Perinatal & Pediatric
Maternal occupational risks and adverse birth outcomes among emergency medical services workers, firefighters, and nurses Paulina Luna Ramirez* Paulina Luna Ramirez Luna Ramirez Luna Ramirez Luna Ramirez Luna Ramirez Luna Ramirez Luna Ramirez Luna Ramirez Luna Ramirez Luna Ramirez The University of Arizona
Emergency service and health care workers face hazardous conditions such as chemical exposure, shift work, stress, and physical strain which may negatively affect pregnancy. Few studies have investigated the impact of occupational exposure as a first responder and adverse pregnancy outcomes. With the use of birth certificates from the state of Arizona (2006-2013), we evaluated adverse birth outcomes among emergency medical services workers without fire exposure (N=414), firefighters(N=376), and nurses(N=13,737) compared to the general population. Using logistic regression, we estimated the association between maternal occupation and risk of low birth weight, preterm birth, cesarean section, low Apgar score, and neonatal intensive care unit (NICU) admission. Models were adjusted for mother’s education and age, as well as birth year. For the outcome of low birth weight, we additionally adjusted for gestational age. We observed higher odds of preterm birth for EMS workers (1.76, 95% CI: 1.34, 2.30), firefighters (1.40, 95% CI: 1.02, 1.88) and nurses (1.22, 95% CI:1.15, 1.30) compared to the general population. Increased odds of cesarean section were observed for EMS workers (1.41, 95% CI: 1.15, 1.72). NICU admission was elevated among emergency medical services workers (2.12, 95% CI: 1.56, 2.89) and firefighters (1.84, 95% CI: 1.30, 2.56) compared to the general population. None of the occupational groups had higher odds of low Apgar score and low birth weight when compared to the general population. These findings suggest associations between maternal occupation in emergency medical services, firefighting, and nursing and select adverse birth outcomes, highlighting the need for future research on implementing workplace protections for pregnant workers.