{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T18:42:55Z","timestamp":1792608175511,"version":"4.5.0"},"reference-count":32,"publisher":"BMJ","issue":"6919","license":[{"start":{"date-parts":[[1993,12,18]],"date-time":"1993-12-18T00:00:00Z","timestamp":756172800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ"],"published-print":{"date-parts":[[1993,12,18]]},"abstract":"<jats:p>OBJECTIVE--To determine whether the incidence of chronic sinusitis, bronchitis, or bronchiectasis in men with obstructive azoospermia (Young's syndrome) has fallen in men born after 1955 when calomel (mercurous chloride) was removed from teething powders and worm medication in the United Kingdom. DESIGN--A prospective study of aetiological factors in subfertile men with epididymal obstruction operated on between 1975 and 1993. SETTING--Central London. SUBJECTS--274 men with obstructive azoospermia undergoing epididymovasostomy; date of birth was recorded and illness in childhood, persistent nasal or respiratory symptoms, and previous urinary or genital infection were asked about. MAIN OUTCOME MEASURE--Site of epididymal block and association with possible aetiological factors, related to date of birth. RESULTS--146 men had hold up in the head of the epididymis (capital blocks): 119 (82%) had Young's syndrome, and 11 gave a definite history of pink disease (mercury intoxication) in childhood. 128 had obstruction lower down towards the tail of the epididymis (caudal blocks): 64 (50%) had a history of genital or urinary infection, and only three had Young's syndrome; none had had pink disease. The incidence of Young's syndrome fell significantly from 114 (50%) of 227 men born up to 1955 to eight (17%) of 47 men born since then. CONCLUSIONS--The decline in incidence of Young's syndrome in those born after 1955 is similar to that observed with pink disease, suggesting that both conditions may have had a similar aetiology--mercury intoxication.<\/jats:p>","DOI":"10.1136\/bmj.307.6919.1579","type":"journal-article","created":{"date-parts":[[2009,3,30]],"date-time":"2009-03-30T08:16:37Z","timestamp":1238400997000},"page":"1579-1582","source":"Crossref","is-referenced-by-count":55,"title":["Was Young's syndrome caused by exposure to mercury in childhood?"],"prefix":"10.1136","volume":"307","author":[{"given":"W F","family":"Hendry","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R P","family":"A'Hern","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P J","family":"Cole","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1993,12,18]]},"reference":[{"key":"ref_1","article-title":"After considerable controversy, products containing calomel were withdrawn from sale in the United Kingdom and Australia in 1955. Pink disease then disappeared (fig 1), apart from a few isolated cases.'5-'7 IfYoung's syndrome and pink disease shared a common aetiology, the syndrome would also be expected to disappear in men bom after 1955. To test this hypothesis we related the dates of birth of a large number of subfertile men with obstructive azoospermia to the site of epididymal obstruction, coexisting nasal or respiratory disease, and any past history of pink disease","unstructured":"After considerable controversy, products containing calomel were withdrawn from sale in the United Kingdom and Australia in 1955. Pink disease then disappeared (fig 1), apart from a few isolated cases.'5-'7 IfYoung's syndrome and pink disease shared a common aetiology, the syndrome would also be expected to disappear in men bom after 1955. To test this hypothesis we related the dates of birth of a large number of subfertile men with obstructive azoospermia to the site of epididymal obstruction, coexisting nasal or respiratory disease, and any past history of pink disease."},{"key":"ref_2","first-page":"391","article-title":"A propos de la friquence insolite de la dilatation bronchique chez les sujets atteints d'azoospermie d'orgine excritiore. In: Coiloque de la Societe nationale pour l'etude de la stirilite et de la feconditi du mdle","author":"Guillon, G.; Chuberre, B.","year":"1972","unstructured":"Guillon G, Chuberre B. A propos de la friquence insolite de la dilatation bronchique chez les sujets atteints d'azoospermie d'orgine excritiore. In: Coiloque de la Societe nationale pour l'etude de la stirilite et de la feconditi du mdle. Paris: Masson, 1972;391-4."