Endocrine Disruptors in the Workplace, Hair Spray, Folate Supplementation, and Risk of Hypospadias: Case-control Study
http://www.ehponline.org/docs/2008/11933/abstract.pdf
Gillian Ormond, Mark J. Nieuwenhuijsen, Paul Nelson, Mireille B. Toledano, Nina Iszatt, Sara Geneletti, and Paul Elliott
doi: 10.1289/ehp.11933 (available at http://dx.doi.org/)
Online
20 November 2008ABSTRACT
BACKGROUND:
Hypospadias is one of the commonest urogenital congenital anomalies affecting baby boys. Prevalence estimates in Europe range from 4 to 24 per 10,000 births, depending on definition with higher rates reported from the United States. Relatively little is known about potential risk factors, but a role for endocrine disrupting chemicals has been proposed.OBJECTIVE:
To elucidate risk of hypospadias associated with occupational exposure of the mother to endocrine disruptor chemicals, use of folate supplementation during pregnancy, and vegetarianism.DESIGN:
Case-control study of 471 hypospadias cases referred to surgeons, and 490 randomly selected birth controls, born 1 January 1997 to 30 September 1998, south-east England. Telephone interview of mothers, including information on folate supplementation during pregnancy and vegetarianism, and a job exposure matrix to classify occupational exposure.RESULTS:
In multiple logistic regression analysis, there were increased risks for self-reported occupational exposure to hairspray (exposed vs non exposed OR 2.39 95% CI 1.40, 4.17), and phthalate exposure obtained by a job exposure matrix (OR 3.12 95% CI 1.04, 11.46). There was a significant protective effect of folate use during the first three months of pregnancy (OR 0.64 95% CI 0.44, 0.93). Vegetarianism was not associated with hypospadias risk.CONCLUSIONS:
Excess risks of hypospadias associated with occupational exposures to phthalates and hair spray suggest that anti-androgenic endocrine disrupting chemicals may play a role in hypospadias. Folate supplementation in early pregnancy may beprotective.
