Velez de la Calle J F, Rachou E, le Martelot M T, Ducot B, Multigner L, Thonneau P F
Clinique Pasteur Saint-Esprit, Brest, France.
Hum Reprod. 2001 Mar;16(3):481-6. doi: 10.1093/humrep/16.3.481.
We investigated infertility risk factors by conducting a population-based case-control study in the military population of the French town of Brest. Sixty couples who had sought medical advice for infertility of more than 12 months duration (cases) were compared with 165 couples who had had a child (controls). All the men in these couples had been employed by the military. The infertility risk factors studied were male and female medical factors, occupational and environmental exposures. We obtained age-adjusted odds ratios of 7.4 [95% confidence interval (CI): 1.4--39.5] for testis surgery, and 13.0 for varicocele (95% CI: 1.4--120.3) in men. In logistic regression, the age-adjusted odds ratio for men who had worked in a nuclear submarine was found to be 2.0 (95% CI: 1.0--3.7), and that for heat exposure was 4.5 (95% CI: 1.9--10.6). One limitation of this study is the lack of exposure measurements, especially for potential exposure to nuclear radiation (type of reactor used in nuclear-powered submarines, inability to obtain personal dosimeters worn by military personnel working in nuclear submarines). In conclusion, this study suggests that in this military population, having worked as a submariner in a nuclear-powered submarine, and having worked in very hot conditions, should be considered as risk factors for infertility.
我们通过在法国布雷斯特镇的军事人群中开展一项基于人群的病例对照研究，调查了不孕风险因素。将60对因不孕问题寻求医疗建议超过12个月的夫妇（病例组）与165对育有子女的夫妇（对照组）进行比较。这些夫妇中的所有男性均为军人。所研究的不孕风险因素包括男性和女性的医学因素、职业和环境暴露。在男性中，睾丸手术的年龄调整优势比为7.4[95%置信区间（CI）：1.4 - 39.5]，精索静脉曲张的年龄调整优势比为13.0（95%CI：1.4 - 120.3）。在逻辑回归分析中，发现曾在核潜艇工作的男性的年龄调整优势比为2.0（95%CI：1.0 - 3.7），受热暴露的年龄调整优势比为4.5（95%CI：1.9 - 10.6）。本研究的一个局限性是缺乏暴露测量，尤其是对于潜在的核辐射暴露（核潜艇使用的反应堆类型，无法获取在核潜艇工作的军事人员佩戴的个人剂量计）。总之，本研究表明，在这一军事人群中，曾在核潜艇担任潜艇船员以及曾在非常炎热的条件下工作，应被视为不孕的风险因素。
