Infertility Risk and Employment History Among US Women: Findings From National Health and Nutrition Examination Survey 2013–2014

INTRODUCTION: It is well established that exposure to chemical, radiological, and biological hazards in the workplace are infertility risk factors. Although workplace-specific infertility risks have been documented, the associations between employment history and infertility risk remain largely unexplored. The cross-sectional, nationally representative US National Health and Nutrition Examination Survey (NHANES) provided an opportunity to explore the relationship between employment history and infertility risk. METHODS: Employment history and reproductive measures are available in the NHANES 2013-2014 cycle. Infertility was assessed using self-reported, binary indicators: unsuccessful conception attempts and sought fertility consultation; combined to create a third, aggregate infertility measure. Associations between infertility risk and employment history, categorized by industry group and compared to respondents with no work history, were examined using three weighted binary logistic regression models while adjusting for sociodemographic, reproductive health, and relevant behavioral covariates. RESULTS: The sample consisted of 1126 women, aged 20 to 50 years; 1082 (96.1%) with a history of employment across 10 industry groups. Infertility was reported by 177 (17.2%), who reported unsuccessful conception attempts or fertility consultations. Across industry sectors, employment in the manufacturing of durable goods industry was significantly associated with unsuccessful conception attempts (adjusted odds ratio [AOR]: 4.15; 95% CI: 1.22, 14.08), fertility consultations (AOR: 6.94; 95% CI: 1.44, 25.25), and the aggregate infertility measure (AOR: 4.43; 95% CI: 1.32, 14.81). CONCLUSION: Employment in durable goods manufacturing is associated with multiple self-reported infertility measures, compared to women with no work history. In the absence of individualized workplace risk assessments, industry-level analyses may better inform workplace health promotion, with emphasis on reproductive health protections.