{
  "abstract": "Background Firefighters are continuously exposed to hazardous conditions including smoke, chemicals, stress, long work shifts and exhaustion, which may lead to a higher risk for chronic conditions and reproductive health issues. However, there is limited research looking at the association between parental firefighting with adverse birth outcomes. This cross-sectional study aimed to determine whether female or male firefighting was associated with adverse birth outcomes.Methods Arizona birth certificates for the years 2006–2013 were used to compare firefighters with teachers, law enforcement officers and all other occupations while stratifying by sex. Logistic regression models estimated ORs and 95% CIs.Results We included 720 686 births, 5490 paternal firefighters and 376 maternal firefighters. Maternal firefighting was associated with increased odds of preterm birth compared with teachers (OR: 1.46, 95% CI 1.06 to 1.97) and all other occupations (OR: 1.41, 95% CI 1.02 to 1.88). Higher odds for neonatal intensive care unit admission were observed when compared with teachers (OR: 1.77, 95% CI 1.22 to 2.48), law enforcement officers (OR: 1.74, 95% CI 1.07 to 2.81) and all other occupations (OR: 1.84, 95% CI 1.30 to 2.56). Paternal firefighting was statistically significantly associated with decreased caesarean section and low birth weight.Conclusions Female firefighters may have higher odds of adverse birth outcomes. Further research should aim on understanding the biological mechanism behind these associations and ways to mitigate the risk in this population.",
  "authors": [
    {
      "affiliations": [
        "Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, Arizona, USA"
      ],
      "name": "Paulina Luna Ramirez"
    },
    {
      "affiliations": [
        "Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, Arizona, USA"
      ],
      "name": "Michelle Valenti"
    },
    {
      "affiliations": [
        "Fairfield Fire Department, Fairfield, Connecticut, USA"
      ],
      "name": "Caitlin Clarkson Pereira"
    },
    {
      "affiliations": [
        "Bellevue Fire Department, Bellevue, Washington, USA"
      ],
      "name": "Maia Brown"
    },
    {
      "affiliations": [
        "Tucson Fire Department, Tucson, Arizona, USA"
      ],
      "name": "Stuart Sherman"
    },
    {
      "affiliations": [
        "Tucson Fire Department, Tucson, Arizona, USA"
      ],
      "name": "John Gulotta"
    },
    {
      "affiliations": [
        "Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, Arizona, USA"
      ],
      "name": "Melissa A Furlong"
    },
    {
      "affiliations": [
        "Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, Arizona, USA"
      ],
      "name": "Jefferey L Burgess"
    },
    {
      "affiliations": [
        "Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, Arizona, USA"
      ],
      "name": "Leslie V Farland"
    }
  ],
  "title": "Association between parental firefighting status and adverse birth outcomes in Arizona: a cross-sectional study",
  "uid": "bc3f2ce6-68e6-5f07-8a6c-84da5d191fe2"
}