ABSTRACT
BACKGROUND: It has been proposed that the intrauterine period of child-mother exposure to hormonally active compounds (endocrine disruptors) is of critical importance. OBJECTIVE: We reviewed all Spanish and English-language epidemiological studies published between 1990 and the first trimester of 2006 that studied the possible association between human exposure to chemical compounds and the risk of cryptorchidism and/or hypospadias. METHODS: The MEDLINE (PubMed) database was searched using the following key words: endocrine disruptors, organochlorine pesticides, xenoestrogens, cryptorchidism and hypospadias. Selection of the 16 studies included was based on the following criteria: study design and population, the measures of exposure used, inclusion and exclusion criteria, and the statistical analysis used. RESULTS AND CONCLUSIONS: Although the studies reviewed do not conclusively confirm the association between exposure to endocrine disruptors and the risk of male genital malformation, this association cannot be ruled out. Further in-depth investigation of this association is required. Issues that remain to be resolved are the diagnostic classification to be used and appropriate measurement of exposure to multiple chemical compounds and environmental contaminants that act conjointly through mechanisms similar to endogenous hormones.
Subject(s)
Abnormalities, Drug-Induced/etiology , Cryptorchidism/chemically induced , Endocrine Disruptors/adverse effects , Hypospadias/chemically induced , Urogenital Abnormalities/chemically induced , Abnormalities, Drug-Induced/epidemiology , Adult , Cryptorchidism/embryology , Endocrine Disruptors/classification , Endocrine Disruptors/toxicity , Environmental Exposure , Environmental Pollutants/toxicity , Epidemiologic Research Design , Female , Humans , Hypospadias/embryology , Infant, Newborn , Male , Pregnancy , Risk Factors , Urogenital Abnormalities/embryology , Urogenital Abnormalities/epidemiologyABSTRACT
Antecedentes: Se ha sugerido que la exposición maternoinfantil a compuestos hormonalmente activos (disruptores endocrinos) tiene en la etapa intrauterina una de sus fases más comprometidas. Objetivo: Revisar los estudios epidemiológicos, nacionales e internacionales, publicados entre 1990 y el primer trimestre de 2006, que tuvieran como hipótesis la asociación entre la exposición humana a disruptores endocrinos y el riesgo de criptorquidia e hipospadias. Métodos: Se han buscado artículos en MEDLINE/PubMed mediante las palabras clave: disruptores endocrinos, xenoestrógenos, pesticidas organoclorados y criptorquidia e hipospadias. La selección de los 16 trabajos incluidos se hizo atendiendo al diseño y la población de estudio, las medidas de exposición empleadas, los criterios de exclusión e inclusión establecidos y el análisis estadístico utilizado. Resultados y conclusiones: Aunque los estudios aquí revisados no son concluyentes para confirmar la asociación entre disruptores endocrinos y riesgo de malformación del tracto genitourinario, tampoco demuestran la falta de tal asociación. Por este motivo parece razonable sugerir que este aspecto de la patología hormonal debería investigarse más en profundidad, resolviendo, al menos, el diagnóstico adecuado de los individuos y la estimación de la exposición a múltiples compuestos químicos, contaminantes ambientales, que actúan conjuntamente a través de mecanismos similares a las hormonas endógenas
Background: It has been proposed that the intrauterine period of child-mother exposure to hormonally active compounds (endocrine disruptors) is of critical importance. Objective: We reviewed all Spanish and English-language epidemiological studies published between 1990 and the first trimester of 2006 that studied the possible association between human exposure to chemical compounds and the risk of cryptorchidism and/or hypospadias. Methods: The MEDLINE (PubMed) database was searched using the following key words: endocrine disruptors, organochlorine pesticides, xenoestrogens, cryptorchidism and hypospadias. Selection of the 16 studies included was based on the following criteria: study design and population, the measures of exposure used, inclusion and exclusion criteria, and the statistical analysis used. Results and conclusions: Although the studies reviewed do not conclusively confirm the association between exposure to endocrine disruptors and the risk of male genital malformation, this association cannot be ruled out. Further in-depth investigation of this association is required. Issues that remain to be resolved are the diagnostic classification to be used and appropriate measurement of exposure to multiple chemical compounds and environmental contaminants that act conjointly through mechanisms similar to endogenous hormones
