title: Parental occupational exposure to endocrine disrupting chemicals and male genital malformations: a study in the Danish National Birth Cohort study.
abstract: BACKGROUND
  Sex hormones closely regulate development of the male genital organs during fetal life. The hypothesis that xenobiotics may disrupt endogenous hormonal signalling has received considerable scientific attention, but human evidence is scarce.
  
  
  OBJECTIVE
  We analyse occurrence of hypospadias and cryptorchidism according to maternal and paternal occupational exposure to possible endocrine disrupting chemicals.
  
  
  METHODS
  We conducted a follow-up study of 45,341 male singleton deliveries in the Danish National Birth Cohort during 1997-2009. Information on work during pregnancy was obtained by telephone interviews around gestational week 16. Parents' job titles were classified according to DISCO-88. A job exposure matrix for endocrine disrupting chemicals (EDCs) was implemented to assess occupational exposures. The Medical Birth and National Hospital Register provided data on congenital anomalies diagnosed at birth or during follow-up, which ended in 2009. Crude and adjusted hazard ratios (HR) were obtained from Cox regression models.
  
  
  RESULTS
  Among all pregnancies, 6.3% were classified as possibly or probably exposed to EDCs. The most prevalent occupations conferring possible exposure were cleaners, laboratory technicians, hairdressers and agricultural workers (58% of all potentially exposed). The final cumulative incidence of cryptorchidism in boys was 2.2% (1002 cases), and of hypospadias 0.6% (262 cases). The occurrence of hypospadias increased when mothers were probably [HRa = 1.8 (95% CI 1.0-2.6)] or possibly exposed to one or more EDCs [HRa = 2.6 (95% CI 1.8-3.4). Possible paternal exposure to heavy metals increased the risk of hypospadias [HRa 2.2 (95% CI: 1.0-3.4)] and cryptorchidism [HRa 1.9 (95% CI: 1.1-2.7)]. None of the exposure groups reached statistical significance.
  
  
  CONCLUSIONS
  The study provides some but limited evidence that occupational exposure to possible endocrine disrupting chemicals during pregnancy increases the risk of hypospadias.
authors.affiliation: Unit of Public Health and Environmental Care, Department of Preventive Medicine, University of Valencia, Valencia, Spain. maria.m.morales@uv.es
authors.forename: María M
authors.initials: MM
authors.lastname: Morales-Suárez-Varela
authors.forename: Gunnar V
authors.initials: GV
authors.lastname: Toft
authors.forename: Morten S
authors.initials: MS
authors.lastname: Jensen
authors.forename: Cecilia
authors.initials: C
authors.lastname: Ramlau-Hansen
authors.forename: Linda
authors.initials: L
authors.lastname: Kaerlev
authors.forename: Ane-Marie
authors.initials: AM
authors.lastname: Thulstrup
authors.forename: Agustín
authors.initials: A
authors.lastname: Llopis-González
authors.forename: Jørn
authors.initials: J
authors.lastname: Olsen
authors.forename: Jens P
authors.initials: JP
authors.lastname: Bonde
mesh_terms: D002675:Child, Preschool; D015331:Cohort Studies; D003456:Cryptorchidism / Q000139:chemically induced*; D003718:Denmark / Q000453:epidemiology; D052244:Endocrine Disruptors / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007021:Hypospadias / Q000139:chemically induced*; D007223:Infant; D007231:Infant, Newborn; D007407:Interviews as Topic; D008297:Male; D018811:Maternal Exposure; D016273:Occupational Exposure / Q000009:adverse effects*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced*
chemical_list: D052244:Endocrine Disruptors