Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen NV, Denmark.
Asian J Androl. 2010 Mar;12(2):152-6. doi: 10.1038/aja.2009.83. Epub 2009 Dec 7.
Male reproductive disorders that are of interest from an environmental point of view include sexual dysfunction, infertility, cryptorchidism, hypospadias and testicular cancer. Several reports suggest declining sperm counts and increase of these reproductive disorders in some areas during some time periods past 50 years. Except for testicular cancer this evidence is circumstantial and needs cautious interpretation. However, the male germ line is one of the most sensitive tissues to the damaging effects of ionizing radiation, radiant heat and a number of known toxicants. So far occupational hazards are the best documented risk factors for impaired male reproductive function and include physical exposures (radiant heat, ionizing radiation, high frequency electromagnetic radiation), chemical exposures (some solvents as carbon disulfide and ethylene glycol ethers, some pesticides as dibromochloropropane, ethylendibromide and DDT/DDE, some heavy metals as inorganic lead and mercury) and work processes such as metal welding. Improved working conditions in affluent countries have dramatically decreased known hazardous workplace exposures, but millions of workers in less affluent countries are at risk from reproductive toxicants. New data show that environmental low-level exposure to biopersistent pollutants in the diet may pose a risk to people in all parts of the world. For other toxicants the evidence is only suggestive and further evaluation is needed before conclusions can be drawn. Whether compounds as phthalates, bisphenol A and boron that are present in a large number of industrial and consumer products entails a risk remains to be established. The same applies to psychosocial stressors and use of mobile phones. Finally, there are data indicating a particular vulnerability of the fetal testis to toxicants-for instance maternal tobacco smoking. Time has come where male reproductive toxicity should be addressed form entirely new angles including exposures very early in life.
从环境角度来看，男性生殖障碍包括性功能障碍、不育、隐睾、尿道下裂和睾丸癌。有几项报告表明，在过去 50 年的某些时期，某些地区的精子数量下降和这些生殖障碍的发生率增加。除了睾丸癌，这些证据都是间接的，需要谨慎解释。然而，男性生殖细胞是对电离辐射、辐射热和许多已知有毒物质的破坏性影响最敏感的组织之一。到目前为止，职业危害是男性生殖功能受损的记录最好的危险因素，包括物理暴露（辐射热、电离辐射、高频电磁辐射）、化学暴露（一些溶剂，如二硫化碳和乙二醇醚，一些杀虫剂，如二溴氯丙烷、乙二溴和滴滴涕/滴滴伊，一些重金属，如无机铅和汞）和工作过程，如金属焊接。富裕国家工作条件的改善大大降低了已知的危险工作场所暴露，但欠发达国家的数百万工人面临生殖毒性剂的风险。新数据显示，环境中饮食中低水平的持久性污染物暴露可能对世界所有地区的人构成风险。对于其他有毒物质，证据只是提示性的，需要进一步评估才能得出结论。目前尚不清楚是否存在大量工业和消费品中存在的邻苯二甲酸酯、双酚 A 和硼等化合物是否存在风险。同样适用于心理社会压力源和使用移动电话。最后，有数据表明，母体吸烟等有毒物质对胎儿睾丸特别脆弱。现在是时候从全新的角度来解决男性生殖毒性问题，包括生命早期的暴露问题了。
