{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:07:20Z","timestamp":1791389240127,"version":"4.3.3"},"reference-count":67,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T00:00:00Z","timestamp":1671753600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Male infertility is a serious concern for public health, and the possible role of exposure to plasticizers such as phthalates and bisphenol A in contributing to the condition is widely debated. We have herein enrolled 155 infertility cases attending an infertility center and 211 controls (fathers of a spontaneously conceived newborn) to investigate this issue. The urinary levels of seven phthalates and BPA were analyzed through HPLC\/MS\/MS. All data were statistically elaborated considering information about clinical situation, life habits, occupational activity, and, for cases, semen parameters (volume, sperm concentration, total count of spermatozoa, and sperm motility). Results showed significantly higher urinary concentrations for all the phthalates in cases compared to controls, except for monoethylphthalate and BPA. In total, 90.07% of cases had sperm motility lower than the WHO reference value (2010), while 53.69%, 46.31%, and 16.56% had sperm total number, concentration, and volume, respectively, out of the reference range. Regarding the possible source of exposure, the use of scents seems to be a significant source of DEP (diethylphthalate). When considering occupational settings, industrial workers, dental technicians, artisans, and farmers using chemicals showed higher risk (OR = 2.766, 95% CI 1.236\u20136.185), particularly in relation to DnBP (di-n-butyl phthalate) and DEHP (di-ethyl-hexyl phthalate) exposure. No clear quantitative correlation between specific plasticizers and sperm parameters could be demonstrated but these findings call for future studies about the risks associated with exposure to their mixture.<\/jats:p>","DOI":"10.3390\/ijerph20010235","type":"journal-article","created":{"date-parts":[[2022,12,27]],"date-time":"2022-12-27T03:05:56Z","timestamp":1672110356000},"page":"235","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["A Case\u2013Control Study on the Effects of Plasticizers Exposure on Male Fertility"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5346-4584","authenticated-orcid":false,"given":"Lidia","family":"Caporossi","sequence":"first","affiliation":[{"name":"National Institute of Insurance against Accidents at Work-Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, 00078 Monte Porzio Catone, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3674-5912","authenticated-orcid":false,"given":"Paola","family":"Vigan\u00f2","sequence":"additional","affiliation":[{"name":"Unit of Obstetrics and Gynecology, San Raffaele Scientific Institute, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Paci","sequence":"additional","affiliation":[{"name":"National Institute of Insurance against Accidents at Work-Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, 00078 Monte Porzio Catone, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1470-0342","authenticated-orcid":false,"given":"Silvia","family":"Capanna","sequence":"additional","affiliation":[{"name":"National Institute of Insurance against Accidents at Work-Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, 00078 Monte Porzio Catone, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3092-3546","authenticated-orcid":false,"given":"Alessandra","family":"Alteri","sequence":"additional","affiliation":[{"name":"Unit of Obstetrics and Gynecology, San Raffaele Scientific Institute, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Pigini","sequence":"additional","affiliation":[{"name":"National Institute of Insurance against Accidents at Work-Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, 00078 Monte Porzio Catone, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8973-6046","authenticated-orcid":false,"given":"Giovanna","family":"Tranfo","sequence":"additional","affiliation":[{"name":"National Institute of Insurance against Accidents at Work-Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, 00078 Monte Porzio Catone, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Papaleo","sequence":"additional","affiliation":[{"name":"National Institute of Insurance against Accidents at Work-Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, 00078 Monte Porzio Catone, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1520","DOI":"10.1016\/j.fertnstert.2009.09.009","article-title":"The international Committee for monitoring assisted reproduction technology (ICMART) and the world health organization (WHO) revised glossary on ART terminology","volume":"92","author":"Adamson","year":"2009","journal-title":"Fertil Steril"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1506","DOI":"10.1093\/humrep\/dem046","article-title":"International estimates of infertility prevalence and treatment-seeking: Potential need and demand for infertility medical care","volume":"22","author":"Boivin","year":"2007","journal-title":"Hum. Reprod."