Abstract
The goal was to evaluate the associations between testicular hormones at adolescence and the exposure to chlorination by-products when attending chlorinated swimming pools. We obtained serum samples from 361 school male adolescents (aged 14–18 years) who had visited swimming pools disinfected with chlorine or by copper–silver ionization. We analysed serum concentrations of inhibin B (two different assays), total and free testosterone, sex hormone-binding globulin, luteinizing hormone (LH), follicle stimulating hormone (FSH) and dehydroepiandrosterone sulphate (DHEAS). There were strong inverse associations between serum levels of inhibin B (both assays) or of total testosterone, adjusted or unadjusted for gonadotropins and the time adolescents had spent in indoor chlorinated pools, especially during their childhood. Adolescents having attended indoor chlorinated pools for more than 250 h before the age of 10 years or for more than 125 h before the age of 7 years were about three times more likely to have an abnormally low serum inhibin B and/or total testosterone (<10th percentile) than their peers who never visited this type of pool during their childhood (odds ratio, 95% CI, 2.83, 1.06–7.52, p = 0.04 and 3.67, 1.45–9.34, p = 0.006, respectively). Such associations were not seen with free testosterone, LH, FSH and DHEAS or with the attendance of outdoor chlorinated pools or of the copper–silver pool. Swimming in indoor chlorinated pools during childhood is strongly associated with lower levels of serum inhibin B and total testosterone. The absorption of reprotoxic chlorination by-products across the highly permeable scrotum might explain these associations.
Highlights
Disinfection of drinking or recreational water with chlorine results in the formation of a wide range of potentially toxic by-products among which the most abundant are the chloramines and various short-chain halogenated hydrocarbons such as trihalomethanes (THMs), haloacetic acids (HAAs) and haloacetonitriles (HANs) (Bull, 2000; World Health Organization, 2000; Weaver et al, 2009). These chlorination by-products (CBPs) arise when active chlorine destroys organic matter brought to water by natural or anthropogenic sources
The study used a wide range of sensitive biomarkers or tests to detect effects of environmental stressors on the respiratory tract, the immune system, the kidney and the testes
Serum hormones are not prone to unavoidable selection bias because of the low participation in populationbased studies on semen quality. By applying such markers in a cross-sectional study on male adolescents, we unexpectedly found strong inverse associations between the serum levels of inhibin B and total testosterone and the cumulative attendance of indoor chlorinated swimming pools
Summary
Disinfection of drinking or recreational water with chlorine results in the formation of a wide range of potentially toxic by-products among which the most abundant are the chloramines and various short-chain halogenated hydrocarbons such as trihalomethanes (THMs), haloacetic acids (HAAs) and haloacetonitriles (HANs) (Bull, 2000; World Health Organization, 2000; Weaver et al, 2009). These chlorination by-products (CBPs) arise when active chlorine (hypochlorite ⁄ hypochlorous acid) destroys organic matter brought to water by natural or anthropogenic sources. There is a widespread human exposure to these potential reprotoxicants, to date, only two epidemiological studies have assessed their possible impact on the e446
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