title: The risk of cryptorchidism among sons of women working in horticulture in Denmark: a cohort study.
abstract: BACKGROUND
  Androgens are crucial for normal testicular descent. Studies show that some pesticides have estrogenic or antiandrogenic effects, and that female workers exposed to pesticides have increased risk of having a boy with cryptorchidism. The main objective of the present study was to investigate whether pregnant women exposed to pesticides due to their work in horticulture experience excess risk of having sons with cryptorchidism.
  
  
  METHODS
  We conducted a cohort study of pregnant women working in horticulture using four cohorts including one cohort established with data from the departments of occupational medicine in Jutland and Funen and three existing mother-child cohorts (n=1,468). A reference group was established from the entire Danish population of boys born in the period of 1986-2007 (n=783,817). Nationwide Danish health registers provided information on birth outcome, cryptorchidism diagnosis and orchiopexy. The level of occupational exposure to pesticides was assessed by expert judgment blinded towards outcome status. Risk of cryptorchidism among exposed horticulture workers compared to the background population and to unexposed horticulture workers was assessed by Cox regression models.
  
  
  RESULTS
  Pesticide exposed women employed in horticulture had a hazard ratio (HR) of having cryptorchid sons of 1.39 (95% CI 0.84; 2.31) and a HR of orchiopexy of 1.34 (0.72; 2.49) compared to the background population. Analysis divided into separate cohorts revealed a significantly increased risk of cryptorchidism in cohort 2: HR 2.58 (1.07;6.20) and increased risk of orchiopexy in cohort 4: HR 2.76 (1.03;7.35), but no significant associations in the other cohorts. Compared to unexposed women working in horticulture, pesticide exposed women had a risk of having sons with cryptorchidism of 1.34 (0.30; 5.96) and of orchiopexy of 1.93 (0.24;15.4).
  
  
  CONCLUSIONS
  The data are compatible with a slightly increased risk of cryptorchidism in sons of women exposed to pesticides by working in horticulture.
authors.affiliation: Danish Ramazzini Center, Department of Occupational medicine, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Pernille
authors.initials: P
authors.lastname: Gabel
authors.forename: Morten Søndergaard
authors.initials: MS
authors.lastname: Jensen
authors.forename: Helle Raun
authors.initials: HR
authors.lastname: Andersen
authors.forename: Jesper
authors.initials: J
authors.lastname: Baelum
authors.forename: Ane Marie
authors.initials: AM
authors.lastname: Thulstrup
authors.forename: Jens Peter
authors.initials: JP
authors.lastname: Bonde
authors.forename: Gunnar
authors.initials: G
authors.lastname: Toft
mesh_terms: D000293:Adolescent; D000328:Adult; D000383:Agriculture; D002648:Child; D015331:Cohort Studies; D003456:Cryptorchidism / Q000139:chemically induced / Q000453:epidemiology*; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D056126:Orchiopexy / Q000706:statistics & numerical data; D010575:Pesticides / Q000633:toxicity*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced / Q000453:epidemiology*; D016016:Proportional Hazards Models; D012307:Risk Factors; D055815:Young Adult
chemical_list: D010575:Pesticides
references.citation: Reprod Toxicol. 2006 Jul;22(1):8-12
references.pmid: 16530380
references.citation: Dan Med Bull. 1999 Jun;46(3):263-8
references.pmid: 10421985
references.citation: J Reprod Fertil. 1988 May;83(1):295-300
references.pmid: 2899644
references.citation: Acta Paediatr. 2007 May;96(5):638-43
references.pmid: 17326760
references.citation: J Urol. 2011 Oct;186(4 Suppl):1595-600
references.pmid: 21855929
references.citation: J Urol. 2008 Jan;179(1):314-8
references.pmid: 18006016
references.citation: Reprod Biomed Online. 2007 Dec;15(6):659-65
references.pmid: 18062862
references.citation: Lancet. 2004 Apr 17;363(9417):1264-9
references.pmid: 15094270
references.citation: Toxicol Ind Health. 1999 Jan-Mar;15(1-2):48-64
references.pmid: 10188191
references.citation: J Pediatr Surg. 2005 Feb;40(2):297-302
references.pmid: 15750918
references.citation: Environ Health Perspect. 1996 Oct;104(10):1090-5
references.pmid: 8930551
references.citation: Toxicol Appl Pharmacol. 2006 Jun 1;213(2):160-71
references.pmid: 16375936
references.citation: Epidemiology. 1995 Mar;6(2):127-31
references.pmid: 7742397
references.citation: Acta Obstet Gynecol Scand. 2003 Oct;82(10):936-41
references.pmid: 12956844
references.citation: Hormones (Athens). 2003 Oct-Dec;2(4):211-6
references.pmid: 17003025
references.citation: Scand J Public Health. 2001 Dec;29(4):300-7
references.pmid: 11775787
references.citation: Toxicol Appl Pharmacol. 2002 Feb 15;179(1):1-12
references.pmid: 11884232
references.citation: Dev Biol. 2000 Aug 15;224(2):354-61
references.pmid: 10926772
references.citation: Epidemiology. 1999 Jul;10(4):364-9
references.pmid: 10401869
references.citation: Curr Opin Urol. 2008 Jul;18(4):395-400
references.pmid: 18520761
references.citation: Ugeskr Laeger. 1987 Mar 2;149(10):677-80
references.pmid: 3576740
references.citation: Environ Health Perspect. 2008 Apr;116(4):566-72
references.pmid: 18414644
references.citation: Arch Environ Contam Toxicol. 1992 Oct;23(3):273-80
references.pmid: 1333747
references.citation: J Clin Invest. 2008 Apr;118(4):1479-90
references.pmid: 18340380
references.citation: Toxicol Ind Health. 1999 Jan-Mar;15(1-2):94-118
references.pmid: 10188194
references.citation: Acta Paediatr. 2007 May;96(5):611-6
references.pmid: 17462053
references.citation: Occup Environ Med. 2007 Oct;64(10):708-14
references.pmid: 17478572
references.citation: Mol Hum Reprod. 2003 Apr;9(4):175-81
references.pmid: 12651898
references.citation: Scand J Work Environ Health. 2000 Aug;26(4):331-7
references.pmid: 10994799
references.citation: J Urol. 2003 Dec;170(6 Pt 1):2396-401
references.pmid: 14634436
references.citation: Hum Reprod Update. 2008 Jan-Feb;14(1):49-58
references.pmid: 18032558
references.citation: Toxicol Appl Pharmacol. 1999 Mar 1;155(2):150-60
references.pmid: 10053169
references.citation: Environ Health Perspect. 2004 Apr;112(5):524-31
references.pmid: 15064155
references.citation: Fertil Steril. 2010 Jan;93(1):124-9
references.pmid: 19022430
references.citation: Int J Androl. 2009 Aug;32(4):423-8
references.pmid: 19515170
references.citation: Acta Paediatr. 2007 May;96(5):622-7
references.pmid: 17462055
references.citation: Environ Health Perspect. 2006 Jul;114(7):1133-8
references.pmid: 16835070
references.citation: Environ Health Perspect. 1998 Dec;106(12):793-6
references.pmid: 9831539
references.citation: Scand J Urol Nephrol Suppl. 1998;196:1-54
references.pmid: 9561565