Document


Title

Occupational factors and miscarriages in the US fire service: a cross-sectional analysis of women firefighters
Document Type: Journal Article
Author(s): Alesia M. Jung; Sara A. Jahnke; Leslie K. Dennis; Melanie L. Bell; Jefferey L. Burgess; Nattinee Jitnarin; Christopher M. Kaipust; Leslie V. Farland
Publication Year: 2021

Cataloging Information

Keyword(s):
  • epidemiology
  • firefighters
  • miscarriage
  • occupational health
  • reproductive health
  • spontaneous abortion
  • women's health
Topic(s):
Record Maintained By:
Record Last Modified: November 18, 2021
FRAMES Record Number: 64737

Description

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.

Online Link(s):
Citation:
Jung, Alesia M.; Jahnke, Sara A.; Dennis, Leslie K.; Bell, Melanie L.; Burgess, Jefferey L.; Jitnarin, Nattinee; Kaipust, Christopher M.; Farland, Leslie V. 2021. Occupational factors and miscarriages in the US fire service: a cross-sectional analysis of women firefighters. Environmental Health 20(1):116.