Feasibility Issues in Reproductive Biomonitoring of Female Flight Attendants and Teachers

Abstract

Flight attendants (FAs) may be at risk of adverse reproductive outcomes. We investigated the feasibility of biomonitoring studies in this mobile workforce. Forty-five female FAs and 26 female teachers (referents) collected daily urine and saliva samples for one menstrual cycle, provided daily diary data for approximately three months, and wore a wrist monitor to measure sleep disruption. A transport system enabled FAs to store samples while traveling. Overall, participation rates were low (37%) but of those recruited, over 90% of FAs and teachers completed the biomonitoring cycle. Data collection and sample integrity were not diminished by travel. Study methods resulted in good compliance and high quality data. It is possible to conduct studies of menstrual cycle function, sleep disruption, and circadian rhythm disruption in a mobile workforce potentially exposed to reproductive hazards.

Measuring and identifying large-study metrics for circadian rhythm disruption in female flight attendants

“…Previous characterization of the participants indicated differences between the flight attendants and teachers for body mass index (BMI) and several other demographic and life-style variables (14). However, the mean ages of the flight attendants and teachers were similar, 36.0 (SD 4.7, range 27-45) years versus 37.4 (SD 5.9, range 24-45) years, respectively.…”

“…Transport procedures were developed to allow flight attendants to carry samples and collection materials as they traveled. Sample quality was not impaired or diminished by work-related travel (14).…”

“…Teachers were selected as a comparison group for this reproductive health study primarily because this predominantly female occupation has minimal air travel, few reproductive hazards, and comparability to flight attendants on several key demographic characteristics (eg, age, race, education, parity) (14). Prior analyses of data from this study estimated the cosmic radiation dose for flight attendants (15) and showed that flight attendants incurred significantly similar sleep impairment when compared with teachers (16).…”

An occupational reproductive research agenda for the third millennium.

“…Several of these markers are associated with conditions including anovulation (Kassam et al 1996), reduced fertility, and the probability of conception (Baird et al 1999). Menstrual function studies of women working in the semiconductor industry (Gold et al 1995a), with jet fuel (Reutman et al 2002), or as flight attendants (Whelan et al 2002) have been conducted or are in progress. Because many of these markers vary with stage of life, analyses should correct for age.…”

“…Study participant collection of small amounts of daily urine for one or more menstrual cycles has been successful in several environmental studies and in occupational groups including semiconductor workers (Gold et al 1995b) and actively traveling flight attendants (Whelan et al 2002). Modification of the hormone assays for field use has resulted in an effective biomonitoring metric for ovulatory function, early pregnancy loss, premature menopause, and other important reproductive outcomes.…”