Associations between testicular hormones at adolescence and attendance at chlorinated swimming pools during childhood.

The goal was to evaluate the associations between testicular hormones at adolescence and the exposure to chlorination by-products when attending chlorinated swimming pools. We obtained serum samples from 361 school male adolescents (aged 14-18years) who had visited swimming pools disinfected with chlorine or by copper-silver ionization. We analysed serum concentrations of inhibin B (two different assays), total and free testosterone, sex hormone-binding globulin, luteinizing hormone (LH), follicle stimulating hormone (FSH) and dehydroepiandrosterone sulphate (DHEAS). There were strong inverse associations between serum levels of inhibin B (both assays) or of total testosterone, adjusted or unadjusted for gonadotropins and the time adolescents had spent in indoor chlorinated pools, especially during their childhood. Adolescents having attended indoor chlorinated pools for more than 250h before the age of 10years or for more than 125h before the age of 7years were about three times more likely to have an abnormally low serum inhibin B and/or total testosterone (<10th percentile) than their peers who never visited this type of pool during their childhood (odds ratio, 95% CI, 2.83, 1.06-7.52, p=0.04 and 3.67, 1.45-9.34, p=0.006, respectively). Such associations were not seen with free testosterone, LH, FSH and DHEAS or with the attendance of outdoor chlorinated pools or of the copper-silver pool. Swimming in indoor chlorinated pools during childhood is strongly associated with lower levels of serum inhibin B and total testosterone. The absorption of reprotoxic chlorination by-products across the highly permeable scrotum might explain these associations.