目的:通过精液参数了解长期暴露于工业空气污染与男性生育能力的关系。
方法:回顾性队列研究。
方法:处于不育症的男性,健康和辅助生殖队列,2005-2017年接受精液分析,测量的精液参数≥1(N=21,563)。
方法:使用通过犹他州人口数据库链接的行政记录中的位置来构建每个人的居住历史。从环境保护局风险筛选环境指标微观数据中确定了空气排放有9种内分泌干扰化合物化学类别的工业设施。在每次精液分析之前的5年内,化学水平与居住历史相关。
方法:使用世界卫生组织浓度截止值,将精液分析分为无精子症或低精子症(<15M/ml)。大量精液参数:浓度,总计数,射精量,总运动性,总游动计数,还测量了总的进行性运动量。使用具有稳健标准误差的多变量回归模型将九个化学类别中的每个类别的暴露四分位数与每个精液参数相关联,调整年龄,种族/民族,和邻里社会经济劣势。
结果:调整人口统计学协变量后,几种化学类别与无精子症和总运动和体积减少相关。对于第4相对于第1四分位数的曝光,观察到丙烯腈的显著关联(β总运动性=-0.87pp),芳烃(Orazoospermia=1.53;β体积=-0.14mL),二恶英(比值比[OR]无精子症=1.31;β体积=-0.09mL;β总运动率=-2.65pp),重金属(β总运动性=-2.78pp),有机溶剂(Orazoospermia=1.75;β体积=-0.10mL),有机氯(Orazoospermia=2.09;β体积=-0.12mL),邻苯二甲酸酯(Orazoospermia=1.44;β体积=-0.09mL;β总运动率=-1.21pp),和银颗粒(Orazoospermia=1.64;β体积=-0.11mL)。随着社会经济劣势的增加,所有精液参数均显着降低。生活在最不利地区的男人集中注意力,volume,总活动力6.70M/mL,0.13mL,和1.79pp更低,分别。伯爵,运动计数,总进行性运动量均减少30-34M。
结论:观察到来自工业来源的内分泌干扰化合物空气污染的慢性低水平环境暴露与精液参数之间存在几个显著关联。无精子症的几率增加,总运动和体积下降,相关性最强。需要进行更多的研究,以进一步探索其他社会和暴露因素,并扩大所研究化学物质对男性生殖健康造成的风险。
To understand how chronic exposure to industrial air pollution is associated with male fertility through semen parameters.
Retrospective cohort study.
Men in the Subfertility, Health, and Assisted Reproduction cohort who underwent a semen analysis in the two largest healthcare systems in Utah from 2005-2017 with ≥1 measured semen parameter (N = 21,563).
Residential histories for each man were constructed using locations from administrative records linked through the Utah Population Database. Industrial facilities with air emissions of nine endocrine-disrupting compound chemical classes were identified from the Environmental Protection Agency Risk-Screening Environmental Indicators microdata. Chemical levels were linked with residential histories for the 5 years before each semen analysis.
Semen analyses were classified as azoospermic or oligozoospermic (< 15 M/mL) using World Health Organization cutoffs for concentration. Bulk semen parameters such as concentration, total count, ejaculate volume, total motility, total motile count, and total progressive motile count were also measured. Multivariable regression models with robust standard errors were used to associate exposure quartiles for each of the nine chemical classes with each semen parameter, adjusting for age, race, and ethnicity, as well as neighborhood socioeconomic disadvantage.
After adjustment for demographic covariates, several chemical classes were associated with azoospermia and decreased total motility and volume. For exposure in the 4th relative to 1st quartile, significant associations were observed for acrylonitrile (βtotal motility = -0.87 pp), aromatic hydrocarbons (odds ratio [OR]azoospermia = 1.53; βvolume = -0.14 mL), dioxins (ORazoospermia = 1.31; βvolume = -0.09 mL; βtotal motility = -2.65 pp), heavy metals (βtotal motility = -2.78pp), organic solvents (ORazoospermia = 1.75; βvolume = -0.10 mL), organochlorines (ORazoospermia = 2.09; βvolume = -0.12 mL), phthalates (ORazoospermia = 1.44; βvolume = -0.09 mL; βtotal motility = -1.21 pp), and silver particles (ORazoospermia = 1.64; βvolume = -0.11 mL). All semen parameters significantly decreased with increasing socioeconomic disadvantage. Men who lived in the most disadvantaged areas had concentration, volume, and total motility of 6.70 M/mL, 0.13 mL, and 1.79 pp lower, respectively. Count, motile count, and total progressive motile count all decreased by 30-34 M.
Several significant associations between chronic low-level environmental exposure to endocrine-disrupting compound air pollution from industrial sources and semen parameters were observed. The strongest associations were seen for increased odds of azoospermia and declines in total motility and volume. More research is needed to further explore additional social and exposure factors as well as expand on the risk posed to male reproductive health by the studied chemicals.