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

Abstract 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 occ...

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Autores principales:	Alesia M. Jung, Sara A. Jahnke, Leslie K. Dennis, Melanie L. Bell, Jefferey L. Burgess, Nattinee Jitnarin, Christopher M. Kaipust, Leslie V. Farland
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Firefighters Occupational health Women’s health Reproductive health Epidemiology Miscarriage Industrial medicine. Industrial hygiene RC963-969 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/055f80a0b9a34e76bbd04bf65e5be123
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spelling	oai:doaj.org-article:055f80a0b9a34e76bbd04bf65e5be1232021-11-14T12:33:00ZOccupational factors and miscarriages in the US fire service: a cross-sectional analysis of women firefighters10.1186/s12940-021-00800-41476-069Xhttps://doaj.org/article/055f80a0b9a34e76bbd04bf65e5be1232021-11-01T00:00:00Zhttps://doi.org/10.1186/s12940-021-00800-4https://doaj.org/toc/1476-069XAbstract 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.Alesia M. JungSara A. JahnkeLeslie K. DennisMelanie L. BellJefferey L. BurgessNattinee JitnarinChristopher M. KaipustLeslie V. FarlandBMCarticleFirefightersOccupational healthWomen’s healthReproductive healthEpidemiologyMiscarriageIndustrial medicine. Industrial hygieneRC963-969Public aspects of medicineRA1-1270ENEnvironmental Health, Vol 20, Iss 1, Pp 1-13 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Firefighters Occupational health Women’s health Reproductive health Epidemiology Miscarriage Industrial medicine. Industrial hygiene RC963-969 Public aspects of medicine RA1-1270
spellingShingle	Firefighters Occupational health Women’s health Reproductive health Epidemiology Miscarriage Industrial medicine. Industrial hygiene RC963-969 Public aspects of medicine RA1-1270 Alesia M. Jung Sara A. Jahnke Leslie K. Dennis Melanie L. Bell Jefferey L. Burgess Nattinee Jitnarin Christopher M. Kaipust Leslie V. Farland Occupational factors and miscarriages in the US fire service: a cross-sectional analysis of women firefighters
description	Abstract 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.
format	article
author	Alesia M. Jung Sara A. Jahnke Leslie K. Dennis Melanie L. Bell Jefferey L. Burgess Nattinee Jitnarin Christopher M. Kaipust Leslie V. Farland
author_facet	Alesia M. Jung Sara A. Jahnke Leslie K. Dennis Melanie L. Bell Jefferey L. Burgess Nattinee Jitnarin Christopher M. Kaipust Leslie V. Farland
author_sort	Alesia M. Jung
title	Occupational factors and miscarriages in the US fire service: a cross-sectional analysis of women firefighters
title_short	Occupational factors and miscarriages in the US fire service: a cross-sectional analysis of women firefighters
title_full	Occupational factors and miscarriages in the US fire service: a cross-sectional analysis of women firefighters
title_fullStr	Occupational factors and miscarriages in the US fire service: a cross-sectional analysis of women firefighters
title_full_unstemmed	Occupational factors and miscarriages in the US fire service: a cross-sectional analysis of women firefighters
title_sort	occupational factors and miscarriages in the us fire service: a cross-sectional analysis of women firefighters
publisher	BMC
publishDate	2021
url	https://doaj.org/article/055f80a0b9a34e76bbd04bf65e5be123
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Occupational factors and miscarriages in the US fire service: a cross-sectional analysis of women firefighters

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