Hypospadias, or the arrested development of several parts of the penis, including the urethra, foreskin, and ventral surface, is usually not a topic for public discussion. But a review of research on the condition points to a link between hypospadias and endocrine-disrupting chemicals, one that Laurence Baskin of the University of California at San Francisco and colleagues are working to bring to the attention of the public and the public health community [EHP 109:1175-1183]. In their review article in this issue, the scientists conclude that the link between hypospadias, which occurs in 1 of every 125 live male births in the United States, and exposure to endocrine-disrupting environmental chemicals is a strong one, while environmental estrogens appear to not be involved. They also suggest that an antiandrogen mechanism may cause hypospadias.
Hypospadias can entail a displacement of the urethral opening to points along the shaft, within the scrotum, or even in the perineum. Severe cases result in penile curvature or ambiguous genitalia, making immediate and accurate sex assignment of the newborn difficult. Hypospadias is generally correctable by surgery, but complications from such procedures and psychosocial problems can result.
The condition has increased in prevalence over the past 14 years in the United States, nearly doubling between 1968 and 1993, according to the Centers for Disease Control and Prevention. The authors suggest this increase may be due to environmental chemicals encountered by pregnant women. However, very few of the 15,000 chemicals in the highest-volume production in the United States have been tested for endocrine-disrupting effects during development at any dose. Principal investigator Theo Colborn, who is director of the World Wildlife Fund's Wildlife and Contaminants Program, cautions women who anticipate becoming pregnant or who learn they are pregnant to be exceptionally careful about their diet and environment, at least until they pass childbearing age. More and more, the evidence reveals that the embryonic and fetal stages of development are the most sensitive to endocrine disruption, she says. …