. Because there is no apparent cause for these post-vaccine disturbances, and their effects are difficult to anticipate, it is preferable to warn those concerned and encourage them to learn more about the biological changes causing these problems.

A Case-Control Study on Factors Associated With Secondary Amenorrhea Among the Medical Students of Universiti Malaysia Sabah

BACKGROUND AND AIM

This study aimed to evaluate the association between body mass index (BMI), anxiety, stress, depression, hormones, and secondary amenorrhea among female medical students at Universiti Malaysia Sabah (UMS).

METHODS

In this case-control study, UMS undergraduate female medical students aged 19-25 years who did not menstruate in the last three months (with a previous history of a regular menstrual cycle) or six months (with a history of irregular menstruation) were included as cases (40 students), and students with similar criteria but no menstrual irregularities were recruited in the study as controls (40 students). The study was conducted at Polyclinic UMS from January 1, 2021, until December 31, 2022. The chi-squared test and odd ratio examined the association of the above-mentioned factors with the secondary amenorrhea. A p-value less than 0.05 was considered significant, and an odds ratio if the confidence interval did not contain one was considered significant.

RESULT

Both the groups had a similar frequency of different BMI grades. The cases exhibited significantly higher levels of depression, anxiety, and stress than the controls. Again, the cases demonstrated higher estradiol (E2), testosterone, and thyroid-stimulating hormone (TSH) levels and lower levels of luteinizing hormone (LH) than those with regular menstruation. The research also revealed that a one-unit decrease in follicle-stimulating hormone (FSH) levels corresponds to a threefold increase in the risk of experiencing secondary amenorrhea, while the risk escalates to fourfold for LH. Moreover, E2, testosterone, and TSH levels exhibited protective effects on secondary amenorrhea.

CONCLUSION

Anxiety, serum LH, and FSH were significantly associated with secondary amenorrhea. Future studies should address the diurnal variation of the hormones and consider the participants' circumstances to get a proper effect of hormonal influence and stress.

Surging trends of infertility and its behavioural determinants in India

The World Health Organisation (WHO) has recognised infertility as a public health issue. Although biological factors are considered to be the primary cause, factors like social, health, and lifestyle factors can all have an adverse effect on a couple's ability to reproduce. The study aimed to comprehend the infertility scenario in India and explore some of the potential causes. The study used standard demographic definitions and four rounds of the National Family Health Survey (NFHS) from 1992-1993 to 2015-16 to estimate the levels of primary and secondary infertility in India. Bivariate analysis, the t-test, and the Chi-square test were applied to capture significant changes in infertility over time. The multivariate logistic regression model was used to understand the extent of infertility among Indian couples from various socioeconomic groups, lifestyle levels, and reproductive behaviour in 2015-16. Primary infertility declined steadily from 1992 to 2015, whereas secondary infertility increased from 19.5% in 1992-93 to 28.6% in 2015-16. This trend is related to declining fertility rates, particularly in India's southern states. Age at marriage, biological factors, and lifestyle factors were all strongly linked to infertility. People with higher education levels and late marriages were more likely to experience primary infertility. Alcohol consumption, smoking, obesity, and noncommunicable disease are all strongly linked to secondary infertility. Our study has policy implications, and we draw attention to alarming infertility in India, which has gone unnoticed due to large population. We suggests enhancing the current health and reproductive programmes, educating people about improving their lifestyle choices and sexual behaviour, and calling attention to a significant shift in fertility dynamics.

Exploratory systematic review and meta-analysis on period poverty

BACKGROUND

Period poverty is a global health and social issue that needs to be addressed. It has been reported that many females compromise their education, employment, and social commitments during their menstruation days due to a number of reasons, including lack of access to toilets or menstrual products.

AIM

To provide a comprehensive understanding on period poverty, including outcomes associated with menstruation.

METHODS

All observational and randomised clinical trials reporting menstruation challenges, menstrual poverty and menstrual products were included. Our search strategy included multiple electronic databases of PubMed, Web of Science, ScienceDirect, ProQuest and EMBASE. Studies published in a peer review journal in English between the 30^th of April 1980 and the 30^th of April 2022 were included. The Newcastle-Ottawa Scale was used to assess the risk of bias of the systematic included studies. Pooled odds ratios (ORs) together with 95% confidence intervals (CIs) are reported overall and for sub-groups.

