Firefighter occupational factors and the risk of preterm birth: results from a survey of women firefighters in the USA

Abstract

ObjectivesPrevious research has suggested that women firefighters may have a greater risk of adverse reproductive outcomes compared with non-firefighting women. In this study, we investigated the association between firefighter occupational factors and risk of preterm birth.MethodsThis cross-sectional analysis of US firefighters surveyed in 2017 compared preterm birth among firefighters to non-firefighters using age-at-pregnancy-standardised prevalence ratios. Generalised estimating equations estimated relative risks and 95% CIs between firefighter occupational factors (career or volunteer, wildland status, shift schedule, fire responses, work restriction) and preterm birth risk. We adjusted for age-at-pregnancy, education, gravidity, BMI, and smoking and considered effect modification by age-at-pregnancy and career versus volunteer status.ResultsAmong 934 women who reported 1356 live births, 12% were preterm (n=161). Preterm birth prevalence among firefighters was 1.41 times greater than non-firefighters (95% CI 1.18 to 1.68). Among wildland and combination wildland/structural firefighters, volunteers had 2.82 times the risk of preterm birth (95% CI 1.19 to 6.67) compared with career firefighters. Firefighters who started restricting their work in the 2nd trimester had a nonsignificant 0.67 times lower risk of preterm birth than those who started in the 3rd trimester or did not restrict work at all (95% CI 0.43 to 1.03).ConclusionsFirefighters may have greater risk of preterm birth than non-firefighters, which could be influenced by roles in the fire service and work restrictions taken.

Excretion of polybrominated diphenyl ethers and AhR activation in breastmilk among firefighters

“…The health effects of firefighting on the offspring of children are largely unknown. However, there is a growing body of evidence that suggests that female firefighters are more likely to experience adverse reproductive health outcomes, including miscarriage and preterm birth compared with nonfirefighters ( Jahnke et al , 2018 ; Jung et al , 2021 , 2023 ). Additionally, risks for adverse pregnancy outcomes among firefighters may vary by roles in the fire service, examined as proxies for different occupational exposures ( Jung et al , 2021 , 2023 ).…”

“…However, there is a growing body of evidence that suggests that female firefighters are more likely to experience adverse reproductive health outcomes, including miscarriage and preterm birth compared with nonfirefighters ( Jahnke et al , 2018 ; Jung et al , 2021 , 2023 ). Additionally, risks for adverse pregnancy outcomes among firefighters may vary by roles in the fire service, examined as proxies for different occupational exposures ( Jung et al , 2021 , 2023 ). Other studies suggest that male firefighters have increased risk for infertility ( Petersen et al , 2019 ) and that female firefighters have lower levels of anti-Müllerian hormone, a functional biomarker of ovarian reserve, compared with nonfirefighters ( Davidson et al , 2022 ).…”