Children’s Health | Pierik et al. collected on all children, we performed separate analyses for those with mother information and those with mother and father information. Regression analyses were performed using PROC LOGISTIC in SAS (version 8.2; SAS Institute, Cary, NC, USA). Results The general characteristics of the study popu- lation are shown in Tables 1 and 2. Table 1 presents the risk factors for cryptorchidism and hypospadias related to the mother and preg- nancy. Significant risk factors were related to intrauterine growth (low birth weight and SGA for hypospadias, preterm delivery for cryptorchidism). Mothers with better general health, higher education, and larger height showed less risk of having offspring with either abnormality. These individual charac- teristics were strongly interrelated. Boys born from mothers of Turkish origin had increased risks for cryptorchidism and hypospadias. Compared with a Dutch origin, a Turkish ori- gin was strongly associated with suboptimal maternal health, a lower education level, and lower maternal height. Dietary phytoestrogens and maternal occupational exposure to poten- tial EDs did not signiﬁcantly alter the risk of either abnormality. Table 2 presents paternal risk factors. Paternal age, education, and country of origin were associated with cryptorchidism and hypospadias. Smoking among fathers was associated with hypospadias (OR = 3.4). ORs for cryptorchidism in offspring were elevated for self-reported solvent exposure (OR = 2.0) and pesticide exposure according to the JEM (OR = 4.5). Self-reported exposure to pesti- cides also gave an increased risk (OR = 2.8) of borderline significance (p = 0.08). Paternal self-reported solvent exposure (OR = 2.4) was also associated with hypospadias. Self-reported exposure to heavy metals, anesthetics, and other JEM categories was not significantly associated with the outcomes. The exposure prevalence in men was significantly higher than in women. Among men, the prevalence of self-reported exposure was 23.0% (n = 75) for solvents, 10.2% (n = 33) for heavy metals, 4.6% (n = 15) for pesticides, and 1.9% (n = 6) for anesthetics, and 31% were exposed to at least one of these categories. The single largest group reporting pesticide exposure were workers in green- houses involved in cultivation of vegetables (n = 3) or ﬂowers (n = 3). The JEM identiﬁed paternal ED exposure in 12.0% of the fathers. In the JEM, pesticide exposure (n = 14) was assigned primarily to greenhouse workers in ﬂowers (n = 7) or vegetables (n = 6). Among couples, maternal and paternal exposures to pesticides were associated for self-reports and the JEM (Spearman rank correlation, 0.18 and 0.21, respectively). The agreement between 1572 pesticide exposures based on self-reports and the JEM was moderate (κ = 0.54; 95% CI, 0.36–0.71). Age, education level, smoking, and country of origin within couples were strongly correlated (Spearman correlation coefﬁcients > 0.50). Tables 3 and 4 present the multivariate models with maternal and paternal risk factors for cryptorchidism and hypospadias, respec- tively. The final models on maternal risk factors (Tables 3 and 4) provide no evidence for an association between maternal dietary and environmental exposure and the occur- rence of both outcomes while adjusting for other risk factors. When manually added to the final multivariate models, the risk esti- mates for occupational exposures and dietary phytoestrogens were very similar to their effects in the univariate analyses in Table 1 (< 15% change in coefficient), although the conﬁdence intervals were somewhat larger. A preterm delivery and a low education level were the strongest risk factors for cryptorchidism in the maternal multivariate model, together with an interaction between country of origin and mother’s age at delivery. Among Turkish mothers ≥ 30 years of age, an increased risk of cryptorchidism in newborns was observed compared with younger Turkish and with Dutch mothers. When taking into account also the characteristics of the father (Table 3), the only paternal risk factor associ- ated with cryptorchidism was probable occu- pational exposure to pesticides (OR = 3.8). Although not selected by the stepwise forward selection, manual addition of self-reported exposure to solvents produced a similar effect as in the univariate analysis (OR = 1.9; 95% CI, 0.9–3.9), but the influence of probable exposure to EDs was substantially smaller (OR = 1.3; 95% CI, 0.5–3.3) than when ana- lyzed univariately. The important maternal risk factors for hypospadias were SGA birth and health status of the mother (Table 4). Again, Turkish ori- gin was associated with an increased risk for Table 1. Univariate analysis of the association between maternal risk factors and the occurrence of cryptorchidism and hypospadias in a case–control study among 443 mother–child pairs. Controls Cryptorchidism (n = 78) Cases OR (95% CI) Hypospadias (n = 56) Cases OR (95% CI) Variable Age at delivery (years) < 25 25–30 30–35 ≥ 35 Height (cm) < 160 160–165 165–170 ≥ 170 Education level Low Intermediate High Country of origin Netherlands Morocco Turkey Surinam Other Good general health Yes No Current smoker Yes No ART Yes No Time to pregnancy 0 months 1–3 months ≥ 4 months Birth weight (g) < 3,000 3,000–3,500 3,500–3,750 ≥ 3,750 SGA Yes No 48 80 111 70 41 65 95 111 65 154 94 170 21 18 35 69 291 22 71 242 14 299 96 113 91 57 106 58 88 7 302 14 20 29 15 16 25 14 23 27 37 14 34 8 15 8 13 66 12 22 56 4 74 26 21 26 19 26 11 20 2 74 1.0 0.9 (0.4–1.9) 0.9 (0.4–1.8) 0.7 (0.3–1.7) 1.0** 1.0 (0.5–2.1) 0.4* (0.2–0.9) 0.5 (0.3–1.1) 1.0 0.6 (0.3–1.0) 0.4* (0.2–0.7) 1.0 1.9 (0.8–4.7) 4.2* (1.9–9.1) 1.1 (0.5–2.7) 0.9 (0.5–1.9) 1.0 2.4* (1.1–5.1) 1.3 (0.8–2.3) 1.0 1.2 (0.3–3.3) 1.0 1.0 0.7 (0.4–1.3) 1.1 (0.6–2.0) 1.5 (0.7–3.0) 1.1 (0.6–2.1) 0.8 (0.4–1.9) 1.0 1.2 (0.2–4.9) 1.0 9 17 19 11 16 10 12 18 21 23 12 28 3 8 5 12 43 13 18 38 3 53 13 24 15 21 15 9 8 6 47 1.0 1.1 (0.5–2.7) 0.9 (0.4 –2.2) 0.8 (0.3–2.2) 1.0** 0.4* (0.2–1.0) 0.3* (0.1–0.8) 0.4* (0.2–0.9) 1.0 0.5* (0.2–0.9) 0.4* (0.2–0.9) 1.0 0.9 (0.2–2.7) 2.7* (1.0–6.6) 0.9 (0.3–2.2) 1.1 (0.5–2.2) 1.0 4.0* (1.9–8.5) 1.6 (0.9–3.0) 1.0 1.2 (0.3–3.9) 1.0 1.0 1.6 (0.8–3.3) 1.2 (0.6–2.7) 4.1* (1.7–9.8) 1.6 (0.6–3.8) 1.7 (0.6–4.7) 1.0** 5.5* (1.8–17.1) 1.0 Continued, next page VOLUME 112 | NUMBER 15 | November 2004 • Environmental Health Perspectives