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  • Combined exposures to bisph...
    Kortenkamp, Andreas; Scholze, Martin; Ermler, Sibylle; Priskorn, Lærke; Jørgensen, Niels; Andersson, Anna-Maria; Frederiksen, Hanne

    Environment international, 07/2022, Letnik: 165
    Journal Article

    •The first mixture risk assessment for 29 chemicals disrupting male reproductive health, with a focus on declines in semen quality.•Assessment based on 9 chemicals jointly monitored in urine samples from 98 young Danish men.•Substantial exceedances of combined acceptable exposures (more than 100-fold)•Bisphenols A, S, F, polychlorinated dioxins and the phthalate DEHP identified as drivers of mixture risks.•Bisphenol A makes a very strong contribution, but elimination of bisphenol A will not reduce combined exposures to acceptable levels. Semen quality in men continues to decline in Western countries, but the contours of the issue remain obscure, in relation to contributing chemicals. To obtain more clarity about the chemicals that drive the deterioration of semen quality, we conducted a mixture risk assessment based on European exposures. We included chemicals capable of affecting semen quality after prenatal exposures, among them androgen receptor antagonists, substances that disrupt prostaglandin signalling, suppress testosterone synthesis, inhibit steroidogenic enzymes or activate the aryl hydrocarbon receptor. We employed the Hazard Index approach (HI), based on risk quotients of exposures in Europe and reference doses for reductions in semen quality. By summing up the risk quotients of the 29 chemicals included in the assessment we examined fold-exceedances of “acceptable” mixture exposures relative to an index value of 1. For bisphenols A, F, S, phthalates DEHP, DnBP, BBzP, DiNP, n-butyl paraben and paracetamol we relied on biomonitoring studies in which these 9 chemicals were measured together in the same subjects. This allowed us to construct personalised Hazard Indices. Highly exposed subjects experienced combined exposures to the 9 chemicals that exceeded the index value of 1 by more than 100-fold; the median was a 17-fold exceedance. Accounting for median background exposures to the remaining 20 chemicals added a Hazard Index of 1.39. Bisphenol A made the largest contribution to the HI, followed by polychlorinated dioxins, bisphenols S and F and DEHP. Eliminating bisphenol A alone would still leave unacceptably high mixture risks. Paracetamol is also a driver of mixture risks among subjects using the drug. Tolerable exposures to substances associated with deteriorations of semen quality are exceeded by a large margin. Bisphenols, polychlorinated dioxins, phthalates and analgesics drive these risks. Dedicated efforts towards lowering exposures to these substances are necessary to mitigate risks.