Combined exposures to bisphenols, polychlorinated dioxins, paracetamol, and phthalates as drivers of deteriorating semen quality

Andreas Kortenkamp, Martin Scholze, Sibylle Ermler, Lærke Priskorn, Niels Jørgensen, Anna-Maria Andersson, Hanne Frederiksen

27 Citations (Scopus)


BACKGROUND: Semen quality in men continues to decline in Western countries, but the contours of the issue remain obscure, in relation to contributing chemicals.

OBJECTIVES: To obtain more clarity about the chemicals that drive the deterioration of semen quality, we conducted a mixture risk assessment based on European exposures.

METHODS: We included chemicals capable of affecting semen quality after prenatal exposures, among them androgen receptor antagonists, substances that disrupt prostaglandin signalling, suppress testosterone synthesis, inhibit steroidogenic enzymes or activate the aryl hydrocarbon receptor. We employed the Hazard Index approach (HI), based on risk quotients of exposures in Europe and reference doses for reductions in semen quality. By summing up the risk quotients of the 29 chemicals included in the assessment we examined fold-exceedances of "acceptable" mixture exposures relative to an index value of 1. For bisphenols A, F, S, phthalates DEHP, DnBP, BBzP, DiNP, n-butyl paraben and paracetamol we relied on biomonitoring studies in which these 9 chemicals were measured together in the same subjects. This allowed us to construct personalised Hazard Indices.

RESULTS: Highly exposed subjects experienced combined exposures to the 9 chemicals that exceeded the index value of 1 by more than 100-fold; the median was a 17-fold exceedance. Accounting for median background exposures to the remaining 20 chemicals added a Hazard Index of 1.39. Bisphenol A made the largest contribution to the HI, followed by polychlorinated dioxins, bisphenols S and F and DEHP. Eliminating bisphenol A alone would still leave unacceptably high mixture risks. Paracetamol is also a driver of mixture risks among subjects using the drug.

CONCLUSIONS: Tolerable exposures to substances associated with deteriorations of semen quality are exceeded by a large margin. Bisphenols, polychlorinated dioxins, phthalates and analgesics drive these risks. Dedicated efforts towards lowering exposures to these substances are necessary to mitigate risks.

Original languageEnglish
Article number107322
JournalEnvironment International
Publication statusPublished - Jul 2022


  • Acetaminophen/toxicity
  • Benzhydryl Compounds
  • Diethylhexyl Phthalate
  • Dioxins/toxicity
  • Environmental Exposure/adverse effects
  • Environmental Pollutants/toxicity
  • Humans
  • Male
  • Phenols
  • Phthalic Acids/toxicity
  • Semen Analysis
  • Male reproductive health
  • Semen quality
  • Phthalates
  • Polychlorinated dioxins
  • Mixture risk assessment
  • Bisphenol


Dive into the research topics of 'Combined exposures to bisphenols, polychlorinated dioxins, paracetamol, and phthalates as drivers of deteriorating semen quality'. Together they form a unique fingerprint.

Cite this