Table 18.
Outcome | Studies (design in parentheses) | Factors that increase confidence | Factors that decrease confidence | Summary of findings | Confidence judgement for outcome | Confidence judgement for overall hazard |
---|---|---|---|---|---|---|
Testosterone | Medium confidence Axelsson et al., 2015a, 2015b (CS) Jurewicz et al., 2013 (CS) Meeker and Ferguson, 2014 (CS) Pan et al., 2015 (CS) Specht et al., 2014 (CS) |
|
|
Inverse associations between DINP exposure and testosterone levels in 3/5 studies (Specht et al., 2014, Meeker and Ferguson, 2014, Pan et al., 2015), 2 included statistically significant results (Pan et al., 2015, Specht et al., 2014), with the latter being a trend (other studies did not examine exposure-response gradient) (Table 14). | ⨁⨁◯ MODERATE | ⨁⨁◯ MODERATE Based on testosterone and semen parameters, supported by coherence of slight findings in other outcomes with few available studies |
Semen parameters | Medium confidence Axelsson et al., 2015a, 2015b (CS) Jurewicz et al., 2013 (CS) (Pan et al., 2015) (CS) Specht et al., 2014 (CS) |
|
|
Inverse associations between DINP exposure and sperm morphology in all 4 studies, 1 of which was statistically significant (Jurewicz et al., 2013). 2/3 studies for motility (Pan et al., 2015, Axelsson et al., 2015a) and 2/4 studies for concentration (Specht et al., 2014, Pan et al., 2015) also reported inverse associations (Table 5). | ⨁⨁◯ MODERATE | |
Anogenital distance, Hypospadias/Cryptorchidism | ⨁◯◯ SLIGHT | |||||
Time to pregnancy, pubertal development | ◯◯◯ INDETERMINATE |
C: cohort, CC: case-control, CS: cross-sectional.