RESULTS

A total of 80 studies were systematically selected, where 38 were included in the meta-analysis. Of the 38 studies, 28 focused on children and young girls (i.e., 10-24 years old) and 10 included participants with a wider age range of 15-49 years. The prevalence of using disposable sanitary pads was 45% (95%CI: 0.35-0.58). The prevalence of menstrual education pre-menarche was 68% (95%CI: 0.56-0.82). The prevalence of good menstrual hygiene management (MHM) was 39% (95%CI: 0.25-0.61). Women in rural areas (OR = 0.30, 95%CI: 0.13-0.69) were 0.70 times less likely to have good MHM practices than those living in urban areas.

CONCLUSION

There was a lack of evidence, especially from low- and middle- income countries. Further research to better understand the scope and prevalence of period poverty should be considered. This will enable the development of improved policies to increase access to menstrual products and medical support where necessary.

Understanding comorbidity between eating disorder and premenstrual symptoms using a network analysis approach

Eating disorder symptoms are associated with ovarian hormones and fluctuate predictably across the menstrual cycle. However, the specific symptoms that underlie these associations remain unclear. The current study aims to examine which specific eating disorder and premenstrual symptoms confer risk and maintain comorbidity using network analysis. Eating disorder and premenstrual symptoms were measured using the Eating Pathology Symptoms Inventory and the Daily Record of Severity of Problems, respectively, in a large sample of young adult females. Network analysis was used to explicate the structure of eating and premenstrual symptom networks separately and together. Eating disorder networks replicated previous literature and identified body dissatisfaction as a core feature, but was unique in identifying monitoring calories as an additional core feature. Central symptoms identified in the premenstrual symptom network were symptoms interference with daily life and activities and negative emotions brought on by hormone changes. Bridge symptoms between networks were identified as relating to eating behaviors, interference with daily activities, joint and muscle pain, and negative emotions brought on by hormone changes. This study suggests that the links between eating disorder and premenstrual symptoms extend past their individual effects on eating behavior and are indicative of a shared underlying mechanism.

Menstrual Symptoms After COVID-19 Vaccine: A Cross-Sectional Investigation in the MENA Region

Background

Since the emergence of COVID-19 vaccinations, many women around the world are reporting abnormalities in their menstrual periods post-vaccination. The aim of this study is to investigate the prevalence and impact of menstrual abnormalities after the COVID-19 vaccine among females residing within the Middle East and North Africa (MENA).

Methods

The study utilized a cross-sectional online self-administered survey from July 2021 to August 2021 targeting females living in the MENA region above the age of menarche who had received vaccine and were not pregnant or lactating, and do not have a history of primary ovarian insufficiency, hypothalamic menopause, or have undergone a hysterectomy. The survey was distributed regionally via social media.

Results

A total of 2269 females were included in our study, with a mean age of 34.3 ± 8.5 years. About 66.3% of participants reported menstrual symptoms post-vaccination, of which 46.7% experienced them after their first dose. However, in 93.6% of participants, the symptoms resolved within 2 months. Vaccine type did not significantly influence the incidence of abnormalities (p > 0.05). Participants who had confirmed previous COVID-19 infection had a very similar percentage of menstrual abnormalities compared to people who did not have COVID-19 infection or symptoms suspected of COVID-19 infection and did not test (67.5%, 66.8%, respectively); nevertheless, those who had experienced the COVID-19 vaccine general side effects had significantly more abnormalities (p < 0.001). Compared to their pandemic status, females reported significantly more abnormalities post-vaccination.

Conclusion

The study showed a possible link between the COVID-19 vaccine and menstrual abnormalities that have impacted their quality of life.

Chronic and Cumulative Adverse Life Events in Women with Primary Ovarian Insufficiency: An Exploratory Qualitative Study

BACKGROUND AND PURPOSE

Primary ovarian insufficiency (POI) has serious physical and psychological consequences due to estradiol deprivation, leading to increased morbidity and mortality. However, the causes of most POI cases remain unknown. Psychological stress, usually caused by stressful life events, is known to be negatively associated with ovarian function. It is important to explore high-frequency adverse life events among women with POI for future interventions.

