Association Between Parental Firefighting Status and Adverse Birth Outcomes

Abstract

Background: Firefighters are exposed to chemicals, smoke, physically demanding activities, and heavy work schedules that have been associated with an increased risk for adverse birth outcomes. There has been limited research that has looked at these associations among both male and female firefighter parents. The objective of this study was to determine whether there is an association between maternal and paternal firefighting status and adverse birth outcomes (i.e., low birth weight, preterm birth, cesarean-section, low Apgar score and NICU admission). Methods: Birth certificate data from the state of Arizona were used to investigate the association between parental occupation and risk for adverse birth outcomes. Firefighters were compared to teachers, law enforcement officers, and non-firefighter occupation groups and occupation of the female parent was investigated separately from the male parent. Logistic regression models were used to estimate the odds ratios and 95% confidence intervals while adjusting for maternal education, age, and birth year. In sensitivity analyses, we additionally adjusted for race, ethnicity, marital status, plurality, county, and gestational age. Results: Maternal firefighting was associated with increased odds of preterm birth (OR: 1.40, 95% CI 1.02, 1.90) when compared to teachers. Maternal firefighting was also associated with increased odds of NICU admission when compared to teachers (OR: 1.70, 95% CI: 1.18, 2.38), law enforcement officers (OR: 1.67, 95% CI: 1.03, 2.71), and the non-firefighter population (adjusted OR: 1.75, 95% CI: 1.21, 2.46). No statistically significant associations were found between maternal firefighting and risk of low birth weight, low Apgar score, and cesarean section. Paternal firefighting was not statistically significantly associated with any of the birth outcomes. Sensitivity analysis results did not significantly differ from multivariable models. Conclusions: Our results suggest that women firefighters may have higher odds of having a newborn born prematurely and of NICU admission. Further research should better understand the mechanism of association and investigate ways to mitigate risk to women firefighters and their babies.