丹麦园艺工作女性的儿子中隐睾症的风险：一项队列研究。
The risk of cryptorchidism among sons of women working in horticulture in Denmark: a cohort study.
机构信息
Danish Ramazzini Center, Department of Occupational medicine, Aarhus University Hospital, Aarhus, Denmark.
出版信息
Environ Health. 2011 Nov 14;10:100. doi: 10.1186/1476-069X-10-100.
BACKGROUND
Androgens are crucial for normal testicular descent. Studies show that some pesticides have estrogenic or antiandrogenic effects, and that female workers exposed to pesticides have increased risk of having a boy with cryptorchidism. The main objective of the present study was to investigate whether pregnant women exposed to pesticides due to their work in horticulture experience excess risk of having sons with cryptorchidism.
METHODS
We conducted a cohort study of pregnant women working in horticulture using four cohorts including one cohort established with data from the departments of occupational medicine in Jutland and Funen and three existing mother-child cohorts (n=1,468). A reference group was established from the entire Danish population of boys born in the period of 1986-2007 (n=783,817). Nationwide Danish health registers provided information on birth outcome, cryptorchidism diagnosis and orchiopexy. The level of occupational exposure to pesticides was assessed by expert judgment blinded towards outcome status. Risk of cryptorchidism among exposed horticulture workers compared to the background population and to unexposed horticulture workers was assessed by Cox regression models.
RESULTS
Pesticide exposed women employed in horticulture had a hazard ratio (HR) of having cryptorchid sons of 1.39 (95% CI 0.84; 2.31) and a HR of orchiopexy of 1.34 (0.72; 2.49) compared to the background population. Analysis divided into separate cohorts revealed a significantly increased risk of cryptorchidism in cohort 2: HR 2.58 (1.07;6.20) and increased risk of orchiopexy in cohort 4: HR 2.76 (1.03;7.35), but no significant associations in the other cohorts. Compared to unexposed women working in horticulture, pesticide exposed women had a risk of having sons with cryptorchidism of 1.34 (0.30; 5.96) and of orchiopexy of 1.93 (0.24;15.4).
CONCLUSIONS
The data are compatible with a slightly increased risk of cryptorchidism in sons of women exposed to pesticides by working in horticulture.
背景
雄激素对于正常的睾丸下降至关重要。研究表明，一些农药具有雌激素或抗雄激素作用，而接触农药的女性工人患有隐睾症的男孩风险增加。本研究的主要目的是调查由于园艺工作而接触农药的孕妇是否会增加其儿子患有隐睾症的风险。
方法
我们对从事园艺工作的孕妇进行了队列研究，使用了四个队列，包括一个由日德兰和菲英岛职业医学部门的数据建立的队列，以及三个现有的母婴队列（n=1468）。一个参考组是从 1986 年至 2007 年期间出生的丹麦男孩的整个人群中建立的（n=783817）。全国丹麦健康登记处提供了关于出生结局、隐睾症诊断和睾丸固定术的信息。职业暴露于农药的程度由专家判断评估，判断时对结局状态进行了盲法处理。通过 Cox 回归模型评估暴露于农药的园艺工人与背景人群和未暴露于农药的园艺工人相比发生隐睾症的风险。
结果
从事园艺工作的接触农药的女性工人的儿子患有隐睾症的风险比（HR）为 1.39（95%CI 0.84；2.31），进行睾丸固定术的风险比（HR）为 1.34（0.72；2.49），与背景人群相比。按单独的队列进行分析显示，队列 2 中隐睾症的风险显著增加：HR 2.58（1.07；6.20），队列 4 中睾丸固定术的风险增加：HR 2.76（1.03；7.35），但其他队列中没有显著的相关性。与从事园艺工作但未接触农药的女性相比，接触农药的女性的儿子患有隐睾症的风险为 1.34（0.30；5.96），进行睾丸固定术的风险为 1.93（0.24；15.4）。
结论
数据表明，接触农药的从事园艺工作的女性其儿子患有隐睾症的风险略有增加。
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