The risk of male subfecundity attributable to welding of metals. Studies of semen quality, infertility, fertility, adverse pregnancy outcome and childhood malignancy.
The risk of male subfecundity attributable to welding of metals. Studies of semen quality, infertility, fertility, adverse pregnancy outcome and childhood malignancy.
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金属焊接导致男性生育力低下的风险。
DOI：
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发表时间：
1993
影响因子：
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通讯作者：
J. Bonde
中科院分区：
文献类型：
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作者：
J. Bonde
这些研究是由两个丹麦不孕症客户的调查结果开始的，这表明男性金属焊工的生育能力降低。其目的是反驳或证实焊接对男性生殖能力的影响，如果有影响，则确定因果接触。最初的假设假定减少精子发生，自然流产，先天性畸形和儿童恶性肿瘤暴露于六价铬不锈钢焊工。随后，提出了一个关于暴露于辐射热对降低精液质量的重要性的假设。这些研究包括不孕症的病例参考研究，精液质量的横断面和纵向研究以及生育力，妊娠结局和后代癌症的历史队列研究。在病例对照研究中，不孕期间暴露于焊接的频率高于受孕前（OR 2.0，95% CI 1.0-4.0）。这一发现与主要横断面研究一致，显示焊工精液质量降低[平均降低范围为8%（卵清中的精子穿透率）至28%（精子总数）]，并且与队列研究一致，显示与焊接相关的生育力降低（OR 0.89，95%CI 0.83-0.97）。然而，降低精液质量和生育能力是不是由于焊接不锈钢，但焊接低碳钢，并没有发现接触铬和精液质量参数的生物措施之间的关系。如果低碳钢焊接和繁殖力下降之间的意外联系是因果关系，所涉及的生物机制是模糊的。一项单独的纵向研究表明，适度的辐射热暴露可能导致精液质量可逆性恶化，但将这一观察结果推广到整个焊工群体是不合理的。研究未表明雄性介导的对不锈钢焊接后代先天畸形和癌症发生的影响。不锈钢焊工的伴侣中自然流产风险增加的弱迹象（OR 1.9，95% CI 1.1-3.2）需要在未来的研究中反驳或证实。低碳钢焊接对男性生殖力的影响应通过暴露前和暴露期间检查的精液质量的纵向对照研究以及试图怀孕的夫妇的生殖力的前瞻性研究来证实。根据目前的知识，不可能推荐合理的预防措施，除非在不孕症的情况下消除辐射热暴露。（400字处截断摘要）
These studies were initiated by the results of two Danish investigations of infertility clients, which indicated the reduced fecundity of male metal welders. The objective was to refute or corroborate the effects of welding on male reproductive capability and--if there was any effect--to identify the causal exposures. The initial hypothesis postulated reduced spermatogenesis, spontaneous abortion, congenital malformation and childhood malignancy following exposure to hexavalent chromium among stainless steel welders. Subsequently, a hypothesis concerned with the significance of exposure to radiant heat on reduced semen quality was put forward. These studies comprised a case-referent study of infertility, cross-sectional and longitudinal studies of semen quality and historical cohort studies of fertility, pregnancy outcome and cancer in offspring. Exposure to welding was reported with a higher frequency during periods of infertility than prior to conception in the case-referent study (OR 2.0, 95% CI 1.0-4.0). This finding is consistent with the main cross-sectional study showing reduced semen quality in welders [average reduction ranging from 8% (sperm penetration rate in eggwhite) to 28% (total sperm count)] and with the cohort study revealing reduced fertility in relation to welding (OR 0.89, 95% CI 0.83-0.97). However, reduced semen quality and fertility were not attributable to the welding of stainless steel but to the welding of mild steel; and no relationship was found between biological measures of exposure to chromium and parameters of semen quality. If the unexpected association between mild steel welding and reduced fecundity is causal, the biological mechanisms involved are obscure. A separate longitudinal study leaves little doubt that moderate radiant heat exposure may cause reversible deterioration of semen quality, but it is not justified to generalize this observation to the entire population of welders. Male-mediated effects on occurrence of congenital malformation and cancer in offspring from stainless steel welding are not indicated by the studies. Weak indications of an increased risk of spontaneous abortion among partners to stainless steel welders (OR 1.9, 95% CI 1.1-3.2) need to be refuted or corroborated in future studies. Suggested effects of mild steel welding on male fecundity should be corroborated by longitudinal controlled studies of semen quality examined before and during exposure and by prospective studies of fecundability in couples trying to conceive a child. On account of the present knowledge it is not possible to recommend rational preventative measures with the exception of elimination of radiant heat exposure in cases of infertility.(ABSTRACT TRUNCATED AT 400 WORDS)