Correlates of Positive Thyroid Peroxidase Antibodies Among Firefighters: A Cross-Sectional-Study

Kemi Ogunsina; Tulay Koru-Sengul; Valentina Rodriguez; Alberto J Caban-Martinez; Natasha Schaefer-Solle; Soyeon Ahn; Erin N Kobetz-Kerman; David J Lee

doi:10.1210/jendso/bvac125

Correlates of Positive Thyroid Peroxidase Antibodies Among Firefighters: A Cross-Sectional-Study

J Endocr Soc. 2022 Aug 23;6(10):bvac125. doi: 10.1210/jendso/bvac125. eCollection 2022 Oct 1.

Authors

Kemi Ogunsina^{1

2}, Tulay Koru-Sengul^{1

2}, Valentina Rodriguez³, Alberto J Caban-Martinez^{1

2}, Natasha Schaefer-Solle^{4

2}, Soyeon Ahn⁵, Erin N Kobetz-Kerman^{1

4

2}, David J Lee^{1

2}

Affiliations

¹ Department of Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
² Sylvester Comprehensive Cancer Center, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
³ Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
⁴ Department of Medicine, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
⁵ Department of Educational and Psychological Studies, School of Education and Human Development, University of Miami, Miami, FL 33146, USA.

Abstract

Context: Exposure to endocrine disrupting chemicals (EDCs) are associated with underactive thyroid glands, and possibly autoimmunity. Firefighters are exposed to EDCs from flame retardants; however, the prevalence and risk factor associations of thyroid antibodies among firefighters are unknown.

Context: We aimed to determine the prevalence of thyroid peroxidase antibodies (TPOAb) and associated sociodemographic and occupational risk factors among firefighters.

Methods: Firefighters attending professional health and safety conferences between November 2018 and January 2020, and with no prior diagnosis of thyroid disease were invited (n = 278) to submit a health survey, blood samples, and complete a thyroid ultrasound. The survey assessed for sociodemographic and occupational characteristics, including a history of familial thyroid disease, smoking, firefighter tenure, and job rank, radiation exposure, and mitigation practices of occupational exposures. Serum thyroid peroxidase antibody (TPOAb) was also assessed.

Results: Approximately 39.9% of firefighters evaluated had a positive TPOAb test. The mean age for those TPOAb positive was lower than those who tested negative (41.4 ± 7.9 vs 43.1 ± 7.9 years, P = 0.07) but this difference was not significant. Firefighters with a family history of thyroid disease had a statistically significant higher prevalence of TPOAb compared with those without a family history (60.0% vs 37.5%, P = 0.02); this association remained significant after adjusting for sociodemographic and occupational factors (odds ratio 2.99; CI, 1.31-6.85).

Conclusion: The prevalence of TPOAb is high among firefighters in our study, and family history is a significant determinant of testing positive for TPOAb. Firefighters may benefit from TPOAb and thyroid stimulating hormone tests, and screening for family history of thyroid disease at baseline employee medical check-ups. This finding suggests the need for further studies.

Keywords: antibody; family; firefighters; history; occupation; thyroid.