The Male Reproductive Health Crisis: Endocrine Disrupting Chemicals and Racial Inequities

May 6, 2021
12:00 pm US Eastern Time

Slides & Resources


Swan, S.H., Main, K.M., Liu, F, Stewart, S.L., Kruse, R.L., Calafat, A.M., Mao, C.S, Redmon, J.B.,  Ternand, C.L., Sullivan, S., and Teague J.L. (2005). Decrease in Anogenital Distance among Male Infants with Prenatal Phthalate Exposure. Environ Health Perspect. 113(8): 1056–1061. DOI: 10.1289/ehp.8100.

Levine, H., Jørgensen, N., Martino-Andrade, A., Mendiola, J., Weksler-Derri, D., Mindlis, I., Pinotti, R., Swan, S.H. Temporal trends in sperm counts: a systematic review and meta-regression analysis. Hum Reprod Update. 1;23(6):646-659. doi: 10.1093/humupd/dmx022.

Fischer, M.B., Ljubicic, M.L., Hagen, C.P., Thankamony, A., Hughes, K.O. J., Jensen, T.K., Main, K.M., Petersen, J.H., Busch, A.S., Upners, E.N., Sathyanarayana, S., Swan, S. H., Juul, A. (2020). Anogenital Distance in Healthy Infants: Method-, Age- and Sex-related Reference Ranges. J. Clin. Endocrinol. Metab. 105(9): 2996–3004. DOI: 10.1210/clinem/dgaa393.

Sathyanarayana, S. Grady , RedmonR. J B, Ivicek, K., Barrett, E., Janssen, S., Nguyen, R., Swan, S.H., TIDES Study Team. (2015). Anogenital distance and penile width measurements in The Infant Development and the Environment Study (TIDES): Methods and predictors. J. Pediatric. Urol. 11(2):76.e1-6. doi: 10.1016/j.jpurol.2014.11.018.

Ann Olsson, Kayo Togawa, Joachim Schüz, Charlotte Le Cornet, Beatrice Fervers, Susanne Oksbjerg Dalton, Eero Pukkala, Maria Feychting, Niels Erik Skakkebæk, Johnni Hansen. (2018). Parental occupational exposure to solvents and heavy metals and risk of developing testicular germ cell tumors in sons (NORD-TEST Denmark). Scand J Work Environ Health. 44(6):658–669. DOI: 10.5271/sjweh.3732.

Togawa K, Le Cornet C, Feychting M, Tynes T, Pukkala E, Hansen J, Olsson A, Oksbjerg Dalton S, Nordby KC, Uuksulainen S, Wiebert P, Woldbæk T, Skakkebæk NE, Fervers B, Schuz J. (2016). Parental Occupational Exposure to Heavy Metals and Welding Fumes and Risk of Testicular Germ Cell Tumors in Offspring: A Registry-Based Case–Control StudyCancer Epidemiol Biomarkers Prev; 25(10). DOI: 10.1158/1055-9965.EPI-16-0328.

Le Cornet C, Fervers, B., Oksbjerg, D.S., Feychting, M., Pukkala, E., Tynes, T., Hansen, J., Nordby, K.C., Beranger, R., Kauppinen, T., Uuksulainen, S., Wiebert, P., Woldbaek, T., Skakkebaek, N.E., Olsson, A., Schuz, J. Testicular germ cell tumours and parental occupational exposure to pesticides: a register-based case-control study in the Nordic countries (NORD-TEST study). Occup Environ Med. 2015 Nov;72(11):805-811.

McCray, N.Thompson, L., Branch, F., Porter, N., Peterson, J, Perry, M.J (2020). Talking About Public Health With African American Men: Perceptions of Environmental Health and Infertility. AM. J. Mens Health.14(1):1557988320901375. DOI: 10.1177/1557988320901375.

Over the past fifty years, sperm count has declined by fifty percent [1], while testicular cancer has risen dramatically over the same time period in western countries. [2] Current science provides evidence linking exposures to hormone disrupting chemicals and many male reproductive health problems with increased risk of disease later in life. Studies looking at environmental and occupational exposures have also shown some associations with adverse male reproductive health outcomes such as decreased anogenital distance (AGD), hypospadia, cryptorchidism, lower sperm count and motility, testicular cancer and dysgenesis, and prostate cancer.

During this webinar Sheela Sathyanarayana, MD, MPH, Ann Olsson, HDR, PhD, MPH, RN, Melissa Perry, ScD, MHS, and Nathan McCray, MPH, discussed the implications of their research on male reproductive health. Dr. Sathyanarayana presented her investigation of EDC exposures and reduced AGD. Dr. Olsson highlighted the research she has done looking at parental occupational exposures and the odds of testicular germ cell tumors in a cohort of Nordic men. Finally, Dr. Perry and Mr. McCray discussed how perceptions and limited inclusion of Black males from many studies in the US has led to data gaps that may hinder a greater understanding of the scope of this male reproductive health crisis. The speakers will also highlight societal perceptions and policy-based solutions that may influence male reproductive health and the health inequities that have arisen.

