Cherry N, Moore H, McNamee R, Pacey A, Burgess G, Clyma J-A, Dippnall M, Baillie H, Povey A
Community and Occupational Medicine Program, 13-103 Clinical Sciences Building, University of Alberta, Edmonton Alberta, Canada T6G2G3.
Occup Environ Med. 2008 Oct;65(10):708-14. doi: 10.1136/oem.2007.035824. Epub 2008 Apr 16.
To investigate the relation between male infertility and occupational exposures, particularly glycol ethers.
A case-referent study was designed in which men attending 14 fertility clinics in 11 centres across the UK in 1999-2002 were recruited following 12 months of unprotected intercourse and without a previous semen analysis. Cases were those with low motile sperm concentration (MSC) relative to the time since their last ejaculation (MSC <12 x 10(6) for 3 days of abstinence). Referents were other men attending these clinics and meeting the inclusion criteria. A single semen sample was collected at the clinic and analysed at the andrology laboratory serving each hospital. Concentration was determined manually with motility assessed centrally from video recordings. Exposures and confounding factors were assessed from self-completed and nurse-interviewer questionnaires, completed prior to the results of the semen analysis. The occupational histories were assessed for exposures relative to UK norms by a team of occupational hygienists blind to case status.
Of 2118 men in employment at the time of the interview, 874 (41.3%) were cases. Work with organic solvents, particularly glycol ethers, in the 3 months before the first clinic visit was associated with the likelihood of low motile sperm count. Unadjusted odds ratios (OR) for moderate and high glycol ether exposure (compared with none) were 1.70 (95% CI: 1.11 to 2.61) and 2.54 (95% CI: 1.24 to 5.21). Adjustment for potential confounders (surgery to the testes, previous conception, wearing boxer shorts, drinking alcohol, employed in manual work) reduced the risk associated with glycol ether exposure: moderate OR = 1.46 (95% CI: 0.93 to 2.28), high OR = 2.25 (95% CI: 1.08 to 4.69). No other occupational risk factor was identified.
Glycol ether exposure was related to low motile sperm count in men attending fertility clinics. This suggests that, at the time of the study, glycol ethers continued to be a hazard for male fertility.
研究男性不育与职业暴露,尤其是乙二醇醚暴露之间的关系。
设计了一项病例对照研究,招募了1999年至2002年期间在英国11个中心的14家生育诊所就诊的男性,这些男性在12个月无保护性交且之前未进行过精液分析。病例为相对于上次射精时间精子活动浓度(MSC)较低的男性(禁欲3天,MSC<12×10⁶)。对照为在这些诊所就诊且符合纳入标准的其他男性。在诊所采集一份精液样本,并在为每家医院服务的男科实验室进行分析。浓度通过人工测定,活动力由视频记录集中评估。暴露和混杂因素通过自我填写和护士访谈问卷进行评估,在精液分析结果出来之前完成。职业史由一组对病例状态不知情的职业卫生学家根据英国标准评估暴露情况。
在访谈时就业的2118名男性中,874名(41.3%)为病例。首次诊所就诊前3个月接触有机溶剂,尤其是乙二醇醚,与精子活动计数低的可能性相关。中度和高度乙二醇醚暴露(与无暴露相比)的未调整比值比(OR)分别为1.70(95%可信区间:1.11至2.61)和2.54(95%可信区间:1.24至5.21)。对潜在混杂因素(睾丸手术、既往受孕、穿平角短裤、饮酒、从事体力劳动)进行调整后,与乙二醇醚暴露相关的风险降低:中度OR = 1.46(95%可信区间:0.93至2.28),高度OR = 2.25(95%可信区间:1.08至4.69)。未发现其他职业危险因素。
在生育诊所就诊的男性中,乙二醇醚暴露与精子活动计数低有关。这表明,在研究期间,乙二醇醚仍然是男性生育的一个危险因素。