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1111\/j.1464-410X.1978.tb06221.x","article-title":"Obstructive azoospermia: respiratory function tests, electron microscopy and the results of surgery","volume":"50","author":"Hendry, W.F.; Knight, R.K.; Whitfield, H.N.; Stansfeld, A.G.; Pryse-Davies, J.; Ryder, T.A.","year":"1978","unstructured":"Hendry WF, Knight RK, Whitfield HN, Stansfeld AG, Pryse-Davies J, Ryder TA, et al. Obstructive azoospermia: respiratory function tests, electron microscopy and the results of surgery. BrJ Urol 1978;50:598-604.","journal-title":"BrJ Urol"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1136\/thx.38.12.929","article-title":"Respiratory tract disease and obstructive azoospermia","volume":"38","author":"Neville, E.; Brewis, R.; Yeates, W.K.; Burridge, A.","year":"1983","unstructured":"Neville E, Brewis R, Yeates WK, Burridge A. Respiratory tract disease and obstructive azoospermia. Thorax 1983;38:929-33.","journal-title":"Thorax"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1056\/NEJM198401053100102","article-title":"Young's syndrome: obstructive azoospermia and chronic sinopulmonary infection","volume":"310","author":"Handelsman, D.J.; Conway, A.J.; Boylan, L.M.; Turtle, JR","year":"1984","unstructured":"Handelsman DJ, Conway AJ, Boylan LM, Turtle JR. Young's syndrome: obstructive azoospermia and chronic sinopulmonary infection. N Engl 7 Med 1984;310:3-9.","journal-title":"N Engl 7 Med"},{"key":"ref_6","first-page":"94","article-title":"Steriliti masculine et dilatation de bronches","volume":"14","author":"D, Le Lannou; B, Lobel; G, Ridoux; B, De Labarthe; J, Bauchart","year":"1980","unstructured":"Le Lannou D, Lobel B, Ridoux G, De Labarthe B, Bauchart J. Steriliti masculine et dilatation de bronches. Ann Urol 1980;14:94-6."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2201","DOI":"10.1001\/archinte.1985.00360120073012","article-title":"Recurrent respiratory disease, azoospermia and nasal polyposis","volume":"145","author":"Schanker, H.M.J.; Rajfer, J.; Saxon, A.","year":"1985","unstructured":"Schanker HMJ, Rajfer J, Saxon A. Recurrent respiratory disease, azoospermia and nasal polyposis. Arch Intern Med 1985;145:2201-3.","journal-title":"Arch Intern Med"},{"key":"ref_8","first-page":"1238","article-title":"Young's syndrome: an often unrecognised correctable cause of obstructive azoospermia","volume":"137","author":"Hughes, T.M.; Skolnick, J.L.; Belker, A.M.","year":"1987","unstructured":"Hughes TM, Skolnick JL, Belker AM. Young's syndrome: an often unrecognised correctable cause of obstructive azoospermia. J7 Urol 1987;137: 1238-40."},{"key":"ref_9","first-page":"396","article-title":"Testicular obstruction: clinico-pathological studies","volume":"72","author":"Hendry, W.F.; Levison, D.; Parkinson, C.M.; Parslow, J.M.; Royle, M.R.","year":"1990","unstructured":"Hendry WF, Levison D, Parkinson CM, Parslow JM, Royle MR. Testicular obstruction: clinico-pathological studies. Ann R Coil Surg Engl 1990;72: 396-407.","journal-title":"Ann R Coil Surg Engl"},{"key":"ref_10","first-page":"23","article-title":"Structure of the human epididymis","volume-title":"semen andfertility regudation in men","author":"Holstein, A.F.","year":"1976","unstructured":"Holstein AF. Structure of the human epididymis. In: Hafez ESE, ed. Human semen andfertility regudation in men. Saint Louis: Mosby, 1976:23-30."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1378\/chest.80.6.892","article-title":"Lung mucociliary clearance in patients with Young's syndrome","volume":"80","author":"Pavia, D.; Agnew, J.E.; Bateman, J.B.M.; Sheahan, N.F.; Knight, R.K.; Hendry, W.F.","year":"1981","unstructured":"Pavia D, Agnew JE, Bateman JBM, Sheahan NF, Knight RK, Hendry WF, et al. Lung mucociliary clearance in patients with Young's syndrome. Chest 1981;80(suppl):892-5.","journal-title":"Chest"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1136\/thx.43.2.153","article-title":"Ciliary function in Young's syndrome","volume":"43","author":"Greenstone, M.A.; Rutman, A.; Hendry, W.F.; Cole, P.J.","year":"1988","unstructured":"Greenstone MA, Rutman A, Hendry WF, Cole PJ. Ciliary function in Young's syndrome. Thorax 1988;43:153-4.","journal-title":"Thorax"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1016\/S0140-6736(48)91924-2","article-title":"Mercury in the urine of children with acrodymia","volume":"i:","author":"Warkany, J.; Hubbard, D.M.","year":"1948","unstructured":"Warkany J, Hubbard DM. Mercury