METHODS

Forty-three women (mean age=33·8 years) were recruited who were newly- diagnosed with idiopathic POI (FSH levels >40 IU/L) to participate in semi-structured interviews through convenience sampling. The main questions covered by the topic guide were designed to explore adverse life events prior to POI diagnosis. Interviews were audio recorded, transcribed and analyzed thematically. Data were analyzed from June 2019 to August 2020.

RESULTS

Among the women with POI, mean age at diagnosis of POI was 33·8 years (range from 19 to 39 years), and the average time between the onset of irregular menstruation and POI diagnosis was 2.3 years. These women with POI had a relatively normal menstrual cycle before the diagnosis. A number of stressful life events prior to POI diagnosis were discussed by them as important factors influencing their health. Four core themes emerged: 1) persistent exposure to workplace stress, 2) persistent exposure to family-related adverse life events, 3) sleep problem/disturbance existed in women with POI before diagnosis, and 4) participants' general cognition and concerns about POI.

CONCLUSIONS

Persistent exposures to adverse life events related to work stress, family stress and sleep problem existed in women with POI. Our findings are consistent with the hypothesis that adverse life events play a role in the development of POI. Future research should investigate how social environmental factors influence POI disease risks, and whether provision of tailored interventions (i.e. preventing or mitigating impact of adverse life events) aimed at high-risk populations may help prevent new POI cases and improve conditions of women with POI. We gained an in-depth understanding of the experiences of these women via 1:1 qualitative method, and find adverse life events are frequent in women with POI prior to the diagnosis.

Effect of family stress on life satisfaction among female workers during the COVID-19 epidemic in China: Exploring the roles of anxiety symptoms and age

The study aimed to investigate the level of life satisfaction (LS) among Chinese female workers after resuming work during the COVID-19 epidemic, and to further explore the potential mediating and moderating roles in the association between family stress and LS. Self-reported questionnaires were completed by 10,175 participants. Results showed that the level of LS decreased. The family stress had a negative effect on LS, and the effect was mediated by anxiety symptoms. Additionally, age moderated the direct and indirect effects within this relationship. Interventions aiming to improve LS should consider these aspects and younger workers should be given special attention.

Interview survey of physical and mental changes and coping strategies among 13 Vietnamese female technical interns living in Japan

We conducted a case study to assess 1) physical and mental changes; 2) self-assessments of symptoms; 3) coping strategies; and 4) adaptation to physical and mental changes by semi-structured interview survey among Vietnamese female migrant workers working in Japan under the Technical Intern Training Program. We found they experienced female-specific physical changes, and some interns' symptoms worsened because they did not consult anyone about their symptoms. We propose increasing opportunities to learn about possible physical and mental changes caused by migration and to improve health literacy, including prevention, coping, help-seeking, and consultations about health concerns among female technical interns.

Prospective associations between physical activity and BMI with irregular periods and heavy menstrual bleeding in a large cohort of Australian women

STUDY QUESTION

Are physical activity (PA) and body mass index (BMI) associated with irregular periods and heavy menstrual bleeding (HMB) in Australian women?

SUMMARY ANSWER

Overweight and obese women have higher odds of both irregular periods and HMB than underweight/normal-weight women, but high levels of PA reduce the odds of HMB.

WHAT IS KNOWN ALREADY

Most studies on relationships between PA and menstrual problems have focused on female athletes, but there have been few population-based studies.

STUDY DESIGN, SIZE, DURATION

Prospective cohort study, 10618 participants in the Australian Longitudinal Study of Women's Health (ALSWH) who completed mailed surveys in 1996, with follow-ups in 2000, 2003, 2006, 2009, 2012, and 2015.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Participants were aged 22 to 27 in 2000. They were asked to report their PA levels and the frequency of irregular periods and HMB in each survey. BMI was calculated at every survey from self-reported weight and height. Generalised estimating equation population-averaged model analyses were conducted to calculate odds ratios (OR) and 95% confidence intervals (95% CIs).

