Women Firefighters Study: Stress, Cancer Risk and Reproductive Toxicity
University of Arizona, Principal Investigator - Jefferey L. Burgess, MD, MS, MPH
RELEVANCE
Women firefighters have high rates of post-traumatic stress disorder (PTSD), cancer, and adverse reproductive outcomes. However, the lack of sufficient information on the causes of and mechanisms leading to these occupationally related illnesses prevents the creation of effective interventions. Stress is linked with PTSD. In addition, stress has been associated with epigenetic changes, cancer, and adverse reproductive outcomes. Epigenetic changes are integral mechanisms in cancer development. Exposure to inhaled toxicants and stress can cause premature ovarian failure (early menopause), associated with reduced serum levels of anti-müllerian hormone (AMH).
METHODS
Building on the Fire Fighter Cancer Cohort Study, we will enroll at least 100 women new recruits and 100 incumbent career and volunteer firefighters across multiple fire departments. Self-reported stress, cancer risk, reproductive health, and occupational exposure data will be collected via a survey on enrollment and annually for two years. Blood will be collected for epigenetic and AMH analysis at enrollment in all firefighters and again after 18-24 months in the recruits. Departmental fire incident response data will be supplemented by the use of a personal exposure reporting application. We will work with the Women in Fire organization to develop a cross-department peer support intervention and carry out a feasibility study.
ANTICIPATED OUTCOMES
We will identify exposures and risk factors for increased stress, cancer, and reduced ovarian reserve in women firefighters, which will inform future intervention studies. The peer support intervention will decrease stress and be suitable for a future large-scale intervention study.