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a Department of
Epidemiology and Public Health, University of Leicester, 22-8 Princess
Road West, Leicester LE1 6TP, UK, b Population Sciences Division, TVW
Telethon Institute for Child Health Research, 100 Roberts Road,
Subiaco, WA 6008, Australia
Correspondence to: Dr J J Kurinczuk jjk6{at}le.ac.uk
Accepted 14 November
2000
OBJECTIVES
To test the
hypothesis that leatherwork is associated with male infertility
mediated through the development of oligozoospermia. The basis of any
association was postulated, at the outset, to be with exposure to the
solvents used in leatherwork.
METHODS
All new
referrals with infertility presenting in Leicestershire hospital
clinics between November 1988 and September 1992 and Kettering District
General Hospital from August 1990 were eligible to participate; 88.5%
agreed to be interviewed. Exposure to leatherwork and work with
solvents was defined by job title. Comparisons were made with fertile
controls and in an analysis within men from infertile couples with
oligozoospermia as the primary outcome. Effects on sperm motility and
deformity were investigated secondarily. Analyses used logistic
regression for binary outcomes and multilevel modelling for continuous outcomes.
RESULTS
1906 men were
interviewed. Compared with the fertile controls the men from infertile
couples were 1.10 times (95% confidence interval (95% CI) 0.46 to
2.63; p=0.99) more likely to be leatherworkers and 1.73 times (95% CI
1.26 to 2.38; p<0.001) more likely to work with solvents. Compared
with other men, leatherworkers were 1.20 times (95% CI 0.43 to 3.33;
p=0.73) more likely to present with oligozoospermia and 1.65 times
(95% CI 0.37 to 7.30; p=0.51) more likely to present with
teratozoospermia. Being a leatherworker was associated with only a 6%
reduction in sperm concentration; motility and deformity were similarly
unaffected by this exposure. Work with solvents did not statistically,
nor clinically, increase the risk of oligozoospermia, teratozoospermia,
or asthenozoospermia.
CONCLUSIONS
There was
little evidence to support the hypothesis that leatherwork is
associated with an increased risk of presenting with infertility or
oligozoospermia. There was limited evidence that leatherwork is a risk
factor for teratozoospermia. Workers with solvents were at an increased
risk of presenting with infertility, although this was not mediated
through effects on standard measures of semen quality; this finding
merits further investigation.
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