},{"key":"ref_3","first-page":"646","article-title":"Temporal trends in sperm count: A systematic review and a meta-regression analysis","volume":"23","author":"Levine","year":"2017","journal-title":"Hum. Reprod."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.1016\/j.envint.2018.10.052","article-title":"Secular trends in semen parameters among men attending a fertility center between 2000 and 2017: Identifying potential predictors","volume":"121","author":"Williams","year":"2018","journal-title":"Environ. Int."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1007\/978-1-4939-0817-2_8","article-title":"Role of post translational protein modifications in epididymal sperm maturation and extracellular quality control","volume":"759","author":"Cornwall","year":"2014","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1111\/tog.12688","article-title":"An update on the management of male infertility","volume":"22","author":"Karavolos","year":"2020","journal-title":"Obstet. Gynaecol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"5413056","DOI":"10.1155\/2018\/5413056","article-title":"Effect of heat stress on sperm DNA: Protamine assessment in ram spermatozoa and testicle","volume":"2018","author":"Hamilton","year":"2018","journal-title":"Oxid. Med. Cell Longev."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1478","DOI":"10.1289\/ehp.6417","article-title":"Semen quality in relation to biomarkers of pesticides exposure","volume":"111","author":"Swan","year":"2003","journal-title":"Environ. Health Perspect."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/s12302-021-00585-w","article-title":"Impact of environmental factors on human semen quality and male fertility: A narrative review","volume":"34","author":"Kumar","year":"2022","journal-title":"Environ. Sci. Eur."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"706532","DOI":"10.3389\/fendo.2021.706532","article-title":"Endocrine disrupting chemicals and reproductive health of boys and men","volume":"12","author":"Rodpraset","year":"2021","journal-title":"Front. Endocrinol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1002\/rmb2.12326","article-title":"Endocrine disrupting chemicals and male reproductive health","volume":"19","author":"Sharma","year":"2020","journal-title":"Reprod. Med. Biol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"111215","DOI":"10.1016\/j.mce.2021.111215","article-title":"Impact of endocrine-disrupting chemicals on steroidogenesis and consequences on testicular function","volume":"527","author":"Walker","year":"2021","journal-title":"Mol. Cell Endocrinol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1016\/j.reprotox.2013.10.001","article-title":"Human urinary phthalate metabolites level and main semen parameters, sperm chromatin structure, sperm aneuploidy and reproductive hormones","volume":"42","author":"Jurewicz","year":"2013","journal-title":"Reprod. Toxicol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1016\/j.jhazmat.2017.06.036","article-title":"Phthalates impact human health: Epidemiological evidences and plausible mechanism of action","volume":"340","author":"Benjamin","year":"2017","journal-title":"J. Hazard. Mater."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1016\/j.scitotenv.2015.09.036","article-title":"Human exposure hazard and risk of alternative plasticizers to phthalate esters","volume":"541","author":"Bui","year":"2016","journal-title":"Sci. Total Environ."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1016\/j.envpol.2017.10.079","article-title":"Characterization of phthalates exposure and risk for cosmetics and perfume sales clerks","volume":"233","author":"Huang","year":"2018","journal-title":"Environ. Pollut."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"11101","DOI":"10.3390\/ijerph120911101","article-title":"Bisphenol-A and female infertility: A possible role of gene-environment interactions","volume":"12","author":"Huo","year":"2015","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1289\/ehp.1003170","article-title":"Food Packaging and Bisphenol A and Bis(2-Ethyhexyl) Phthalate Exposure: Findings from a Dietary Intervention","volume":"119","author":"Rudel","year":"2011","journal-title":"Environ. Health Perspect."