Pregnancy, childbirth, and puerperium outcomes in female firefighters in Korea

Park, Juha; Ahn, Yeon-Soon; Kim, Min Gi

doi:10.35371/aoem.2020.32.e8

Cited by 6 publications

(12 citation statements)

References 33 publications

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“…As suggested previously, women who initiated early prenatal care might have sought early care because of a threatened miscarriage or because they were at increased risk for miscarriage [ 43 ]. Our finding builds on previous studies that have also reported increased risk of adverse reproductive outcomes among firefighters compared to non-firefighters [ 7 , 8 ]. Potential mechanisms by which firefighters may have greater risk of miscarriages may involve potential occupational exposures (e.g., byproducts of combustion and certain PFAS), which have been studied in in other populations [ 11 , 13 ].…”

Section: Discussionsupporting

confidence: 88%

“…Health and safety issues among women in the fire service were first identified in the early 1990’s, but many of those concerns remain relevant and unanswered today. Previous research suggests that women firefighters are at greater risk of adverse reproductive health conditions [ 7 , 8 ]. Career firefighters in the US have been suggested to have higher self-reported prevalence of pregnancy loss (miscarriages and stillbirths combined) compared to the general population [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Occupational factors and miscarriages in the US fire service: a cross-sectional analysis of women firefighters

Jung

Jahnke²,

Dennis

et al. 2021

Environ Health

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Background Evidence from previous studies suggests that women firefighters have greater risk of some adverse reproductive outcomes. The purpose of this study was to investigate whether women firefighters had greater risk of miscarriage compared to non-firefighters and whether there were occupational factors associated with risk of miscarriage among firefighters. Methods We studied pregnancies in the United States fire service using data from the Health and Wellness of Women Firefighters Study (n = 3181). We compared the prevalence of miscarriage among firefighters to published rates among non-firefighters using age-standardized prevalence ratios. We used generalized estimating equations to estimate relative risks (RRs) and 95% confidence intervals (CIs) between occupational factors (employment (career/volunteer), wildland firefighter status (wildland or wildland-urban-interface/structural), shift schedule, fire/rescue calls at pregnancy start) and risk of miscarriage, adjusted for age at pregnancy, education, gravidity, BMI, and smoking. We evaluated if associations varied by age at pregnancy or employment. Results Among 1074 firefighters and 1864 total pregnancies, 404 pregnancies resulted in miscarriages (22%). Among most recent pregnancies, 138 resulted in miscarriage (13%). Compared to a study of US nurses, firefighters had 2.33 times greater age-standardized prevalence of miscarriage (95% CI 1.96–2.75). Overall, we observed that volunteer firefighters had an increased risk of miscarriage which varied by wildland status (interaction p-value< 0.01). Among structural firefighters, volunteer firefighters had 1.42 times the risk of miscarriage (95% CI 1.11–1.80) compared to career firefighters. Among wildland/wildland-urban-interface firefighters, volunteer firefighters had 2.53 times the risk of miscarriage (95% CI 1.35–4.78) compared to career firefighters. Conclusions Age-standardized miscarriage prevalence among firefighters may be greater than non-firefighters and there may be variation in risk of miscarriage by fire service role. Further research is needed to clarify these associations to inform policy and decision-making.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Occupational factors and miscarriages in the US fire service: a cross-sectional analysis of women firefighters

Jung

Jahnke²,

Dennis

et al. 2021

Environ Health

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“… ‡Model 1 is adjusted for age-at-pregnancy, modelled as age-at-pregnancy and age-at-pregnancy. 2 §Model 2 is additionally adjusted for highest education completed (some college/at least college degree), gravidity (yes/no), BMI (<30 kg/m 2 /≥30 kg/m 2 ) and smoking status (current or former/never). Highest education completed, BMI and smoking status were measured in 2017 at time of survey.…”

Section: Resultsmentioning

confidence: 99%

“…Overall, we did observe consistent patterns, supporting previous studies that used indirect comparison methods to demonstrate that adverse reproductive outcomes may be greater in firefighters compared with non-firefighters. [1][2][3] on January…”

Section: Discussionmentioning

confidence: 99%

“…Previous observational studies suggest that women firefighters experience more adverse reproductive outcomes, such as pregnancy loss, preterm birth and hospital admissions for adverse pregnancy, childbirth and postpartum outcomes compared with non-firefighters. [1][2][3] Some potential occupational exposures (air pollutants, perfluoroalkyl and polyfluoroalkyl substances (PFAS), and high temperatures) have also been associated with adverse reproductive outcomes among non-firefighters. [4][5][6][7] Firefighters could be particularly vulnerable to these exposures, given their high level of exposures.…”

Section: Introductionmentioning

confidence: 99%

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

Jung

Jahnke²,

Dennis

et al. 2022

Occup Environ Med

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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.

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Birth defects associated with paternal firefighting in the National Birth Defects Prevention Study

Siegel

Rocheleau

Hollerbach³

et al. 2022

American J Industrial Med

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Background: Few studies have evaluated birth defects among children of firefighters. We investigated associations between birth defects and paternal work as a firefighter compared to work in non-firefighting and police officer occupations. Methods:We analyzed 1997-2011 data from the multi-site case-control National Birth Defects Prevention Study. Cases included fetuses or infants with major structural birth defects and controls included a random sample of live-born infants without major birth defects. Mothers of infants self-reported information about parents' occupations held during pregnancy. We investigated associations between paternal firefighting and birth defect groups using logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Referent groups included families reporting fathers working non-firefighting and police officer jobs.Results: Occupational groups included 227 firefighters, 36,285 non-firefighters, and 433 police officers. Twenty-nine birth defects were analyzed. In adjusted analyses, fathers of children with total anomalous pulmonary venous return (TAPVR; OR = 3.1; 95% CI = 1.1-8.7), cleft palate (OR = 1.8; 95% CI = 1.0-3.3), cleft lip (OR = 2.2; 95% CI = 1.2-4.2), and transverse limb deficiency (OR = 2.2; 95% CI = 1.1-4.7) were more likely than fathers of controls to be firefighters, versus non-firefighters. In policereferent analyses, fathers of children with cleft palate were 2.4 times more likely to be firefighters than fathers of controls (95% CI = 1.1-5.4).Conclusions: Paternal firefighting may be associated with an elevated risk of birth defects in offspring. Additional studies are warranted to replicate these findings.Further research may contribute to a greater understanding of the reproductive health of firefighters and their families for guiding workplace practices.

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Pregnancy, childbirth, and puerperium outcomes in female firefighters in Korea

Cited by 6 publications

References 33 publications

Occupational factors and miscarriages in the US fire service: a cross-sectional analysis of women firefighters

Occupational factors and miscarriages in the US fire service: a cross-sectional analysis of women firefighters

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

Birth defects associated with paternal firefighting in the National Birth Defects Prevention Study

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