Subject(s)
Humans , Pesticide Exposure , Cryptorchidism/chemically induced , Urogenital Abnormalities/chemically induced , Hypospadias/chemically induced , Endocrine SystemABSTRACT
BACKGROUND: Exposure to xenoestrogens during pregnancy may disturb the development and function of male sexual organs. OBJECTIVE: In this study we aimed to determine whether the combined effect of environmental estrogens measured as total effective xenoestrogen burden (TEXB) is a risk factor for male urogenital malformations. METHODS: In a case-control study, nested in a mother-child cohort (n = 702) established at Granada University Hospital, we compared 50 newborns with diagnosis of cryptorchidism and/or hypospadias with 114 boys without malformations matched by gestational age, date of birth, and parity. Controls did not differ from the total cohort in confounding variables. TEXB and levels of 16 organochlorine pesticides were measured in placenta tissues. Characteristics of parents, pregnancy, and birth were gathered by questionnaire. We used conditional and unconditional regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: TEXB from organohalogenated compounds was detectable in 72% and 54% of case and control placentas, respectively. Compared with controls, cases had an OR for detectable versus non-detectable TEXB of 2.82 (95% CI, 1.10-7.24). More pesticides were detected in cases than in controls (9.34 +/- 3.19 vs. 6.97 +/- 3.93). ORs for cases with detectable levels of pesticides, after adjusting for potential confounders in the conditional regression analysis, were o,p'-DDT (OR = 2.25; 95% CI, 1.03-4.89), p,p'-DDT (OR = 2.63; 95% CI, 1.21-5.72), lindane (OR = 3.38; 95% CI, 1.36-8.38), mirex (OR = 2.85; 95% CI, 1.22-6.66), and endosulfan alpha (OR = 2.19; 95% CI, 0.99-4.82). Engagement of mothers in agriculture (OR = 3.47; 95% CI, 1.33-9.03), fathers' occupational exposure to xenoestrogens (OR = 2.98; 95% CI, 1.11-8.01), and history of previous stillbirths (OR = 4.20; 95% CI, 1.11-16.66) were also associated with risk of malformations. CONCLUSIONS: We found an increased risk for male urogenital malformations related to the combined effect of environmental estrogens in placenta.
Subject(s)
Cryptorchidism/etiology , Endocrine Disruptors/toxicity , Estrogens/toxicity , Hypospadias/etiology , Occupational Exposure/adverse effects , Pesticide Residues/toxicity , Adult , Agriculture , Case-Control Studies , Cryptorchidism/epidemiology , Female , Hospitals, University , Humans , Hydrocarbons, Chlorinated/toxicity , Hypospadias/epidemiology , Infant, Newborn , Male , Maternal Exposure/adverse effects , Paternal Exposure/adverse effects , Placenta/chemistry , Pregnancy , Risk Factors , Spain/epidemiology , Surveys and QuestionnairesABSTRACT
Although industrialized nations have restricted or banned many organochlorine pesticides, some of these chemicals (e.g., endosulfans) are still used, on the assumption that they pose little threat to the environment, wildlife, or human health. According to available information, Spain is the main consumer of endosulfans within the European Union, accounting for almost half of the total consumption. Reports on human exposure in Southern Spain to persistent bioacumulable organochlorine pesticides have indicated considerable exposure to endosulfans. The present study investigated the presence of endosulfan I, endosulfan II, and endosulfan metabolites in fatty and non-fatty tissues and fluids from women of reproductive age and children in Southern Spain. The highest concentration of commercial endosulfan I and endosulfan II was found in adipose tissue, with a mean value (I+II) of 17.72 ng/g lipid, followed by human milk, with a mean value (I+II) of 11.38 ng/mL milk. These findings support the lipophilicity of these chemicals and their elimination by milk secretion. The concentration in the placenta homogenate was similar to that in the blood from the umbilical cord (7.74 and 6.11 ng/mL, respectively) and reflected their lower fat content. Endosulfan diol and endosulfan sulfate were more frequently found in placenta homogenate, with a mean concentration of 12.56 and 3.57 ng/mL, respectively, and in blood from umbilical cord, at 13.23 and 2.82 ng/mL, respectively. Therefore, women of reproductive age in Southern Spain appear to be currently exposed to endosulfans. Because these chemicals can be mobilized during pregnancy and lactation, further research is warranted to investigate the health consequence in children resulting from exposure to chemicals suspected of immunotoxic, neurotoxic, or endocrine-disrupting effects.
