Birth defects associated with paternal firefighting in the National Birth Defects Prevention Study

BACKGROUND: Few studies have evaluated birth defects among children of firefighters. We investigated associations between birth defects and paternal work as a firefighter compared to work in non‐firefighting and police officer occupations. METHODS: We analyzed 1997–2011 data from the multi‐site case‐control National Birth Defects Prevention Study. Cases included fetuses or infants with major structural birth defects and controls included a random sample of live‐born infants without major birth defects. Mothers of infants self‐reported information about parents' occupations held during pregnancy. We investigated associations between paternal firefighting and birth defect groups using logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Referent groups included families reporting fathers working non‐firefighting and police officer jobs. RESULTS: Occupational groups included 227 firefighters, 36,285 non‐firefighters, and 433 police officers. Twenty‐nine birth defects were analyzed. In adjusted analyses, fathers of children with total anomalous pulmonary venous return (TAPVR; OR = 3.1; 95% CI = 1.1–8.7), cleft palate (OR = 1.8; 95% CI = 1.0–3.3), cleft lip (OR = 2.2; 95% CI = 1.2–4.2), and transverse limb deficiency (OR = 2.2; 95% CI = 1.1–4.7) were more likely than fathers of controls to be firefighters, versus non‐firefighters. In police‐referent analyses, fathers of children with cleft palate were 2.4 times more likely to be firefighters than fathers of controls (95% CI = 1.1–5.4). CONCLUSIONS: Paternal firefighting may be associated with an elevated risk of birth defects in offspring. Additional studies are warranted to replicate these findings. Further research may contribute to a greater understanding of the reproductive health of firefighters and their families for guiding workplace practices.