Declining trends of male proportion at birth in Europe

Multi-factorial influences on sex ratio: a spatio-temporal investigation of endocrine disruptor pollution and neighborhood stress

Background:

It is suggested the declining male birth proportion in some industrialized countries is linked to ubiquitous endocrine disruptor exposure. Stress and advanced parental age are determinants which frequently present positive findings. Multi-factorial influences on population sex ratio are rarely explored or tested in research.

Objectives:

To test the hypothesis that dual factors of pollution and population stress affects sex proportion at birth through geographical analysis of Central Scotland.

Methods:

The study incorporates the use of Geographical Information Systems (GIS) tools to overlay modeled point source endocrine disruptor air emissions with “small-area” data on multiple deprivation (a proxy measurement of stress) and birth sex. Historical review of regional sex ratio trends presents additional data on sex ratio in Scotland to consider.

Results:

There was no overall concentration in Central Scotland of low sex ratio neighborhoods with areas where endocrine disruptor air pollution and deprivation or economic stress were high. Historical regional trends in Scotland (from 1973), however, do show significantly lower sex ratio values for populations where industrial air pollution is highest (i.e. Eastern Central Scotland).

Conclusions:

Use of small area data sets and pollution inventories is a potential new method of inquiry for reproductive environmental and health protection monitoring and has produced interesting findings.

Polychlorinated biphenyls (PCBs) in relation to secondary sex ratio--a systematic review of published studies

There is reasonably strong evidence linking reduced secondary sex ratio (proportion of males) and environmental exposures. Polychlorinated biphenyls (PCBs) are persistent contaminants of the environment and several studies have reported an association of PCBs with birth outcomes. A decrease in the male/female sex ratio at birth has been reported in some, but not all studies. The aim of this systematic review was to summarize and pool the research findings about the influence of PCBs on sex ratio. Several article databases and reference lists of identified articles were searched. Studies reporting the proportion of boys and girls born to individuals who were exposed to high PCB concentrations were included. The primary outcome measure was the proportion of males in groups exposed to high or low levels of PCBs. Studies with both direct and indirect surrogate PCB measurements were included. The search and selection resulted in 15 eligible studies on the association between the sex ratio and parental PCB exposures. Analyses of the high exposure groups showed that the sex ratio was not significantly altered from the historical reference range in 13 of the 15 articles. The majority of the exposure studies reported also internal comparisons between high and low PCB exposure levels. The pooled 95% confidence interval estimate for the difference in high and low maternal exposure with direct PCB measure was - 0.048 with 95% CI of (-0.121, 0.026). There was no strong or moderate indication that parental exposure to PCBs alters the sex ratio of the children.

Response to W. Kramer: The human sex odds at birth after the atmospheric atomic bomb tests, after Chernobyl, and in the vicinity of nuclear facilities: comment (doi:10.1007/s11356-011-0644-8)

INTRODUCTION

This paper is in response to criticism of our article "The human sex odds at birth after the atmospheric atomic bomb tests, after Chernobyl, and in the vicinity of nuclear facilities" published in Environ Sci Pollut Res 18(5):697-707, 2011.

METHODS

Our findings and methods concerning the disturbed human sex odds at birth have been criticized in this journal for being artifacts of data mining, that the concept of statistical significance was misunderstood, and that confounding factors have not been accounted for. Here, we show that this criticism has no basis. We applied well-established statistical methods to large official data sets, and confounding is less important at the level of secular sex odds trends in aggregated annual figures from countries or continents.

RESULTS AND CONCLUSIONS

Moreover, our results are strengthened by recent findings concerning increased infant death sex odds in Germany and increased Down syndrome prevalence at birth across Europe after Chernobyl. Prompted by our studies, an official investigation in Lower Saxony, Germany, by the "Niedersächsisches Landesgesundheitsamt (NLGA)" confirmed our observation of severely escalated sex odds within 40 km distance from the nuclear storage site in Gorleben, Germany.

