Occupational risks for male fertility: an analysis of patients attending atertiary referral centre

The impact of environment and occupation on male fertility is still under d ebate. We investigated whether certain occupations may be over- or under-re presented among men attending our infertility clinic in relation to the ent ire population of the area. Diagnoses and semen parameters of 2054 infertil e men from the district of Munster were analysed retrospectively. The patie nts were categorized into 29 occupational groups. The relative size of each group was compared with that of the entire population in the district of M unster. Farmers were over-represented compared with the general population. Farmers and painters/varnishers showed a significantly higher proportion o f reduced sperm counts [odds ratios (OR): 2.13 and 2.17, 95% confidence int ervals: 1.18-3.88 and 1.02-4.65] and severely reduced sperm concentrations compared with the entire group of infertile men; in addition, significantly more farmers presented with a history of maldescended testes than other oc cupational groups (OR: 2.76 and 2.84; Cl: 1.12-6.75 and 1.27-6.34). Metal w orkers/welders formed significantly higher proportions of patients with red uced sperm motility (OR: 5.99; Cl: 1.38-26.00). The relatively poor semen p arameters of the painters/vamishers could be caused by exposure to toxins. This may also apply to the farmers (fertilizers, herbicides); however, the elevated rate of maldescended testes suggests an effect of exposure during prenatal development or a genetic cause. The findings for metal workers/wel ders may be because of heat or toxins at the workplace. The study demonstra tes that certain occupations are preferentially associated with male infert ility.