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1080\/02652030600936383","article-title":"Bisphenol A (BPA) and its source in foods in Japanese markets","volume":"24","author":"Sajiki","year":"2007","journal-title":"Food Addit. Contam"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Ribeiro, E., Ladeira, C., and Viegas, S. (2017). Occupational Exposure to Bisphenol A (BPA): A Reality That Still Needs to Be Unveiled. Toxics, 5.","DOI":"10.3390\/toxics5030022"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"106903","DOI":"10.1016\/j.envint.2021.106903","article-title":"Human health impacts of exposure to phthalate plasticizers: An overview of reviews","volume":"158","author":"Eales","year":"2022","journal-title":"Environ. Int"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"13240","DOI":"10.3390\/ijerph121013240","article-title":"Associations between bisphenol A exposure and reproductive hormones among female workers","volume":"12","author":"Miao","year":"2015","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/S0303-7207(98)00084-7","article-title":"Bisphenol A interacts with the estrogen receptor alpha in a distinct manner from estradiol","volume":"142","author":"Gould","year":"1998","journal-title":"Mol. Cell Endocrinol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"215","DOI":"10.21608\/ejh.2018.5474.1030","article-title":"The possible protective effect of Omega 3 fatty acids against Bisphenol A induced disruption of pituitary-testicular axis in albino rat. Biohemical, histological and immunohistochemical study","volume":"42","author":"Mahmoud","year":"2019","journal-title":"Egypt J. Histol."},{"key":"ref_25","first-page":"508","article-title":"Testicular dysgenesis syndrome and phthalate exposure: A review of literature","volume":"71","author":"Erkekoglu","year":"2021","journal-title":"Arch. Pharm."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1111\/j.1365-2605.2010.01095.x","article-title":"Association between urinary metabolites of di(2-ethylhexyl)phthalate and reproductive hormones in fertile men","volume":"34","author":"Mendiola","year":"2010","journal-title":"Int. J. Androl."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.envint.2014.02.002","article-title":"Association between serum phthalates and biomarkers of reproductive function in 589 adult men","volume":"66","author":"Toft","year":"2014","journal-title":"Environ. Int."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"118969","DOI":"10.1016\/j.envpol.2022.118969","article-title":"The association of certain seminal phthalate metabolites on spermatozoa apoptosis: An exploratory mediation analysis via sperm protamine","volume":"300","author":"Xiong","year":"2022","journal-title":"Environ. Pollut."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Hlisnikova, H., Petrovi\u010dova, I., Kolena, B., \u0160idlovsk\u00e1, M., and Sirotkin, A. (2020). Effects and mechanisms of phthalates\u2019 action on reproductive processes and reproductive health: A literature review. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17186811"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"132464","DOI":"10.1016\/j.chemosphere.2021.132464","article-title":"Urinary and seminal plasma concentrations of phthalate metabolites in relation to spermatogenesis-related miRNA106a among men from an infertility clinic","volume":"288","author":"Cui","year":"2022","journal-title":"Chemosphere"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"426","DOI":"10.3389\/fcell.2020.00426","article-title":"The impact of di-2-ethylhexyl phthalate on sperm fertility","volume":"8","author":"Khasin","year":"2020","journal-title":"Front. Cell Develop. Biol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2159","DOI":"10.1093\/humrep\/dex283","article-title":"Preconception urinary phthalate concentrations and sperm DNA methylation profiles among men undergoing IVF treatment: A cross sectional study","volume":"32","author":"Wu","year":"2017","journal-title":"Hum. Reprod."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1016\/j.chemosphere.2018.12.155","article-title":"Positive association of low-level environmental phthalate exposure with sperm motility was mediated by DNA methylation: A pilot study","volume":"220","author":"Tian","year":"2019","journal-title":"Chemosphere"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1289\/ehp.1307309","article-title":"Urinary bisphenol A levels in young men: Association with reproductive hormones and semen quality","volume":"122","author":"Lassen","year":"2014","journal-title":"Environ. Health Perspect."