This webinar series is brought to you by the Collaborative on Health and the Environment (CHE), the University of California, San Francisco Program on Reproductive Health and the Environment (PRHE), and the Environment Research and Translation for Health Center (EaRTH), the International Federation of Gynecology and Obstetrics (FIGO), the Endocrine Society, the Alliance of Nurses for Healthy Environments (ANHE), and the International Federation of Fertility Societies (IFFS).

Anogenital distance as a sentinel marker of endocrine disrupting chemical exposures and hormone mediated disease

Dr. Sheela Sathyanarayana gave a brief overview of her work on male reproductive health, highlighting a few of her studies looking at endocrine disrupting chemical (EDC) exposures and AGD. AGD was originally used as a marker of androgen exposure in utero in animals. It has since been applied to human studies and associated with numerous reproductive outcomes in relation to EDCs. AGD may be a sentinel marker for androgen based disease and has significant future applications with respect to disease over the life course.

Parental Occupational Exposures and Testicular Germ Cell Tumors in their Offspring: NORD-TEST Study.

Dr. Ann Olsson discussed several studies that investigated associations between occupational exposures and testicular germ cell tumors (TGCT) from the NORD-TEST cohort, a registry based case-control study in the Nordic countries including 9,500 men diagnosed with TGCT between 1978 and 2012 and 32,000 control subjects. Dr. Olsson presented results published to date on parental occupational exposures to pesticides, solvents, and heavy metals in relation to TGCT risk in their sons. Additional work on this topic that involves her Branch at IARC was also discussed.

Including Men of Color in Environmental and Reproductive Health Research: Results from an Exploratory Qualitative Study

Dr. Melissa Perry, Nathan McCray, and colleagues conducted a qualitative study to evaluate urban African American male perspectives on environmental health, reproductive health and fertility, and participation in research.  In recent decades, there has been increased limelight and research attention on the environmental contributions to male infertility.  Despite being disproportionately exposed to environmental hazards, Black and other populations of color have seldom been included as participants in studies on sperm health and reproductive capacity.  As a result the perceptions of and experiences with infertility among men of color have been overlooked and are not well known.  To begin exploring some of these existing knowledge gaps, Dr. Perry and colleagues held a series of small focus groups to give voice to the perceptions of urban African American men on these topics.

Featured Speakers

Sheela Sathyanarayana, MD, MPH, is an Associate Professor of Pediatrics and Adjunct Associate Professor within the Department of Environmental and Occupational Health Sciences at the University of Washington. Her research interests focus on exposures to endocrine disrupting chemicals including phthalates and bisphenol A and their impact on perinatal and child health. Dr. Sathyanarayana serves as the center director for The Infant Development and Environment Study.  She is a co-principal investigator for the NIH Environmental Factors Affecting Child Health Outcomes PATHWAYS study at the University of Washington and the Seattle Children’s Research Institute. This study is a 35 million dollar initiative to combine three cohorts, GAPPS, TIDES, and CANDLE to examine environmental exposures, the placental transcriptome, and child health outcomes. She served as past chair of the US Environmental Protection Agency’s Children’s Health Protection Advisory Committee and as well as on the National Academies of Sciences, National Research Council Committee on Endocrine-Related Low Dose Toxicity. She currently serves on the US EPA’s Scientific Advisory Committee on Chemicals for the Toxics Substances Control Act. She also practices pediatric medicine at the University of Washington Medical Center as Medical Director of the Newborn Nursery.


Ann Olsson HDR, PhD, MPH, RN, is an occupational cancer epidemiologist in the Environment and Lifestyle Epidemiology Branch at the International Agency for Research on Cancer (IARC/WHO) in Lyon, France, since 2011. Her primary interest is conducting multi-centre epidemiological studies to identify environmental and occupational risk factors for human cancers. Much of this involves coordination and collaboration within large international consortia such as the NORD-TEST study - a registry-based case-control study of testicular germ cell tumors nested in the general populations of Denmark, Finland, Norway and Sweden. 



Melissa Perry, ScD, MHS, is Professor and Chair of Environmental and Occupational Health and Professor of Epidemiology and Biostatistics at the George Washington University Milken Institute School of Public Health. She is past President of the American College of Epidemiology (ACE), and is currently Co-Chair of the National Academies of Sciences, Engineering, and Math Committee on Emerging Sciences for Environmental Health Decision Making. She leads an environmental epidemiology laboratory at George Washington investigating the reproductive health effects of pesticides and other environmental contaminants. She also teaches graduate students how to research the public health impacts of climate change.

Nathan McCray, MPH, is an Epidemiology Research Associate for the Pennsylvania Department of Health (PADOH) Division of Environmental Health Epidemiology.  He earned an MPH at The George Washington University’s Milken Institute School of Public Health (GWSPH) and from 2016-2020 worked as a Research Associate and Teaching Assistant for GWSPH’s Department of Environmental and Occupational Health.  Nathan worked in Dr. Melissa Perry’s laboratory as a researcher and recruiter for several studies on male reproductive health.  He also collaborated on research pertaining to endocrine disorders, phthalates in fast food, and chronic kidney disease of unknown origin (CKDu).  Prior to his time at GW, Nathan worked as a Press Assistant for several years for the U.S. Senate Committee on Environment and Public Works, chaired by former Senator Barbara Boxer (D-CA).