title: Maternal occupational pesticide exposure and risk of hypospadias in the National Birth Defects Prevention Study.
abstract: BACKGROUND
  Hypospadias is a common congenital malformation among men in which the urethral opening is ventrally displaced. Pesticide exposure has been suggested as a possible etiologic factor, but previous epidemiologic studies have produced inconsistent results.
  
  
  METHODS
  We used data from the National Birth Defects Prevention Study (NBDPS), a population-based case-control study, to examine maternal occupational exposure to fungicides, insecticides, and herbicides among 647 hypospadias case infants and 1496 unaffected male control infants with estimated delivery dates from October 1997 to December 2002. Periconceptional (1 month before conception through the first trimester of pregnancy) pesticide exposures were assigned by an expert rater, assisted by a job-exposure matrix (JEM), from a job history completed by mothers during a telephone interview. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated with multivariable logistic regression, and adjusted for relevant covariates.
  
  
  RESULTS
  Maternal periconceptional occupational exposure to any pesticides (yes/no) was not associated with an increased risk of hypospadias (OR = 0.78; 95% CI = 0.61-1.01). Maternal occupational periconceptional pesticide exposure type (insecticides, fungicides, and herbicides) and estimated quantity also showed no significantly increased risk of hypospadias and no evidence of a dose-response relationship; however, the estimated pesticide exposure levels in this population were low.
  
  
  CONCLUSIONS
  Using broad classes of insecticides, herbicides, and fungicides, we found no evidence that low intensity maternal periconceptional occupational pesticide exposure was a risk factor for hypospadias.
authors.affiliation: Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa 52242, USA. CRocheleau@cdc.gov
authors.forename: Carissa M
authors.initials: CM
authors.lastname: Rocheleau
authors.forename: Paul A
authors.initials: PA
authors.lastname: Romitti
authors.forename: Wayne T
authors.initials: WT
authors.lastname: Sanderson
authors.forename: Lixian
authors.initials: L
authors.lastname: Sun
authors.forename: Christina C
authors.initials: CC
authors.lastname: Lawson
authors.forename: Martha A
authors.initials: MA
authors.lastname: Waters
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Stewart
authors.forename: Richard S
authors.initials: RS
authors.lastname: Olney
authors.forename: Jennita
authors.initials: J
authors.lastname: Reefhuis
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005659:Fungicides, Industrial / Q000009:adverse effects; D006540:Herbicides / Q000009:adverse effects; D006801:Humans; D007021:Hypospadias / Q000453:epidemiology* / Q000209:etiology; D007231:Infant, Newborn; D007306:Insecticides / Q000009:adverse effects; D016015:Logistic Models; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects*; D016273:Occupational Exposure / Q000009:adverse effects*; D016017:Odds Ratio; D010575:Pesticides / Q000009:adverse effects* / Q000145:classification; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D055815:Young Adult
chemical_list: D005659:Fungicides, Industrial; D006540:Herbicides; D007306:Insecticides; D010575:Pesticides