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2144","DOI":"10.1177\/1557988318799163","article-title":"Urinary bisphenol A levels and male fertility","volume":"12","author":"Radwan","year":"2018","journal-title":"Am. J. Men Health"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.biopha.2018.03.045","article-title":"Protective effect of Lespedeza cuneate ethanol extract on Bisphenol A-induced testicular dysfunction in vivo and in vitro","volume":"102","author":"Park","year":"2018","journal-title":"Biomed. Pharmacother."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e13427","DOI":"10.1111\/and.13427","article-title":"Cuscuta chinensis flavonoids alleviate bisphenol A induced apoptosis of testicular cells in male mice offspring","volume":"51","author":"Wei","year":"2019","journal-title":"Andrologia"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.reprotox.2007.05.010","article-title":"In vitro molecular mechanisms of bisphenol A action","volume":"24","author":"Wetherill","year":"2007","journal-title":"Reprod. Toxicol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.reprotox.2018.06.005","article-title":"Effects of bisphenol A and its analogs on reproductive health: A mini review","volume":"79","author":"Siracusa","year":"2018","journal-title":"Reprod. Toxicol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1016\/j.reprotox.2010.07.005","article-title":"Semen quality and sperm DNA damage in relation to urinary bisphenol A among men from an infertility clinic","volume":"30","author":"Meeker","year":"2010","journal-title":"Reprod. Toxicol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/j.envint.2016.01.021","article-title":"Associations of bisphenol A and polychlorinated bisphenyls with spermatogenesis and steroidogenesis in two biological fluids from men attending an infertility clinic","volume":"89","author":"Vitku","year":"2016","journal-title":"Environ. Int."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Krais, A.M., Andersen, C., Eriksson, A.C., Johnsson, E., Nielsen, J., Pagels, J., Gudmundsson, A., Lindh, C.H., and Wierzbicka, A. (2018). Excretion of Urinary Metabolites of the Phthalate Esters DEP and DEHP in 16 Volunteers after Inhalation and Dermal Exposure. Int. J. Environ. Res. Public Health, 15.","DOI":"10.3390\/ijerph15112514"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1748","DOI":"10.1124\/dmd.105.005454","article-title":"Quantitation of bisphenol A and bisphenol A glucuronide in biological samples by high performance liquid chromatography tandem mass spectrometry","volume":"33","author":"Bittner","year":"2005","journal-title":"Drug Metab. Dispos."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1002\/mnfr.200600243","article-title":"Metabolism of phthalates in humans","volume":"51","author":"Frederiksen","year":"2007","journal-title":"Mol. Nutr. Food Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1038\/jes.2008.74","article-title":"A simple pharmacokinetic model to characterize exposure of Americans to di-2-ethylhexyl phthalate","volume":"20","author":"Lorber","year":"2009","journal-title":"J. Expo. Sci. Environ. Epidemiol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1007\/s00204-003-0486-3","article-title":"Glucuronidation patterns of common urinary and serum monoester phthalate metabolites","volume":"77","author":"Silva","year":"2003","journal-title":"Arch. Toxicol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"123639","DOI":"10.1016\/j.talanta.2022.123639","article-title":"Rapid and simultaneous determination of multiple endocrine-disrupting chemicals and their metabolites in human serum and urine samples","volume":"248","author":"Li","year":"2022","journal-title":"Talanta"},{"key":"ref_48","unstructured":"WHO (1996). Biological Monitoring of Chemical Exposure in the Workplace, World Health Organization."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.toxlet.2011.11.033","article-title":"Urinary phthalate monoesters concentration in couples with infertility problems","volume":"213","author":"Tranfo","year":"2012","journal-title":"Toxicol. Lett."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Caporossi, L., Alteri, A., Campo, G., Paci, E., Tranfo, G., Capanna, S., Papaleo, E., Pigini, D., Vigan\u00f2, P., and Papaleo, B. (2020). Cross Sectional Study on Exposure to BPA and Phthalates and Semen Parameters in Men Attending a Fertility Center. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17020489"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1093\/clinchem\/32.3.446","article-title":"Automated determination of urinary creatinine without sample dilution: Theory and practice","volume":"32","author":"Kroll","year":"1986","journal-title":"Clin. Chem."},{"key":"ref_52","unstructured":"ACGIH\u2014American Conference of Governmental Industrial Hygienists (2014). Recommendation, TLVs and BEIs, Signature Publications."