The human sex odds at birth after the atmospheric atomic bomb tests, after Chernobyl, and in the vicinity of nuclear facilities

BACKGROUND, AIM, AND SCOPE

Ever since the discovery of the mutagenic properties of ionizing radiation, the possibility of birth sex odds shifts in exposed human populations was considered in the scientific community. Positive evidence, however weak, was obtained after the atomic bombing of Japan. We previously investigated trends in the sex odds before and after the Chernobyl Nuclear Power Plant accident. In a pilot study, combined data from the Czech Republic, Denmark, Finland, Germany, Hungary, Norway, Poland, and Sweden between 1982 and 1992 showed a downward trend in the sex odds and a significant jump in 1987, the year immediately after Chernobyl. Moreover, a significant positive association of the sex odds between 1986 and 1991 with Chernobyl fallout at the district level in Germany was observed. Both of these findings, temporality (effect after exposure) and dose response association, yield evidence of causality. The primary aim of this study was to investigate longer time periods (1950-2007) in all of Europe and in the USA with emphasis on the global atmospheric atomic bomb test fallout and on the Chernobyl accident. To obtain further evidence, we also analyze sex odds data near nuclear facilities in Germany and Switzerland. DATA AND STATISTICAL METHODS: National gender-specific annual live births data for 39 European countries from 1975 to 2007 were compiled using the pertinent internet data bases provided by the World Health Organization, United Nations, Council of Europe, and EUROSTAT. For a synoptic re-analysis of the period 1950 to 1990, published data from the USA and from a predominantly western and less Chernobyl-exposed part of Europe were studied additionally. To assess spatial, temporal, as well as spatial-temporal trends in the sex odds and to investigate possible changes in those trends after the atomic bomb tests, after Chernobyl, and in the vicinity of nuclear facilities, we applied ordinary linear logistic regression. Region-specific and eventually changing spatial-temporal trends were analyzed using dummy variables coding for continents, countries, districts, municipalities, time periods, and appropriate spatial-temporal interactions.

RESULTS

The predominantly western European sex odds trend together with the US sex odds trend (1950-1990 each) show a similar behavior. Both trends are consistent with a uniform reduction from 1950 to 1964, an increase from 1964 to 1975 that may be associated with delayed global atomic bomb test fallout released prior to the Partial Test Ban Treaty in 1963 and again a more or less constant decrease from 1975 to 1990. In practically all of Europe, including eastern European countries, from 1975 to 1986, and in the USA from 1975 to 2002, there were highly significant uniform downward trends in the sex odds with a reduction of 0.22% to 0.25% per 10 years. In contrast to the USA, in Europe there was a highly significant jump of the sex odds of 0.20% in the year 1987 following Chernobyl. From 1987 to 2000, the European sex odds trend reversed its sign and went upward, highly significantly so, with 0.42% per 10 years relative to the downward trend before Chernobyl. The global secular trend analyses are corroborated by the analysis of spatial-temporal sex odds trends near nuclear facilities (NF) in Germany and Switzerland. Within 35 km distance from those NF, the sex odds increase significantly in the range of 0.30% to 0.40% during NF operating time.

CONCLUSIONS

The atmospheric atomic bomb test fallout affected the human sex odds at birth overall, and the Chernobyl fallout had a similar impact in Europe and parts of Asia. The birth sex odds near nuclear facilities are also distorted. The persistently disturbed secular human sex odds trends allow the estimation of the global deficit of births in the range of several millions.

Can economic stress affect secondary sex ratio in Poland?