MAIN RESULTS AND THE ROLE OF CHANCE

At age 22 to 27 years, the prevalence of irregular periods was 19.4%. This remained stable over 15 years. There were no associations between PA and irregular periods. Overweight and obese women had higher odds of irregular periods [overweight: OR 1.08, (95% CI 1.00-1.17); obese: OR 1.29, (95%CI 1.18-1.41)] than women who were underweight/normal weight.The prevalence of HMB at age 22-27 years was 15.9%; this doubled over 15 years. Women who were highly active had 10% lower odds of HMB than women who reported no PA [OR 0.90, (95%CI 0.82-0.98)]. Overweight and obese women had higher odds of HMB [overweight: OR 1.15, (95%CI 1.07-1.23); obese: OR 1.37, (95%CI 1.26-1.49)] than women who were underweight/normal weight. Among obese women, high levels of PA were associated with 19% [OR 0.81, (95%CI 0.68-0.97)] reduction in the odds of HMB.

LIMITATIONS, REASONS FOR CAUTION

Data collected in the ALSWH are self-reported, which may be subject to recall bias. Reverse causation, due to menstrual problems impacting PA, is possible although sensitivity analyses suggest this is unlikely to have affected the results. Other conditions, e.g., polycystic ovary syndrome, for which no or incomplete data were available, could have affected the results.

WIDER IMPLICATIONS OF THE FINDINGS

Intervention studies are needed to assess the effect of increasing PA in women with HMB, but these preliminary findings suggest that promoting PA could be an affordable and feasible strategy for reducing HMB in young adult women.

STUDY FUNDING/COMPETING INTEREST(S)

The ALSWH is funded by the Australian Government. Funding for these analyses was provided by a University of Queensland (UQ) International Postgraduate Research Scholarship and a UQ International Development Fellowship. The authors declare no conflicts of interest.

TRIAL REGISTRATION NUMBER

N/A.

Work stress, family stress, and suicide ideation: A cross-sectional survey among working women in Shenzhen, China

BACKGROUND

This study aimed to explore the associations of work characteristics, work stress, and family stress with suicide ideation among working women, further to detect potential joint effects between different types of stress.

METHODS

From March to June in 2015, a cross-sectional survey on working women were conducted in Shenzhen, China. Demographic and work characteristics, work stress, family stress, and suicide ideation were collected. Multivariate logistic regression models were applied to assess possible associations by calculating the odds ratios (OR) and 95% confident intervals (CI).

RESULTS

Totally 968 working women were included with a mean age of 31.62 (standard deviation: 7.43) years. The prevalence of suicide ideation was 19.4%. We found that night shift work, sickness absence, work stress, and family stress were positively associated with suicide ideation, after adjusting for age, education level, marital status, and occupation type. None joint effect on multiplicative or additive scale of work stress and family stress on suicide ideation was found (P for multiplicative and additive interaction: 0.736 and 0.595, respectively), however, women with both high work stress and high family stress appeared more than five-time odds of suicide ideation (OR: 5.253, 95%CI: 2.982∼9.252).

LIMITATIONS

We did not collect information on other psychosocial profiles and failed to explore potential mediated effects within current associations.

CONCLUSIONS

This study lends support to suicide prevention that immediate relief allocated to working women with both high level of work stress and family stress is warranted of necessity.

Correlation Individual Characteristics and Work Stress with Menstrual Disorders in Tobacco Farmers

Introduction: Women participation at work, especially in the agricultural sector, is implies a status of gender equality that positions women as capable of doing work like men. However, women naturally have physically and biologically differenced with men, for example in reproductive health conditions. Menstrual disorders are important to know because it can show the function of women reproductive health disorder. Menstrual disorders can be caused by various factors. The purpose of this study was to identify individual characteristics and psychological factor (work stress) with menstrual disorders of female tobacco farmers in Ambulu Village, Jember City. Methods: This study was an observational analytic with a cross-sectional approach. The research was conducted on August 2018 and respondents were 36 female tobacco farmers chosen by simple random sampling. Dependent variable of this study was menstrual disorders and the independent variables were individual characteristics (age, marital status, and work period) and psychological factor (work stress). Results: Obtained were that most of the respondents aged 35-44 years (55.6%), married (91.7%), having work period over 5 years (69.4%) and 58.3% respondents experienced a moderate level of work stress. Conclusion: There was a relationship between work stress and menstrual disorders. There was no relationship between individual characteristics with menstrual disorders in tobacco farmers in Ambulu Village, Jember City. Keywords: individual characteristics, menstrual disorders, work stress

Association between irregular menstrual cycles and occupational characteristics among female workers in Korea

OBJECTIVE

To examine the association between irregular menstrual cycles and occupational characteristics among Korean female workers.

