大气污染暴露与育龄妇女月经周期长度的关联

Association of atmospheric pollution exposure with menstrual cycle length among fertile women

招募343名山西常住的育龄妇女,开展大气污染暴露与育龄妇女月经周期长度的横断面研究.基于妇女月经周期生理特点,设置大气污染暴露的时间窗口期.采集妇女所在城市的空气质量监测点大气SO2、NO2、PM2.5和O3的日报浓度,分别计算不同暴露时间的大气污染物浓度水平.采用广义线性模型,分析大气污染暴露与育龄妇女月经周期长度的关联效应,阐明大气污染暴露对妇女生育力的潜在健康风险.结果表明,当控制混杂因素后,妇女在SO2暴露窗第1期(0.053,95%CI:0.022,0.083)、第2期(0.049,95%CI:0.02,0.078)和第3期(0.045;95%CI:0.017、0.073),Q4组SO2的暴露水平与月经周期总长度呈显著的正相关;而且,SO2与月经周期总长度的正相关主要表现在卵泡期长度的延长上.在NO2暴露窗第1期(0.060,95CI:0.035,0.085)、第2期(0.056,95CI:0.030,0.083)和第3期(0.050,95CI:0.025,0.075),Q3组NO2的暴露水平与卵泡期长度呈显著的正相关.在PM2.5暴露窗的第1期(0.043;95%CI:0.012,0.074)和第2期(0.049;95%CI:0.020,0.079),Q3组PM2.5的暴露水平与月经周期总长度呈显著的正相关.此外,妇女在暴露窗第1期(-0.043,95%CI:-0.079,-0.003)、第2期(-0.047,95%CI:-0.072,-0.022)和第3期(-0.046,95%CI:-0.081,-0.011),Q4组O3的暴露水平与卵泡期长度呈显著的负相关.总体而言,妇女的月经卵泡期可能是大气污染暴露的敏感阶段.而且,结果表明,在低于现行的国家标准限值时,仍然可以观察到大气污染暴露与妇女卵泡期长度显著的关联效应.本研究结果可为精准制定我国大气污染防控措施,推动出台区域性健康风险防范政策提供了参考依据.

343reproductive aged women permanently dwelling in Shanxi were recruited to conduct a cross-sectional study for the association between ambient air pollution exposure and menstrual cycle length.Based on physiological characteristics of menstrual cycle length,exposure windows for menstrual cycle length were designed.Daily concentrations of sulfur dioxide(SO2),nitrogen dioxide(NO2),particulate matters with the diameter≤2.5μm(PM2.5),and ozone(O3)were obtained from local air quality monitoring stations.Generalized linear model(GLM)was employed to evaluate the association of ambient air pollution exposure with total menstrual cycle length,follicular phase length,and luteal phase length during distinct exposure windows.SO2exposure level in Q4group were significantly associated with prolonged total menstrual cycle length during period 1(0.053;95%CI:0.022,0.083),period 2(0.049;95%CI:0.02,0.078),and period 3(0.045;95%CI:0.017,0.073).Furthermore,the effect of SO2exposure was particularly on the prolongation of follicular phase.Similarly,NO2exposure level in Q3 group were significantly associated with prolonged total menstrual cycle length during period 1(0.060;95CI:0.035,0.085),period 2(0.056;95CI:0.030,0.083),and period 3(0.050;95CI:0.025,0.075).PM2.5exposure level in Q3 group were significantly associated with prolonged total menstrual cycle length during period 1(0.043;95%CI:0.012,0.074)and period 2(0.049;95%CI:0.020,0.079).However,O3exposure level in Q4group were significantly associated with shortened follicular phase during period 1(-0.043;95%CI:-0.079,-0.003),period 2(-0.047;95%CI:-0.072,-0.022),and period 3(-0.046;95CI:-0.081,-0.011).In summary,follicular phase of menstrual cycle may be sensitive to ambient air pollution exposure.Moreover,the significant association of ambient air pollution exposure and menstrual cycle length was still observed even when exposed below Chinese existing standard levels.Our findings provided important reference evidence of precise formulation of atmospheric pollution control measures in China and accelerate implementation of regional health risk prevention policy.