{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T08:12:52Z","timestamp":1778746372973,"version":"3.51.4"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,3,21]],"date-time":"2025-03-21T00:00:00Z","timestamp":1742515200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The association between paternal occupational radiation exposure and the sex ratio of offspring remains controversial. Therefore, we aimed to explore testicular radiation exposure in spine surgeons and its association with their offspring\u2019s sex ratio.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The Minimally Invasive Spine Treatment Society in Japan administered a survey in October 2020. Male surgeons were divided into high- and low-radiation exposure groups according to the type of lead protectors used during the time frame surrounding the child\u2019s conception. Apron-type lead protectors were associated with high exposure, while no radiation or using a coat-type protector was considered low exposure. Risk ratios were calculated via generalized estimating equations with a log link binomial distribution. A secondary analysis was conducted wherein the high-exposure group was further divided into 2 categories based on whether they were in a posture that facilitated exposure during the procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 209 male surgeons participated, providing responses regarding 436 children, of which 308 and 128 were associated with high and low radiation exposure, respectively. There were more female children in the high-exposure group (53% versus 39%). The adjusted risk ratio for the child being female with high exposure was 1.35 (95% CI: 1.04 to 1.73). A dose\u2013response relationship was observed: the adjusted risk ratios for high exposure with and without an exposure-prone posture were 1.36 (1.04 to 1.78) and 1.30 (0.96 to 1.78), respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>High radiation exposure to the testes is associated with a lower male-sex ratio in offspring. Medical professionals using radiation should ensure proper radiation protection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/annweh\/wxae093","type":"journal-article","created":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T23:19:19Z","timestamp":1740007159000},"page":"544-552","source":"Crossref","is-referenced-by-count":2,"title":["Association of occupational testicular radiation exposure with offspring sex ratio"],"prefix":"10.1093","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8619-5977","authenticated-orcid":false,"given":"Yasukazu","family":"Hijikata","sequence":"first","affiliation":[{"name":"Department of Healthcare Epidemiology, Graduate School of Medicine and Public Health, Kyoto University , Yoshida Konoe-cho, Sakyo-ku, Kyoto 606-8501 ,","place":["Japan"]},{"name":"Section of Clinical Epidemiology, Department of Community Medicine, Kyoto University , 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto 606-8507 ,","place":["Japan"]},{"name":"Spine 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,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshinori","family":"Matsuoka","sequence":"additional","affiliation":[{"name":"Department of Healthcare Epidemiology, Graduate School of Medicine and Public Health, Kyoto University , Yoshida Konoe-cho, Sakyo-ku, Kyoto 606-8501 ,","place":["Japan"]},{"name":"Department of Emergency Medicine, Kobe City Medical Center General Hospital , 2-1-1 Minatojima Minamimachi, Chuo-ku, Kobe 650-0047 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koichi","family":"Morota","sequence":"additional","affiliation":[{"name":"Department of Radiology, Shinkomonji Hospital , 2-5 Dairi Shinmachi, Moji-ku, Kitakyushu 800-0057 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haruki","family":"Funao","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare , 852 Hatakeda, Narita 286-8520 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masayuki","family":"Miyagi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Kitasato University, School of Medicine , 1-15-1 Kitasato, Minami-ku, Sagamihara 252-0375 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tadatsugu","family":"Morimoto","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Faculty of Medicine, Saga University , 5-1-1 Nabeshima, Saga 849-8501 ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haruo","family":"Kanno","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Tohoku Medical and Pharmaceutical University , 1-15-1 Fukumuro, Miyagino-ku, Sendai 983-8536 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