Background: It has been proposed that the intrauterine period of child-mother exposure to hormonally active compounds (endocrine disruptors) is of critical importance.
Objective: We reviewed all Spanish and English-language epidemiological studies published between 1990 and the first trimester of 2006 that studied the possible association between human exposure to chemical compounds and the risk of cryptorchidism and/or hypospadias.
Methods: The MEDLINE (PubMed) database was searched using the following key words: endocrine disruptors, organochlorine pesticides, xenoestrogens, cryptorchidism and hypospadias. Selection of the 16 studies included was based on the following criteria: study design and population, the measures of exposure used, inclusion and exclusion criteria, and the statistical analysis used.
Results and conclusions: Although the studies reviewed do not conclusively confirm the association between exposure to endocrine disruptors and the risk of male genital malformation, this association cannot be ruled out. Further in-depth investigation of this association is required. Issues that remain to be resolved are the diagnostic classification to be used and appropriate measurement of exposure to multiple chemical compounds and environmental contaminants that act conjointly through mechanisms similar to endogenous hormones.