in the urine of children with acrodymia. Lancet 1948;i:829-30.","journal-title":"Lancet"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"242","DOI":"10.5694\/j.1326-5377.1957.tb57870.x","article-title":"A biochemical approach to calomel induced mercurialism and to the aetiology of pink disease","volume":"ii:","author":"Barrett, FR","year":"1957","unstructured":"Barrett FR. A biochemical approach to calomel induced mercurialism and to the aetiology of pink disease. Med3'Aust 1957;ii:242-5.","journal-title":"Med3'Aust"},{"key":"ref_15","first-page":"922","article-title":"The rise and decline of pink disease","volume":"i:","author":"Clements, F.W.","year":"1960","unstructured":"Clements FW. The rise and decline of pink disease. MedjAust 1960;i:922-5.","journal-title":"MedjAust"},{"key":"ref_16","first-page":"181","article-title":"Pink disease-ten years after (the epilogue)","volume":"1","author":"Dathan, J.G.; Harvey, C.C.","year":"1965","unstructured":"Dathan JG, Harvey CC. Pink disease-ten years after (the epilogue). BMJ 1965;i:1 181-2.","journal-title":"BMJ"},{"key":"ref_17","first-page":"147","article-title":"Acrodynia-post mortem of a disease","volume":"112","author":"Warkany, J.","year":"1966","unstructured":"Warkany J. Acrodynia-post mortem of a disease. Am Dis Child 1966;112:147-56.","journal-title":"Am Dis Child"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1111\/j.1464-410X.1983.tb03426.x","article-title":"Exploratory scrototomy in 168 azoospermic males","volume":"55","author":"Hendry, W.F.; Parslow, J.M.; Stedronska, J.","year":"1983","unstructured":"Hendry WF, Parslow JM, Stedronska J. Exploratory scrototomy in 168 azoospermic males. BrJ Urol 1983;55:785-91.","journal-title":"BrJ Urol"},{"key":"ref_19","article-title":"Toxicity of mercury and its compounds","author":"Bidstrup, P.L.","year":"1964","unstructured":"Bidstrup PL. Toxicity of mercury and its compounds. Amsterdam: Elsevier, 1964."},{"key":"ref_20","first-page":"182","article-title":"Mercury: a history of quicksilver","author":"Goldwater, U.","year":"1972","unstructured":"Goldwater U. Mercury: a history of quicksilver. 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BMJ 1956;i: 897-908.","journal-title":"BMJ"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1016\/S0140-6736(52)91953-3","article-title":"Mercury and pink disease","volume":"i:","author":"Holzel, A.; James, T.","year":"1952","unstructured":"Holzel A, James T. Mercury and pink disease. Lancet 1952;i:441-3.","journal-title":"Lancet"},{"key":"ref_30","first-page":"333","article-title":"Skin lighteners cause permanent damage","volume":"305","author":"Godlee, F.","year":"1992","unstructured":"Godlee F. Skin lighteners cause permanent damage. BMJ 1992;305:333.","journal-title":"BMJ"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1136\/bmj.306.6876.506","article-title":"Arsenic and mercury intoxication due to Indian ethnic remedies","volume":"306","author":"Kew, J.; Morris, C.; Aihie, A.; Fysh, R.; Jones, S.; Brooks, D.","year":"1993","unstructured":"Kew J, Morris C, Aihie A, Fysh R, Jones S, Brooks D. Arsenic and mercury intoxication due to Indian ethnic remedies. BMJ 1993;306:506-7.","journal-title":"BMJ"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1177\/000992286300200808","article-title":"Acrodynia-a long term study of 62 cases","volume":"2","author":"Chamberlain, J.L.; Quillian, W.W.","year":"1963","unstructured":"Chamberlain JL, Quillian WW. Acrodynia-a long term study of 62 cases. Clin Pediatrics 1963;2:439-43.","journal-title":"Clin Pediatrics"}],"container-title":["BMJ"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bmj.307.6919.1579","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmj.307.6919.1579","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T17:00:32Z","timestamp":1766509232000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.bmj.com\/lookup\/doi\/10.1136\/bmj.307.6919.1579"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1993,12,18]]},"references-count":32,"journal-issue":{"issue":"6919","published-online":{"date-parts":[[1993,12,18]]},"published-print":{"date-parts":[[1993,12,18]]}},"alternative-id":["10.1136\/bmj.307.6919.1579"],"URL":"https:\/\/doi.org\/10.1136\/bmj.307.6919.1579","relation":{},"ISSN":["0959-8138","1468-5833"],"issn-type":[{"value":"0959-8138","type":"print"},{"value":"1468-5833","type":"electronic"}],"subject":[],"published":{"date-parts":[[1993,12,18]]}}}