Toppari J, Larsen J C, Christiansen P, Giwercman A, Grandjean P, Guillette L J, Jégou B, Jensen T K, Jouannet P, Keiding N, Leffers H, McLachlan J A, Meyer O, Müller J, Rajpert-De Meyts E, Scheike T, Sharpe R, Sumpter J, Skakkebaek N E
Department of Growth and Reproduction, Juliane Marie Center, National University Hospital, Copenhagen, Denmark.
Environ Health Perspect. 1996 Aug;104 Suppl 4(Suppl 4):741-803. doi: 10.1289/ehp.96104s4741.
Male reproductive health has deteriorated in many countries during the last few decades. In the 1990s, declining semen quality has been reported from Belgium, Denmark, France, and Great Britain. The incidence of testicular cancer has increased during the same time incidences of hypospadias and cryptorchidism also appear to be increasing. Similar reproductive problems occur in many wildlife species. There are marked geographic differences in the prevalence of male reproductive disorders. While the reasons for these differences are currently unknown, both clinical and laboratory research suggest that the adverse changes may be inter-related and have a common origin in fetal life or childhood. Exposure of the male fetus to supranormal levels of estrogens, such as diethlylstilbestrol, can result in the above-mentioned reproductive defects. The growing number of reports demonstrating that common environmental contaminants and natural factors possess estrogenic activity presents the working hypothesis that the adverse trends in male reproductive health may be, at least in part, associated with exposure to estrogenic or other hormonally active (e.g., antiandrogenic) environmental chemicals during fetal and childhood development. An extensive research program is needed to understand the extent of the problem, its underlying etiology, and the development of a strategy for prevention and intervention.
在过去几十年里,许多国家男性生殖健康状况恶化。20世纪90年代,比利时、丹麦、法国和英国均报告精液质量下降。同期,睾丸癌发病率上升,尿道下裂和隐睾症发病率似乎也在增加。许多野生动物物种也出现了类似的生殖问题。男性生殖障碍的患病率存在明显的地理差异。虽然目前尚不清楚这些差异的原因,但临床和实验室研究均表明,这些不良变化可能相互关联,且在胎儿期或儿童期有共同的起源。男性胎儿接触超正常水平的雌激素,如己烯雌酚,可导致上述生殖缺陷。越来越多的报告表明,常见的环境污染物和自然因素具有雌激素活性,这提出了一个工作假设,即男性生殖健康的不良趋势可能至少部分与胎儿期和儿童期发育过程中接触雌激素或其他具有激素活性的(如抗雄激素)环境化学物质有关。需要开展广泛的研究项目,以了解该问题的严重程度、其潜在病因,并制定预防和干预策略。