Table 1.

Summary of epidemiological studies analyzing effects of DLCs on male reproductive health.

Study	Population	Analyzed compounds	Levels	Design and timing of exposure	Exposure assessment	Timing of outcomes	Reproductive outcomes
Burns et al., 2016 [41]	473 Russian boys (Chapaevsk)	Dioxins, furans, dioxin-like PCBs	Wide range ΣDLC, median 362 pg/g lipid ΣTEQ, median 21.1 pg TEQ/g lipid	Longitudinal, 8–9 years, 2003–2005	Serum concentrations and TEQ	8–18 years, 2003–2015	Delayed pubertal onset and sexual maturity by testicular volume and genitalia staging.
Den Hond et al., 2002 [36]	80 Flemish boys in 3 areas, 2 exposed and one control	DLCs	CALUX assay, geometric means 0.15–0.20 in 3 areas	Cross-sectional, 15.8–19.6 Years	CALUX assay	15.8–19.6 years	No effect on pubertal staging.
Faure et al., 2014 [51]	251 French men-patients of infertility clinic	Dioxins	-	Longitudinal, adulthood, 1971–2007	Atmospheric diffusion model around the municipal waste incinerator in two periods, high and low emission	Adulthood, 2001–2003 and 2004–2007	Increased abnormal spermatozoa.
Guo et al., 2000 [38]	35 Taiwanese young adults (Yu-Cheng and unexposed)	PCBs, PCDFs	-	Longitudinal, prenatal and lactational, 1978–1998	Serum concentrations in mothers and children	16–18 years, 1998	Increased abnormal sperm morphology, decreased motility, decreased hamster oocyte penetration.
Guo et al., 2004 [37]	110 Taiwanese boys (Yu-Cheng and unexposed)	PCBs, PCDFs	Mothers: 2,3,4,7,8-Pe CDF, 6940 pg/g lipid; Children: PnCDF, 89pg/g/lipid	Longitudinal, prenatal and lactational, 1978–1991	Estimated (in mothers) and measured (in children) serum concentrations	11–14 years, 1991–1993	Decreased penile length.
Henriksen et al., 1996 [59]	1006 U.S. men (veterans of Operation Ranch Hand and unexposed)	Agent Orange, TCDD	TCDD median 130ppt	Longitudinal, adulthood, 1962–1971	Serum concentrations	37–74 years, 1982, 1985, 1987, 1992	No effect on testosterone, follicle stimulating hormone (FSH), luteinizing hormone (LH), testicular abnormalities, sperm count, sperm abnormalities.
Hsu et al., 2003 [39]	68 Taiwanese young men (Yu-Cheng and unexposed)	PCBs, PCDFs	-	Adulthood	Serum concentration	37–50 years	Increased abnormal sperm morphology, decreased motility, decreased hamster oocyte penetration.
Korrick et al., 2011 [40]	499 Russian boys (Chapaevsk)	Dioxins	Wide range Medians, pg/TEQ/g lipid for TCDD - 2.8; PCDDTEQ-8.2	Longitudinal, 8–9 years; 2003–2005	Serum concentrations and TEQ	8–12 years, 2003–2006	Delayed pubertal onsetby testicular volume
Minguez-Alarcon et al.,2016 [55]	133 Russian young adults (Chapaevsk)	TCDD, dioxins	Wide range Medians, pg/TEQ/g lipid for TCDD-2.9; PCDDTEQ-8.7	Longitudinal, 8–9 years; 2003–2005	Serum concentrations and TEQ	18–19 years, 2012–2015	Decreased sperm count, total sperm count and total motile sperm count.
Mocarelli et al., 2008 [13]	319 Italian men (Seveso accident and unexposed)	TCDD	Medians, ppt 1–9 years - 210; 10–17 years - 164: 18–26 years - 123	Longitudinal, three age groups: 1–9 years 10–17 years 18–26 years; 1976	Serum concentration	Three age groups: 22–31 years 32–39 years 40–47 years	Exposed at 1–9 years - decreased sperm count, motility, estradiol, increased FSH Exposed at 10–17 years - increased total sperm count, total motile sperm count, FSH, reduced estradiol Exposed at 18–26 years - no effects.
Mocarelli et al., 2011 [50]	97 Italian men (Seveso accident breast-fed, formula-fed and un xposed)	TCDD	Median, ppt at conception -breast-fed - 19.0: formula-fed - 27.9	Longitudinal, prenatal and lactational, 1976–1983	Maternal serum concentrations	18–26 years, 2002–2003	In breast-fed group - decreased sperm count, total sperm count and progressive motility, increased FSH, decreased inhibin B.
Paoli et al., 2015 [53]	125 testicular cancer patients and 103 controls	PCBs	-	Adulthood	Serum concentrations	Adulthood	Decreased sperm concentration count and motility, increased abnormalspermatozoa.