Occupational Stress Of Working Women: Associated Factors And Correlations With Serum Cortisol, Estradiol And β-endorphin

Occupational stress has become one of the issues of great con-cern. One of the four foucus of the 4th WHO Occupational Health Association Center Internet Meeting is how to control occupational stress[1]. It is reported that 52% women are experiencing occupational stress in 1987[4].Another report from Sweden publishes that 58% women complain over-workload. However, no specific data about women's occupational stress has been published in China.Researchers abroad have pay much attention on the effects of occupational stress on female's reproductive endocrine and related mechanism. It is referred that cortisol is one of the biological markers of occupational stress.β-EP plays an important role in the female's reproductive endorcrine system, which is secrected when the hypo-thalamo-pituitary-adrenal axis is activated. Thus, it is necessary to in-vestigate the relationship between occupational stress and serumβ-EP. Rresearch suggests that stressful macaques with normal menstrual cy-cle have significantly lower serum estradiol peak value. Neponaschy's research concludes that the level of urinary cortisol does not relate with estrone. So far, no published data refer the effect of occupational stress on serum estradiol andβ-EP. To illuminate the specific rela-tionship and potential mechanisms, we conduct this research. We questioned 510 working women by typical cluster sampling.The questionare consists of self-made inventory about individual in-formation and Occupational Stress Inventory (Revised) (OSI-R). Data was analyzed with SPSS 13.0 statistic software. The statistic results show that 79.80% female workers complained heavy work load, 41.96% female workers have severe personal strain reaction, and 44.12% female workers don't have enough coping resources. Occupa-tional women are facing relatively heavy occupational stress, so it is urgent to take according measures to relieve stress. As for this result, 74.71% of sample people are doctors and nurses, and 18.04% are teachers.It may be related with their jobs of strong responsibilities.Descriptive and analytic statistics was done for OSI-R scale scores for different groups.①The results of age group show that the score of occupational role questionnaire increases with the age's increasing.It is consistent with the actual conditions:as the age grows,female workers have more experiences and more responsibilities[25].The level of psychological strain reaction decreases with the age's growing,but the 30～40 age group have the highest score of personal strain, voca-tional strain and interpersonal strain comparing with other groups, which probably relates with the double load of occupation and fam-ily.This is proved by Zhang Rui's[25] research. 30～40 group have the lowest Personal Resources Questionarie(PRQ) score.The scores of self-care and rational/cognitive increase as the ages grow, which relate with enriching of the social and occupational experience.②The re-sult of different length of working:the score of occupational role questionnaire increase with the length's growth, which imply that oc-cupational role grows with the length of work's increase.Women who have worked for 10～15 years gradually adapt their job and are in charge of more work load, so it is natural for them to feel more stressor and work stress. Those who have worked for more than 15 years have more coping resources and less personal strain reaction, which results from better self-care and rational attitudes.The results of different education degree: the differences of scores of role-overload, role-boundary, personal-strain, voction-strain, psychological strain's reaction, interpersonal strain and recreation among different education groups are statistically significant. The junior college group have the highest score of personal strain ques-tionnaire, while the senior high school group have the lowest score. On the other hand, the senior high school group have the most coping resources, and the bachelor group have the lest coping resources. Gu Guizhen has also suggested that"higher education group experiece stronger stress than the lower education group"[28]. This can be ex-plained by the reason that higher education women have more profes-sional skills and burden more tasks.④The results of different shift : This research implies that night shift female workers have higher score than the pure day shift ones as for occupational role question-naire and personal strain questionnaire ,while the result is opposite asfor coping resources . Shifts change the human's bioclock rhyme,and cause burnout and lower working ability. What is more, the hormone secretion may be perturbed[29].We can conclude from this research that occupational role ques-tionarie and its items and personal strain questionarie and its items are positively related, and occupational role questionarie and its item and coping resources and its items are negatively related. The results is consistent with the occupational stress model[34] and OSI-R occupa-tional stress-strain reaction theory[19], which means more occupational role ,more strain reaction ,and more coping resources ,less occupa-tional strain reaction.To relieve the occupational stress and maintain physical and psychological health, one way is to decrease stressors'effect, another way is to enhance coping abilities. Prevention and control of occupa-tional stress not only need personal effort but also need related or-ganization's participation.According to norm formula made by Zeng Fanghua's[18], we quantify female workers'occupational stress. Those whose occupa-tional role and personal strain questionnaire scores are more than 60 are classified as the occupational stress group, and those whose scores are below 40 are classified as the control group. After excluding the mixed factors, 30 women were randomly selected from the two groups. By case-control method, we measure the serum cortisol,beta-endorphin and estradiol using radioimmune assay. Combined the radioimmune assay results and questionaire scores, we conclude the following results:①The occupational stress group's serum cortisol is higher than the control group's, which is similar in previous researches [41~43]. The mechanism is that: everlasting occupa-tional stress,without adequate coping resources , may reduce HPA axis continuing activated, and increase the serum cortisol[49] .Serum cortisol can be referred as the evaluating marker of occupational stress.②This research suggests that the difference of serum estradiol between the two groups is not statistically significant. Netter found that follicular phase high cortisol under stressed conditions is related with the decrease of estradiol[12]. Nepomnaschy discovered that child-bearing period the level of women's urinary cortisol did not re-late with the level of estrone[45]. Macaca researches suggest that the stressed macacas had the lower serum estrodiol.③This research suggests that the difference of serum beta-endorphin between the two groups is statistically significant, and serum beta-endorphin level is positively related with cortisol. There is evidence that under stressful conditions, such as exercise and military training, the level of cortisol andβ-EP are positively elevated.β-EP is one of the endogenous opioid peptides[60]. Activation of the parvicellular neurons of the paraventricular nucleus increase the release of corticotropin releas-ing hormone and initiates the endocrine response to a stressor, stimu-lating the release of pro-opiomelanocortin products ,which include ACTH and beta-endorphin[9]. ACTH stimulates the adrenal cortex to release cortisol, thusβ-EP is positively related with cortisol.④The level of serumβ-EP is not related with the level of the level of serum estradiol. Some evidence suggest that psychological stress may reduce the elevation ofβ-EP and influence reproductive function to some ex-tent[62]. So far no result of the relationship ofβ-EP and estradiol has been published. It is has been proved thatβ-EP can inhibit the release of GnRH and inhibit the release of LH.We obtain the incidence of occupational stress of occupational women in Changchun and related influence factors, further prove that serum cortisol is one of the believable biomarker. It is proved that high occupational stress reduce the early follicular phase serumβ-EP elevated, but has no relationship with the serum estradiol. These results will help us to illuminate the specific mechanism of how ocu-pational stess affects female's reproductive endocrine function and offer the theoretical evidence for the protection physical and mental health. Also, from the source of occupational femle's stressors, we can attract the whole society's high attention.To control and reduce the related risk factors, effective interventions should be taken.