STUDY DESIGN

We analyzed data on paid female workers from the Korea National Health and Nutrition Examination Survey (KNHANES) V (2010-2012).

MAIN OUTCOME MEASURES

We evaluated the possible associations between irregular menstrual cycles and work variables (occupational classification, working hours, and shift work) using univariate and multivariate logistic regression analyses. Weighted prevalence was calculated according to each work variable to approximate the Korean population.

RESULTS

Irregular menstrual cycles were the most common in women in the 'pink collar' group (16.61%). The frequency of irregular menstrual cycles was 2-fold higher in women working >60 h per week (25.64%) than in those working 20-60 h per week (11.09%). Irregular menstrual cycles were more prevalent in shift workers (15.85%) than in non-shift workers (11.06%). A significantly high risk of irregular menstrual cycles was found for pink-collar occupations (adjusted odds ratio [OR] = 1.687, 95% confidence interval [CI] = 1.044-2.710, reference: white-collar occupation group) and in women with long working hours (adjusted OR = 2.139, 95% CI = 1.243-3.559, reference: 20-60 working hours group) and shift work (adjusted OR = 1.487, 95% CI = 1.028-2.118, reference: fixed working schedule group).

CONCLUSIONS

Our study showed associations between irregular menstrual cycles and occupational characteristics of female workers. Long working hours, shift work, and pink-collar occupations are positively associated with irregular menstrual cycles. Therefore, working hours and shift schedules for female workers should be structured considering these factors. Further research is needed to determine the optimal working time and shift schedules for female workers.

Prevalence of irregular menstruation according to socioeconomic status: A population-based nationwide cross-sectional study

Irregular menstruation is an important indicator of current and potential health problems. A woman’s health is greatly influenced by her socioeconomic status. The purpose of this study was to examine the prevalence of irregular menstruation by socioeconomic status among South Korean women. Secondary data analyses were conducted among 4,709 women, aged 19–54 years, using raw data from the Korea National Health and Nutrition Examination Survey V (2010–2012), a nationally representative survey. Compared to women who graduated from university, the adjusted odds ratios (95% confidence intervals) for those who graduated from elementary school or lower, middle school, and high school were 3.256 (1.969–5.385), 2.857 (1.866–4.376), and 1.607 (1.261–2.048), respectively. Compared to women with a medium-high income level, the adjusted odds ratio (95% confidence interval) for women with the highest household income level was 1.409 (1.091–1.819). Irregular menstruation was prevalent among adult women and appeared to be associated with socioeconomic status, especially in terms of education and household income. This study’s findings suggest that attention must be paid to women with low educational levels or high household incomes, to ensure early diagnosis and the provision of medical attention for irregular menstruation.

Prevalence of menstrual problems and their association with psychological stress in young female students studying health sciences

Objectives:

To identify the prevalence of various menstrual problems in young females studying health sciences and to identify their association with academic stress.

Methods:

This was a cross-sectional study, conducted in the health colleges of Immam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia between February 2015 and February 2016. Seven hundred and thirty-eight female students aged 18-25 years anonymously completed menstrual problem identification and perceived stress scale questionnaire. The data was analyzed using the Statistical Package for Social Sciences version 16.0.

Results:

Ninety-one percent of the students were suffering from some kind of menstrual problem. The different menstrual problems reported, and their incidences included irregular menstruation (27%), abnormal vaginal bleeding (9.3%), amenorrhea (9.2%), menorrhagia (3.4%), dysmenorrhea (89.7%), and premenstrual symptoms (46.7%). High perceived stress (HPS) was identified in 39% of the students. A significant positive correlation was found between HPS and menstrual problems. Students with HPS had 4 times, 2 times, and 2.8 times increased odds ratio for experiencing amenorrhea, dysmenorrhea, and premenstrual syndrome (p<0.05).