The ratio of male to female births described as the male proportion is expected to be about 1.06. The secondary sex ratio can be influenced by various stresses experienced by parents (e.g., parents' exposure to chemical and physical pollution, natural phenomena, wars and economic crises). The seminal study in this field speculated that fewer goods and services than needed or desired might sufficiently stress human populations to lower the secondary sex ratio. The main purpose of this study is to examine the relationship between economic stress and the fluctuations of sex ratio at birth in Poland. The statistical analysis was based on annual demographic data obtained from year-books issued by the Central Statistical Office on the overall number of male and female live births in Poland in the years 1956-2005 as well as on the annual data of percentage change in total private consumption. In order to verify the hypothesis that the observed time-series of the secondary sex ratio in Poland declines with deterioration in economic conditions, we constructed mathematical models (ARIMA) of both analyzed phenomena following the statistical procedure proposed by Catalano and Bruckner [2005]. We found a statistically significant decline of SSR in Poland over the last 50 years. The decrease appeared to be stronger in villages than in towns. However, the consumption rate as related to the strength of economic stress had no effect on the fluctuation of the sex ratio at birth.

Sex Selection: Some Ethical And Policy Considerations

Sex selection, which refers to the attempt to choose or control the sex of a child prior to its birth, has become the subject of increasing ethical scrutiny and many jurisdictions have criminalized it except for serious sex-linked diseases or conditions that cannot easily be ameliorated or remedied. This paper argues that such a blanket prohibition is ethically unwarranted because it is based on a flawed understanding of the difference between sexist values and mere sex-oriented preferences. It distinguishes between ethics and public policy, and suggests a way of allowing preference-based sex selection as a matter of public policy without permitting value-based sex selection. It further argues that medically-based sex selection should be publicly funded but that preference-base sex selection should not be paid for by society, and that the prohibition against value-based sex selection should be enforced through legislation that controls the licensing of health care facilities and through disciplinary procedures against health care professionals.

Ratio of boys to girls at birth

Is not related to the time taken to conceive, or exposure to environmental agents

Trends in the sex ratio of California births, 1960-1996

STUDY OBJECTIVE

The male sex ratio at birth (or the proportion of male births in a population) has been suggested as a sentinel environmental health indicator. Usually around 51%, the proportion may be dramatically decreased in offspring of persons with chemical exposures. Recent publications from the USA and elsewhere have noted a small but apparently declining male birth proportion, suggesting the effect of some environmental exposures. This paper sought to examine these trends more closely in California's large and diverse population.

DESIGN

Using computerised birth certificate data, time trends were examined by multivariate linear and spline regression, controlling for demographic factors.

SETTING

California.

PARTICIPANTS

About 15 million births from 1960 to 1996.

MAIN RESULTS

In the raw data, the male birth proportion is indeed declining. However, during this period, there were also shifts in demographics that influence the sex ratio. Controlling for birth order, parents' age, and race/ethnicity, different trends emerged. White births (which account for over 80%) continued to show a statistically significant decline, while other racial groups showed non-statistically significant declines (Japanese, Native American, other), little or no change (black), or an increase (Chinese). Finally, when the white births were divided into Hispanic and non-Hispanic (possible since 1982), it was found that both white subgroups suggest an increase in male births.

CONCLUSION

This analysis shows that the decline in male births in California is largely attributable to changes in demographics.

Clinical correlates of environmental endocrine disruptors

Endocrine disrupting chemicals (EDCs), such as environmental estrogens, are hypothesized to be associated with a global decrease in sperm counts, other male reproductive tract problems and increasing rates of female breast cancer. Results of human population studies do not support the association between certain organochlorine EDCs and female breast cancer. Moreover, there is minimal evidence linking EDCs or exposure to other environmental chemicals with male reproductive tract problems. With the exception of the increasing incidence of testicular cancer, it is also questionable whether male reproductive tract problems are increasing, decreasing or unchanged. However, several studies report large differences in sperm count and quality and other endocrine-related problems within countries and regions, but the environmental, dietary and/or lifestyle factors responsible remain unknown.

