- Full (HTML) - Related EHP Articles - Purchase This Issue

José García-Rodríguez,¹ Miguel García-Martín,¹ Mercedes Nogueras-Ocaña,² Juan de Dios Luna-del-Castillo,³ Miguel Espigares García,¹ Nicolás Olea,⁴ Pablo Lardelli-Claret¹

¹Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Granada; ²Servicio de Urología, Hospital Universitario de Granada; ³Departamento de Estadística, Facultad de Medicina, Universidad de Granada; ⁴Laboratorio de Investigaciones Médicas, Hospital Universitario de Granada, Granada, Spain

Abstract

Synthetic hormone-disrupting chemicals may play a role in the increased frequency of cryptorchidism observed in some studies. We used a spatial ecological design to search for variations in orchidopexy rates in the province of Granada in Spain and to search for relationships between these differences and geographical variations in exposure to pesticides. Orchidopexy rates were estimated for the period from 1980 to 1991 in all municipalities and health care districts served by the University of Granada Hospital. A random sample of males of the same age (1-16 years) admitted for any reason during the same period was used to estimate inpatient control rates. Each municipality was assigned to one of four levels of pesticide use. We used Poisson homogeneity tests to detect significant differences in rates of orchidopexy between districts and between levels of pesticide use. Poisson and logistic regression models were also used to estimate the strength of association between orchidopexy and level of pesticide use. Orchidopexy rates tended to be higher in districts near the Mediterranean coast where intensive farming is widespread. The city of Granada, where the reference hospital is located, also had higher figures both for orchidopexy and inpatient control rates. Regression models showed that the strength of association between orchidopexy and level of pesticide use tended to increase with higher levels of use, with the exception of level 0 (mainly in the city of Granada) . Our results are compatible with a hypothetical association between exposure to hormone-disruptive chemicals and the induction of cryptorchidism. Several methodological limitations in the design make it necessary to evaluate the results with caution. Key words: cryptorchidism, ecological design, pesticides, hormone-disruptive substances, risk factor. Environ Health Perspect 104:1090-1095 (1996)

Address correspondence to P. Lardelli-Claret, Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Granada, 18071 Granada, Spain.

We thank technicians of the Sección de Protección Agraria, Delegación Provincial de la Consejería de Agricultura of the Andalusian Regional Government for providing the classification of pesticide use ; the Documentation Service of the University of Granada Hospital for providing records on cases of orchidopexy and admissions ; and Karen Shashok for translating the original manuscript into English. This work was partially supported by the Health Council, Andalusian Regional Government through grant no. 94/556-140.

Received 9 February 1996 ; accepted 25 June 1996.