大气细颗粒物长期暴露对男性精子质量的影响

Association between long-term exposure to ambient fine particulate matter and semen quality

目的定量评估大气细颗粒物(PM2.5)长期暴露与男性精子质量之间的暴露-效应关系。方法选取湖北省2857对在2013—2016年间接受辅助生殖技术治疗夫妇中的男方为研究对象,收集其基本信息、精液检查等资料,基于常住地址估算各研究对象近2年、5年、10年和15年PM2.5暴露水平,采用线性混合模型分析PM2.5暴露与精子浓度、活力之间的暴露-效应关系。结果研究期间对2857名研究对象共进行了3144次精液检查,其中258(9.0%)名研究对象进行过至少两次精液检查。精液检查近2年、5年、10年和15年的PM2.5平均浓度分别为51.0(标准差:12.1)、50.1(10.8)、51.4(11.0)和49.0(10.6)μg/m^3,经调整年龄、民族、文化程度、吸烟、身高体重指数、季节等潜在混杂因素,近2年PM2.5暴露水平每升高10μg/m^3,精子总活力和前向运动力分别下降1.81%(95%CI:0.69%,2.94%)和1.49%(95%CI:0.39%,2.58%),呈近似直线下降趋势,但精子浓度无显著变化(P>0.05);近5年、10年和15年PM2.5暴露与精子质量的关联与2年类似。结论湖北省PM2.5长期暴露可能与精子质量下降有关。

Objective To quantitatively evaluate the association between long-term exposure to ambient fine particulate matter(PM2.5)and semen quality.Methods We enrolled male partners of2857couples from Hubei province.China who received assisted reproductive technology treatments between2013and2016,and collected data on their demographic information and semen examinations.Long-term exposure to PM2.5was assessed as the average concentrations during the recent2,5,10and15years at the date of semen examination.Linear mixed models were used to investigate the exposure-response associations between PM2.5exposure and semen quality parameters,including sperm concentration and motility.Results The2857study subjects underwent a total of3144semen examinations,and258(9.0)of them underwent at least2semen examinations.PM2.5exposures during the recent2,5,10and15years of semen examination were51.0(standardized deviation:12.1)、50.1(10.8)、51.4(11.0)and49.0(10.6)μg/m^3,respectively.With adjustment for potential confounders including age,race,education,smoking,body mass index and season,each increase of PM2.5exposure during the recent2years of semen examination was significantly associated with1.81%(95%CI:0.69%,2.94%)and1.49%(95%CI:0.39%,2.58%)decrease in total motility and progressive motility,respectively,and the associations were close to linear.No significant associations were observed between PM2.5exposure and sperm concentration(P>0.05).Exposure-response analyses using PM2.5exposures during the recent5,10and15years of semen examination gave similar results.Conclusion Long-term exposure to ambient PM2.5may adversely affect semen quality,especially sperm motility.