Endocrine disruptors in the workplace, hair spray, folate supplementation, and risk of hypospadias: case-control study.

TitleEndocrine disruptors in the workplace, hair spray, folate supplementation, and risk of hypospadias: case-control study.
Publication TypeJournal Article
Year of Publication2009
AuthorsOrmond G, Nieuwenhuijsen MJ, Nelson P, Toledano MB, Iszatt N, Geneletti S, Elliott P
JournalEnviron Health Perspect
Volume117
Issue2
Pagination303-7
Date Published02/2009
ISSN0091-6765
KeywordsAdolescent, Adult, Birth Weight, Case-Control Studies, Child, Cosmetics, Dietary Supplements, Endocrine Disruptors, England, Female, Folic Acid, Gestational Age, Humans, Hypospadias, Infant, Newborn, Male, Middle Aged, Occupational Exposure, Pregnancy, Socioeconomic Factors, Workplace, Young Adult
Abstract

BACKGROUND: Hypospadias is one of the most common urogenital congenital anomalies affecting baby boys. Prevalence estimates in Europe range from 4 to 24 per 10,000 births, depending on definition, with higher rates reported from the United States. Relatively little is known about potential risk factors, but a role for endocrine-disrupting chemicals (EDCs) has been proposed. OBJECTIVE: Our goal was to elucidate the risk of hypospadias associated with occupational exposure of the mother to endocrine-disruptor chemicals, use of folate supplementation during pregnancy, and vegetarianism. DESIGN: We designed a case-control study of 471 hypospadias cases referred to surgeons and 490 randomly selected birth controls, born 1 January 1997-30 September 1998 in southeast England. Telephone interviews of mothers elicited information on folate supplementation during pregnancy and vegetarianism. We used a job exposure matrix to classify occupational exposure. RESULTS: In multiple logistic regression analysis, there were increased risks for self-reported occupational exposure to hair spray [exposed vs. nonexposed, odds ratio (OR) = 2.39; 95% confidence interval (CI), 1.40-4.17] and phthalate exposure obtained by a job exposure matrix (OR = 3.12; 95% CI, 1.04-11.46). There was a significantly reduced risk of hypospadias associated with of folate use during the first 3 months of pregnancy (OR = 0.64; 95% CI, 0.44-0.93). Vegetarianism was not associated with hypospadias risk. CONCLUSIONS: Excess risks of hypospadias associated with occupational exposures to phthalates and hair spray suggest that antiandrogenic EDCs may play a role in hypospadias. Folate supplementation in early pregnancy may be protective.

DOI10.1289/ehp.11933
Alternate JournalEnviron. Health Perspect.
PubMed ID19270804