Male Infertility Is an Overlooked Hazard of Toxic Exposure

He doesn’t want his name used.

“I do not want people to know,” he says in Spanish, “that I am not a man.”

He earns his living at a factory in Pico Rivera. He and his wife hope to have a family one day, but his sperm count is so low, his doctor has told him, that the couple will probably have to adopt.

The metals and chemicals to which he has been exposed on his job each workday for the past nine years, the doctor has explained, are probably responsible for his inability to conceive a child.

“I would quit,” he says, “but the money is good.”

Although toxic substances have long been linked to illnesses ranging from skin rashes to cancer, studies have shown increasingly that on-the-job exposure to hazardous materials can have another profound health consequence: male infertility.

The problem, some physicians believe, may be particularly acute among Latinos, who comprise nearly half of Los Angeles County’s manufacturing work force and disproportionately fill jobs that hold the greatest dangers of toxic overexposure.

Identifying and treating immigrant Latinos for infertility can be especially difficult because cultural and religious beliefs, coupled with limited financial means, preclude many from seeking help, medical specialists say.

Even when they suspect that toxics are preventing them from conceiving children, many Latinos take such pride in having a job that they continue to expose themselves to hazards.

Steeped in machismo culture, some will not seek treatment because they refuse to acknowledge that their infertility may be preventing their wives from becoming pregnant, according to local doctors.

Others refuse to visit fertility specialists, doctors say, because it would require having to provide semen samples by masturbation--an act considered sinful by the Roman Catholic Church. And still others decline help because they cannot afford it. Even if they have health insurance, policies usually do not cover infertility treatments.

“A lot of these workers are much more concerned about whether they can put food on the table (rather) than altering their sperm count,” said Dr. Rebecca Z. Sokol, a Beverly Hills endocrinologist and expert on the male reproductive system.

Historically, infertility and workplace toxics have been viewed as an issue primarily affecting women. Abnormal menstruation and damaged eggs as well as spontaneous abortions and birth defects have been linked in some cases to exposure to gases, chemicals or heavy metals. Some employers have sought to prevent women of childbearing years from working in jobs that expose them to hazardous substances. However, the U.S. Supreme Court in 1991 struck down such restrictions as discriminatory.

The infertility risks faced by men working in factories have drawn much less public attention, doctors say.

“(Semen) is a delicate mirror of a man’s health,” said Dr. Cappy Miles Rothman, a Los Angeles male infertility specialist. “Depending on what he is working with, the direct toxic effect on his testicular function can be profound.”

Lead is a prime suspect, say Rothman and others. High levels in the bloodstream are believed to reduce the production of hormones that stimulate the pituitary gland, resulting in lower testosterone levels and, in turn, diminished sperm development.

Lead, however, is but one substance among many thought to affect a man’s fertility. Among other suspected agents: borates, used in textile and steel manufacturing; cadmium, found at battery and plastics plants and smelting facilities; chloroprene, used in latex and rubber manufacture, and manganese, used to make glass, pottery and steel. Borates and manganese also are believed to reduce male sex drive.

Other recent studies have tentatively suggested that electronics workers, metal processors and other factory laborers exposed to certain toxics may conceive children who develop some forms of cancer and leukemia with disproportionate frequency.

Because so little study has taken place on the subject, doctors say, it will likely be years before the impact on children is known.

“Our knowledge in this area,” said Dr. Robert deLemos, neonatology director at Los Angeles County-USC Medical Center, “is not everything it could be.”