Abstract
Endometriosis is the presence of functioning endometrial glands and stroma outside the uterine cavity, most often in the pelvic peritoneal cavity. Women with endometriosis commonly have dysmenorrhea, dyspareunia, pain, menorrhagia, and/or metrorrhagia. Disease complications can include adhesions, chronic pain, and infertility. In this exploratory case-control study, we investigated the relationship between lifetime occupational history and surgically confirmed endometriosis in a population-based sample. We conducted interviews with participants, all reproductive-aged female members of a large health-maintenance organization who were first diagnosed with surgically confirmed endometriosis between April 1, 1996 and March 31, 2001. Interviews were also conducted with randomly selected controls, reproductive-aged female enrollees of the same organization from the same time period. Each reported job was coded using US Census Occupations and Industries codes, and classified into categories. We used unconditional logistic regression to compare having worked in a given job class with never having done so. Our study found that an increased risk of endometriosis was associated with having worked as a flight attendant, service station attendant, or health worker, particularly as a nurse or health aide (flight attendant: odds ratio (OR) 9.80, 95% CI 1.08-89.02; service station attendant: OR 5.77, 95% CI 1.03-32.43; health worker: OR 1.49, 95% CI 1.03-2.15). Income and education did not make a difference in the OR estimates for the occupations examined. This exploratory study suggested that there might be an associated risk of endometriosis for those women who have worked as a flight attendant, service station attendant, or health worker, particularly a nurse.
Highlights
Endometriosis, which affects 5-10% of US women of reproductive age, is the presence of functioning endometrial glands and stroma outside the uterine cavity, most often in the pelvic peritoneal cavity [1]
This exploratory study suggests that having ever worked as a flight attendant, service station attendant, or health worker, as a nurse, may be associated with an increased risk of endometriosis
As described elsewhere [10], all female enrollees of Group Health Cooperative (GH), a large health-maintenance organization (HMO) in Washington State, USA, between 18 and 49 years of age and first diagnosed with surgically confirmed endometriosis between April 1, 1996 and March 31, 2001 were invited to participate as cases (n = 467.) Potential cases’ reference dates were the month and year of the first GH visit for symptoms leading to the diagnosis of endometriosis
Summary
Endometriosis, which affects 5-10% of US women of reproductive age, is the presence of functioning endometrial glands and stroma outside the uterine cavity, most often in the pelvic peritoneal cavity [1]. Endometriosis has been studied as a potential outcome of occupational exposure to dioxins and included as a secondary outcome in general studies of reduced fertility among workers in certain industries and occupations. These studies have found increased risk of endometriosis-associated infertility among workers exposed to formaldehyde [6], video display terminals [7], chemical dusts [7], or organic solvents [6,7]; and among workers in agricultural industries and occupations, in particular farmworkers [8]. If occupational risks for endometriosis do exist, such exposures will affect many women. This analysis explores the relationship between occupation and endometriosis in a large population-based case-control study
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