Table 20.
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 Meeker and Ferguson, 2014 (CS) Pan et al., 2015 (CS) Low confidence Chang et al., 2015 (CS) Den Hond et al., 2015 (CS) |
|
|
Inverse associations between DIBP exposure and testosterone levels in 3/4 studies (Meeker and Ferguson, 2014, Pan et al., 2015, Chang et al., 2015), 2 of which were statistically significant. No studies examined exposure-response gradient (Table 15). | ⨁⨁◯ MODERATE |
⨁⨁◯ MODERATE Based on testosterone and supported by slight evidence in other outcomes, with explanation for weaker observed associations (i.e., sensitivity and few available studies). Results for DBP, a structurally similar phthalate are also supportive. |
Anogenital distance, semen parameters, time to pregnancy hypospadias/cryptorchidism | ⨁◯◯ SLIGHT |
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Pubertal development | ◯◯◯ INDETERMINATE |
C: cohort, CC: case-control, CS: cross-sectional.