},{"key":"ref_53","unstructured":"World Health Organization (2010). Laboratory Manual for the Examination and Processing of Human Semen, WHO Press. [5th ed.]."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1093\/humrep\/des355","article-title":"Special interest Group in Andrology of the European Society of Human Reproduction and Embriology. Proposal of guidelines for the appraisal of SEMen QUAlity studies (SEMQUA)","volume":"28","author":"Mendiola","year":"2013","journal-title":"Hum. Reprod."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1111\/andr.12124","article-title":"Phthalate exposure and semen quality in fertile US men","volume":"4","author":"Thurston","year":"2016","journal-title":"Andrology"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.envint.2015.07.005","article-title":"Phthalate exposure and reproductive parameters in young men from the general Swedish population","volume":"85","author":"Axelsson","year":"2015","journal-title":"Environ. Int."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1016\/j.jhazmat.2015.08.011","article-title":"Association between phthalate metabolites and biomarkers of reproductive function in 1066 Chinese men of reproductive age","volume":"300","author":"Pan","year":"2015","journal-title":"J. Hazard. Mat."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1007\/s11356-015-5267-z","article-title":"Screening of phthalate esters in 47 branded perfumes","volume":"23","author":"Elkhatib","year":"2016","journal-title":"Environ. Sci. Pollut. Res."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"140673","DOI":"10.1016\/j.scitotenv.2020.140673","article-title":"Phthalate exposure and semen quality in infertile male population from Tianjin, China: Associations and potential mediation by reproductive hormones","volume":"744","author":"Wang","year":"2020","journal-title":"Sci. Total Environ."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"114602","DOI":"10.1016\/j.envpol.2020.114602","article-title":"Correlations of phthalate metabolites in urine samples from fertile and infertile men: Free-form concentration vs conjugated-form concentration","volume":"263","author":"Feng","year":"2020","journal-title":"Environ. Pollut."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/j.envint.2015.07.017","article-title":"Human exposure to endocrine disrupting chemicals and fertility: A case-control study in male subfertility patients","volume":"84","author":"Tournaye","year":"2015","journal-title":"Environ. Int."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.envres.2015.06.010","article-title":"Phthalate exposure and human semen quality: Results from an infertility clinic in China","volume":"142","author":"Wang","year":"2015","journal-title":"Environ. Res."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.envint.2011.04.005","article-title":"Phthalates exposure of Chinese reproductive age couples and its effect on male semen quality, a primary study","volume":"42","author":"Liu","year":"2012","journal-title":"Environ. Int."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"2645","DOI":"10.1093\/humrep\/dev219","article-title":"Association between urinary phthalate concentrations and semen quality parameters in a general population","volume":"30","author":"Bloom","year":"2015","journal-title":"Hum. Reprod."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1093\/humrep\/dey009","article-title":"Association between use of phthalate containing medication and semen quality among men in couples referred for assisted reproduction","volume":"33","author":"Broe","year":"2018","journal-title":"Hum. Reprod."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"105536","DOI":"10.1016\/j.phrs.2021.105536","article-title":"Reproductive toxic potential of phthalates compounds-state of the art review","volume":"167","author":"Sedha","year":"2021","journal-title":"Pharmacol. Res."},{"key":"ref_67","first-page":"101","article-title":"Environmental and occupational exposures associated with male infertility","volume":"72","author":"Aghayanian","year":"2021","journal-title":"Arch. Ind. Hyg. Toxicol."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/1\/235\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:49:31Z","timestamp":1760147371000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/1\/235"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,23]]},"references-count":67,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1]]}},"alternative-id":["ijerph20010235"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20010235","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,23]]}}}