Secular trends in uncertain-sex births and proportion of male births in Norway, 1967-1998

It has been hypothesized that environmental factors influence sex differentiation in the fetus, thus causing a reduced sex ratio (male/female) at birth, an increase in the prevalence of ambiguous-sex infants, and possibly an increase in spontaneous abortion rates. In Norway, subsequent to 1967, all deliveries, including late abortions after 16 wk of gestation, have been reported to the Medical Birth Registry of Norway. The authors used these data to assess birth-weight-specific secular trends of uncertain-sex infants and the proportion of male births, from 1967 through 1998. Total rates of uncertain-sex infants increased from 2.3/10,000 births in 1967 to 8.0/10,000 births in 1998 in the birth weight strata of less than 600 gm. The total proportion of male births was stable; however, there was a reduction in the proportion of male births among births weighing less than 400 gm--from 58.4% to 53.4%. Incomplete ascertainment of abortions may have biased the results, but it would not have accounted for the increased occurrence of uncertain-sex infants and the decreased proportion of males observed among late-term abortions.

Endocrine disruptors: effects on male fertility and screening tools for their assessment

During the recent decades, a lot of research has been performed concerning the so-called "endocrine disruptors", which are widespread in the environment. These compounds of anthropogenic or natural origin mimic the action of sex hormones and can interfere with the endocrine system. The largest body of evidence exists for those compounds that are estrogenic in nature, but the amount of experimental data on other types of interactions, especially anti-androgenic, steadily increases. Because of the growing public and scientific concern, epidemiological studies have been initiated to analyse the short and long-term effects of endocrine disruptors. In addition, a number of assays have been developed and are undergoing validation, aiming at high throughput screening of chemical agents with suspected endocrine disrupting properties. In the present review, we briefly describe the results of epidemiological studies dealing with observed time trends in male fertility disorders. In the second part of the article, an overview is given of the different classes of endocrine disruptors, followed by a description of the most important in vitro and in vivo bioassays, used to screen for the possible endocrine disruptive capacity of chemicals, together with future research needs for in vitro test development.

Male reproductive hormones and thyroid function in pesticide applicators in the Red River Valley of Minnesota

In the present effort, 144 pesticide applicators and 49 urban control subjects who reported no chronic disease were studied. Applicators provided records of the season's pesticides used by product, volumes, dates, and methods of application. Blood specimens for examination of hormone levels were obtained in summer and fall. In the herbicide-only applicator group, significant increases in testosterone levels in fall compared to summer and also elevated levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) in the fall were noted. With respect to fungicide use, in an earlier cross-sectional epidemiologic study, data demonstrated that historic fungicide use was associated with a significant alteration of the sex ratio of children borne to applicators. As before, among current study subjects it was noted that historic fungicide use was associated with increased numbers of girls being born. Lower mean total testosterone concentrations by quartile were also correlated with increased numbers of live-born female infants. A downward summer to fall seasonal shift in thyroid-stimulating hormone (TSH) concentrations occurred among applicators but not among controls. Farmers who had aerial application of fungicides to their land in the current season showed a significant shift in TSH values (from 1.75 to 1.11 mU/L). Subclinical hypothyroidism was noted in 5/144 applicators (TSH values >4.5 mU/L), but not in urban control subjects. Based on current and past studies, it was concluded that, in addition to pesticide exposure, individual susceptibility and perhaps economic factors may play a supporting role in the reported results.

Environmental factors and the proportion of males at birth in Italy

A significant decline in the proportion of male births has been observed in recent decades in several western countries, and several researchers have raised the question of the possible role of environmental pollution in this trend. In the present analysis, the authors examined the effect of environmental factors (pollution from pesticides, urban pollution, and industrial pollution) on the sex ratio (proportion of males) of Italian singleton 1st births for the years 1989-1993, controlling for the age of the mother. The data show a slight increase in the sex ratio from north to south; however, no reduction in the proportion of males was seen in areas with higher pesticide consumption or intense industrial pollution. A small reduction in sex ratio was found in the major urban centers. The analysis was based on individual information on birth order and maternal age, as well as on ecological data on environmental pollution. No significant association was found between environmental pollution and the proportion of male births in Italy during the study period.