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Helle R. Andersen,¹ Ida M. Schmidt,² Philippe Grandjean,¹ Tina K. Jensen,¹ Esben Budtz-Jørgensen,³ Mia B. Kjærstad,¹ Jesper Bælum,⁴ Jesper B. Nielsen,¹ Niels E. Skakkebæk,² and Katharina M. Main²

¹Institute of Public Health, Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark; ²University Department of Growth and Reproduction, Rigshospitalet, Copenhagen, Denmark; ³Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark; ⁴Department of Occupational and Environmental Medicine, Odense University Hospital, Odense, Denmark

Abstract
Objectives: The aim of this prospective study was to investigate whether occupational pesticide exposure during pregnancy causes adverse effects on the reproductive development in the male infants.

Design and measurements: Pregnant women employed in greenhouses in Denmark were consecutively recruited, and 113 mother–son pairs were included. The mothers were categorized as occupationally exposed (91 sons) or unexposed (22 sons) to pesticides during pregnancy. Testicular position and volume, penile length, and position of urethral opening were determined at 3 months of age using standardized techniques. Concentrations of reproductive hormones in serum from the boys were analyzed.

Results: The prevalence of cryptorchidism at 3 months of age was 6.2% [95% confidence interval (CI) , 3.0–12.4]. This prevalence was considerably higher than among Danish boys born in the Copenhagen area (1.9% ; 95% CI, 1.2–3.0) examined by the same procedure. Boys of pesticide-exposed mothers showed decreased penile length, testicular volume, serum concentrations of testosterone, and inhibin B. Serum concentrations of sex hormone-binding globulin, follicle-stimulating hormone, and the luteinizing hormone:testosterone ratio were increased compared with boys of nonexposed mothers. For individual parameters, only the decreased penile length was statistically significant (p = 0.04) . However, all observed effects were in the anticipated direction, and a joint multivariate test showed that this finding had a p-value of 0.012.

Conclusions: Our findings suggest an adverse effect of maternal occupational pesticide exposure on reproductive development in the sons despite current greenhouse safeguards and special measures to protect pregnant women.

Key words: cryptorchidism, greenhouse workers, hormones, occupational exposure, pesticides, prenatal, reproductive development. Environ Health Perspect 116:566–572 (2008) . doi:10.1289/ehp.10790 available via http://dx.doi.org/ [Online 22 January 2008]

Address correspondence to H.R. Andersen, Institute of Public Health, Department of Environmental Medicine, University of Southern Denmark, Winsløwparken 17, Dk-5000 Odense C, Denmark. Telephone: 45 6550 3765. Fax: 45 6591 1458. E-mail: hrandersen@health.sdu.dk

We are grateful to the families who participated, and we appreciate the skilled help of secretary M. Bøllund.

This work was supported by the Danish Environmental Research Program (grant 96.01.015.16.05) , the European Union (QLK-2001-00269) , and The Danish Medical Research Council (9700909) . The sponsors had no part in study design, data collection, analysis, or preparation of the manuscript.

The authors declare they have no competing financial interests.

Received 22 August 2007 ; accepted 22 January 2008.