Occupational radiation exposure is a known hazard and necessary evil in orthopaedic surgery. Few studies have noted increased female sex ratio amongst the off spring of male orthopaedic surgeons attributed to testicular radiation decreasing the ratio of male sex-determining sperms.
Kiyana Mirza et al conducted a cross-sectional study by circulating a questionnaire across the Indian Orthopaedic Association. Participants were stratified into high- and low-risk based on sub-speciality and the type as well as method of storing the lead apron. To eliminate recall bias, participants with children aged < 10 years were included in a subgroup analysis to ascertain characteristics of work at the time of conceiving their child. Regression analysis was done to determine factors associated with an increased likelihood of a female child.
The key findings of the study were:
• A total of 718 biological children of male orthopaedic surgeons were included in this study.
• 49.6% of children were female, and 48.3% were aged below 10-years.
• Younger surgeons (age < 50) were noted to have a higher proportion of female children (p = 0.037).
• Surgeons wearing lead aprons which extended below the knee were more likely to produce a male child (p = 0.025).
• Regression analysis revealed significant (p = 0.002) number of male children amongst paediatric orthopaedic and pelvi-acetabular surgeons with an odds ratio close to 1.
• Majority reported inconsistent dosimeter use and lack of formal radiation safety training.
The authors concluded that – “Younger age of the surgeon and length of lead apron being above the knee significantly correlated with altered off spring sex ratio, laying emphasis on increased radiation safety awareness and wearing appropriate protection especially during training years. Further research is warranted to corroborate an association and it is important to consider the confounding factors that exist in stratification as most Indian orthopaedic surgeons do not restrict their practise to a single sub-speciality in orthopaedics.”
Further reading:
Effect of Occupational Radiation Exposure on Off spring Sex Ratio Amongst Male Orthopaedic Surgeons in India—A Cross-Sectional Study
Kiyana Mirza et al
Indian Journal of Orthopaedics (2025) 59:1712–1719
https://doi.org/10.1007/s43465-025-01465-8
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