Conclusion:

The most prevalent menstrual problems (dysmenorrhea and premenstrual symptoms) in the target population were strongly associated with stress. Therefore, it is recommended that health science students should be provided with early psychological and gynecological counselling to prevent future complications.

Associations between Job Strain and Arterial Stiffness: A Large Survey among Enterprise Employees from Thailand

As an intermediate endpoint to cardiovascular disease, arterial stiffness has received much attention recently. So far, the research on work stress and arterial stiffness is still sparse and inconsistent, and no investigations on work stress and cardiovascular health among the Thai working population have been reported. Therefore, we conducted an epidemiological study among 2141 Thai enterprise employees (858 men and 1283 women) who were free from any diagnosed cardiovascular disease. Work stress was measured using Karasek’s Job Demand–Control model for job strain (a combination of high demand and low control). Arterial stiffness was evaluated by a non-invasive approach using pulse-wave analysis based on a finger photoplethysmogram. Multivariable linear regression was applied to examine associations between job strain and arterial stiffness. In men, job strain was significantly associated with arterial stiffness (β  =  0.078, 95% confidence interval  =  0.026 to 0.130), after accounting for sociodemographic, behavioral, dietary and biomedical factors. However, the association in women was not significant. As the first study in Thailand on work stress and cardiovascular risk, we found that job strain might be an important risk factor for cardiovascular disease among Thai working men. Further studies with longitudinal design are warranted.

Work stress, family stress and asthma: a cross-sectional study among women in China

PURPOSE

Research addressing links of work stress or family stress with asthma is constrained by (1) inconsistent evidence, (2) failure to consider the combined exposure to work stress and family stress, and (3) its primary focus on Western study populations. We aimed to address these knowledge gaps.

METHODS

We used cross-sectional data collected in 2015 among 7816 women from five professional groups in five Chinese cities. Work stress was measured by the 10-item effort-reward imbalance (ERI) questionnaire. Family stress was assessed by a psychometrically evaluated instrument comprising five items on, e.g., familial conflicts or domestic workload. Asthma was operationalized by self-reports of a physician diagnosis. Associations were examined by multivariable logistic regression estimating odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS

Both high work stress (i.e., ERI score >1) and high family stress (i.e., score above the median) were associated with asthma (OR 1.66, 95% CI 1.22-2.27 and OR 1.48, 95% CI 1.10-1.99, respectively). Women with combined exposure (versus none) had somewhat higher odds of asthma (OR 2.13, 95% CI 1.42-3.19) than those with sole exposure to either work stress (OR 1.89, 95% CI 1.20-2.96) or family stress (OR 1.71, 95% CI 1.03-2.84). Interaction terms were significant for continuous variables (p = 0.046), but not for dichotomized variables (p = 0.199).

CONCLUSIONS

The present study suggests that both work stress and family stress are positively associated with asthma in women in China. Further, the combined exposure may be associated with a further excess of asthma occurrence. Longitudinal studies are needed to confirm our findings and to explore potential temporal relationships.

Effort-reward Imbalance at Work, Parental Support, and Suicidal Ideation in Adolescents: A Cross-sectional Study from Chinese Dual-earner Families

BACKGROUND

In contemporary China, most parents are dual-earner couples and there is only one child in the family. We aimed to examine the associations of parents' work stress with suicidal ideation among the corresponding adolescent. We further hypothesized that low parental support experienced by adolescents may mediate the associations.

METHODS

Cross-sectional data from school students and their working parents were used, with 907 families from Kunming City, China. Stress at work was measured by the effort-reward imbalance questionnaire. Perceived parental support was assessed by an item on parental empathy and their willingness to communicate with the adolescent. Suicidal ideation was considered positive if students reported thoughts about suicide every month or more frequently during the previous 6 months. Logistic regression was used to examine the associations.

RESULTS

We observed that parents' work stress was positively associated with low parental support, which was in turn associated with adolescent suicidal ideation. The odds ratio for parents' work stress and adolescent suicidal ideation was 2.91 (95% confidence interval: 1.53-5.53), and this association was markedly attenuated to 2.24 (95% confidence interval: 1.15-4.36) after additional adjustment for parental support. Notably, mothers' work stress levels exerted stronger effects on children's suicidal ideation than those of fathers.

