A day in the life of a flight attendant often involves grueling physical demands: pushing and pulling service carts, lifting heavy luggage and standing for hours in airplane cabins.
A recent study by Duke University School of Medicine and the U.S. Centers for Disease Control and Prevention found that flight attendants who perform these strenuous tasks experience more intense menstrual cramps and irregular cycles.
Since the 1960s, studies have documented menstrual irregularities, severe cramps and heavier menstrual flows among flight attendants. The latest study published on January 13 in Occupational and environmental medicinea BMJ journal, stands out for analyzing how occupational exposures play a role in painful periods.
It is also one of the few studies to address women’s health in the workplace. Most occupational health research focuses on men and the health problems they face while working in male-dominated fields such as coal mining and construction.
“This study highlights a link between work and health outcomes that we don’t normally think about,” he said. Candice Y. Johnson, Ph.D.Assistant Professor at the Department of Family Medicine and Community Health at Duke Medical School.
Candice Johnson, Ph.D.
In the United States, 85% of women suffer from painful menstrual periods and more than a third of them are unable to perform their daily activities, including work, because of their symptoms. “Menstrual cramps affect so many people. If we can do something to help reduce them, even by a fraction, we will improve the quality of life and productivity of many people in the workforce,” Johnson said.
The team analyzed data collected for an earlier CDC study comparing the health conditions of flight attendants to teachers. In the new study, flight attendants reported greater physical demands than teachers: 61 percent of them described their workday as hard work, compared with just 12 percent of teachers who felt the same way.
Flight attendants also reported performing activities such as standing for more than eight hours, lifting objects weighing about 15 pounds, pushing or pulling objects, and bending or twisting at the waist more frequently than teachers.
“Conditions that affect women, especially menstrual cycles, are considered a part of life. Menstrual cramps are not life-threatening conditions, but they do cause a lot of pain, suffering and loss of time from work.”
– Candice Y. Johnson, PhD, associate professor of family medicine
Flight attendants also reported experiencing cramps more often than teachers. According to the study, 61 percent of flight attendants experienced moderate or severe cramps compared to 51 percent of teachers.
“Other studies (not related to flight attendants) have shown that frequent heavy lifting is associated with increased menstrual pain. This study was an opportunity to see if physical labor was the reason flight attendants said their cramps were worse while working than when they weren’t,” Johnson said.
Addressing menstrual health in the workplace
Part of Johnson’s motivation to lead this study came from realizing how understudied menstrual cycles are.
“There is a lot of evidence that working conditions influence our health, but much of the occupational health literature is based on cohorts of men in male-dominated occupations. While that is important, conditions that affect women, especially menstrual cycles, are seen as simply part of life,” Johnson said. “Menstrual cramps are not life-threatening conditions, but they do cause a lot of pain, suffering and lost time from work.”
She began the recent study while working as an epidemiologist at the CDC. National Institute for Occupational Safety and Health (NIOSH)She and her team used data collected by the CDC for a larger study. Study comparing miscarriage rates between flight attendants and teachers.
Information was collected from 694 flight attendants and 120 teachers in three U.S. cities between 1992 and 2001. Flight records were obtained and interviews were conducted to gather information on a variety of reproductive health topics.
Thanks to the volume of data collected, the agency was able to conduct additional studies, such as the recent one on menstrual irregularities.
“The publication of this study… helps raise awareness of how the work environment affects things like menstrual health and will encourage others to study it. The more research we can do, the more answers we will have,” Johnson said.
“If flight attendants miss work because of menstrual cramps, they don’t get paid and the airline is understaffed. You can’t fly a plane without a flight attendant,” Johnson said. “Workers and employers have a shared interest in making sure everyone is healthy at work and can come to work.”
Johnson hopes that industries will be inspired to improve their working environment.
“We now know that people who have more physically demanding jobs, such as flight attendants, tend to suffer more severe menstrual cramps. If there is some aspect of the work environment that is causing more severe cramps, we need to determine what we can do to improve it.”
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