Association of occupational testicular radiation exposure with offspring sex ratio

Abstract

Objectives: The association between paternal occupational radiation exposure and the sex ratio of offspring remains controversial. Therefore, we aimed to explore testicular radiation exposure in spine surgeons and its association with their offspring's sex ratio.

Methods: The Minimally Invasive Spine Treatment Society in Japan administered a survey in October 2020. Male surgeons were divided into high- and low-radiation exposure groups according to the type of lead protectors used during the time frame surrounding the child's conception. Apron-type lead protectors were associated with high exposure, while no radiation or using a coat-type protector was considered low exposure. Risk ratios were calculated via generalized estimating equations with a log link binomial distribution. A secondary analysis was conducted wherein the high-exposure group was further divided into 2 categories based on whether they were in a posture that facilitated exposure during the procedures.

Results: A total of 209 male surgeons participated, providing responses regarding 436 children, of which 308 and 128 were associated with high and low radiation exposure, respectively. There were more female children in the high-exposure group (53% versus 39%). The adjusted risk ratio for the child being female with high exposure was 1.35 (95% CI: 1.04 to 1.73). A dose-response relationship was observed: the adjusted risk ratios for high exposure with and without an exposure-prone posture were 1.36 (1.04 to 1.78) and 1.30 (0.96 to 1.78), respectively.

Conclusions: High radiation exposure to the testes is associated with a lower male-sex ratio in offspring. Medical professionals using radiation should ensure proper radiation protection.

Keywords: Y-chromosomes; ionizing radiation; occupational exposure; orthopaedic surgeon; paternal exposure; sex ratio; sperm quality; spine surgeon; surveys and questionnaires; testicular radiation.