CONCLUSION

Parents' work stress (particularly mother's work stress) was strongly associated with adolescent's suicidal ideation, and the association was partially mediated by low parental support. These results need to be replicated and extended in prospective investigations within and beyond China, in order to explore potential causal pathways as a basis of preventive action.

Dispositional resilience as a moderator of the relationship between chronic stress and irregular menstrual cycle

PURPOSE

Menstrual-cycle irregularity may have an important influence on the subsequent development of chronic diseases. Several risk factors for irregular menstrual cycles have been detected, including stress. Our aim was to extend research on the link between chronic stress and menstrual-cycle irregularity and to assess potential protective factors, such as dispositional resilience, which we hypothesize to be associated with the maintenance or promotion of a healthy menstrual cycle.

METHODS

For this cross-sectional study, data on 696 healthy women aged 20-40 years were obtained. The women completed measures of chronic stress, dispositional resilience and menstrual-cycle irregularity. Furthermore, potential confounds were assessed.

RESULTS

Of the participants, 383 (55%) reported no current use of hormonal contraceptives; 313 (45%) reported current use hormonal contraception and were included as a control group. The results suggest that in women not using hormonal contraception, chronic stress (OR = 1.05, 95%CI = 1.02-1.08, p = 0.001) and dispositional resilience (OR = 0.43, 95%CI = 0.31-0.59, p < 0.001) have a main effect on menstrual cycle regularity. In addition, women with greater dispositional resilience have reduced risk for irregular menstrual cycles in the face of low to moderate chronic stress; however, this association is changed at the highest level of chronic stress.

CONCLUSIONS

These findings suggest that dispositional resilience may be a protective psychological trait that modulates reproductive functioning.

Validation of a short measure of effort-reward imbalance in the workplace: evidence from China

OBJECTIVES

Work stress is an emergent risk in occupational health in China, and its measurement is still a critical issue. The aim of this study was to examine the reliability and validity of a short version of the effort-reward imbalance (ERI) questionnaire in a sample of Chinese workers.

METHODS

A community-based survey was conducted in 1,916 subjects aged 30-65 years with paid employment (971 men and 945 women).

RESULTS

Acceptable internal consistencies of the three scales, effort, reward and overcommitment, were obtained. Confirmatory factor analysis showed a good model fit of the data with the theoretical structure (goodness-of-fit index = 0.95). Evidence of criterion validity was demonstrated, as all three scales were independently associated with elevated odds ratios of both poor physical and mental health.

CONCLUSIONS

Based on the findings of our study, this short version of the ERI questionnaire is considered to be a reliable and valid tool for measuring psychosocial work environment in Chinese working populations.

Risk factors of early spontaneous abortions among Japanese: a matched case-control study

BACKGROUND

No epidemiological studies have examined risk factors for early spontaneous abortions among Japanese women. In this matched case-control study, we investigated the associations of reproductive, physical, and lifestyle characteristics of women and their husbands with early spontaneous abortion <12 weeks of gestation.

METHODS

Information was collected through medical records for 430 cases of early spontaneous abortion and 860 controls of term delivery. Two controls were individual-matched to one case according to maternal age (± 3 years) and calendar year of events (either early spontaneous abortion or delivery). Multivariable conditional odds ratios (ORs) and 95% confidence interval (CI) were calculated with conditional logistic-regression.

RESULTS

The risk of early spontaneous abortions was higher for women with a past history of early spontaneous abortions; OR was 1.98 (95% CI: 1.35, 2.89) for one previous spontaneous abortion, 2.36 (95% CI: 1.47, 3.79) for two, and 8.73 (95% CI: 5.22, 14.62) for three or more. Other factors also influence risk; an OR of 2.39 (95% CI: 1.26, 4.25) was found for women who smoked, and 1.65 (95%CI: 1.17, 2.35) for women working outside the home.

CONCLUSIONS

Our finding suggests that for Japanese women, smoking and working may be important public health issue targets for the prevention of early spontaneous abortions.