Risk of Polycystic Ovary Syndrome in Women Exposed to Fine Air Pollutants and Acidic Gases: A Nationwide Cohort Analysis

Shih-Yi Lin; Yu-Cih Yang; Cherry Yin-Yi Chang; Cheng-Chieh Lin; Wu-Huei Hsu; Shu-Woei Ju; Chung-Y Hsu; Chia-Hung Kao

doi:10.3390/ijerph16234816

Risk of Polycystic Ovary Syndrome in Women Exposed to Fine Air Pollutants and Acidic Gases: A Nationwide Cohort Analysis

Int J Environ Res Public Health. 2019 Nov 30;16(23):4816. doi: 10.3390/ijerph16234816.

Authors

Shih-Yi Lin^{1

2}, Yu-Cih Yang^{3

4}, Cherry Yin-Yi Chang^{1

5}, Cheng-Chieh Lin^{1

6}, Wu-Huei Hsu^{1

7}, Shu-Woei Ju^{1

2}, Chung-Y Hsu¹, Chia-Hung Kao^{1

8

9

10}

Affiliations

¹ Graduate Institute of Biomedical Sciences and School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung 40447, Taiwan.
² Division of Nephrology and Kidney Institute, China Medical University Hospital, Taichung 40402, Taiwan.
³ Management Office for Health Data, China Medical University Hospital, Taichung 40402, Taiwan.
⁴ College of Medicine, China Medical University, Taichung 40402, Taiwan.
⁵ Department of Gynecology, China Medical University Hospital, Taichung 40402, Taiwan.
⁶ Department of Family Medicine, China Medical University Hospital, Taichung 40402, Taiwan.
⁷ Department of Chest Medicine, China Medical University Hospital, Taichung 40402, Taiwan.
⁸ Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung 40402, Taiwan.
⁹ Department of Bioinformatics and Medical Engineering, Asia University, Taichung, 40402, Taiwan.
¹⁰ Center of Augmented Intelligence in Healthcare, China Medical University Hospital, Taichung, 40402, Taiwan.

Abstract

Background: Air pollutants cause endocrine disorders and hormone disruption. The relationship between air pollutants and polycystic ovary syndrome (PCOS) must be carefully investigated using a nationwide cohort.

Methods: Data were extracted from two nationwide databases, namely Longitudinal Health Insurance Database and Taiwan Air Quality Monitoring Database, and analyzed. The study considered a range of data that began on 1 January 2000 and ended on 31 December 2013. Women diagnosed with PCOS were excluded. From the residential data, the study assessed the daily concentrations of sulfur dioxide (SO₂), nitrogen oxides (NOx), nitrogen monoxide (NO), nitrogen dioxide (NO₂), and PM_2.5 the women were exposed to. A Cox proportional hazard regression model was applied to assess PCOS risk.

Results: In total, 91,803 women were enrolled in this study; of those women, 2072 developed PCOS after 12 years of follow-up. The mean daily concentrations of SO₂, NOx, NO, NO₂, and PM_2.5 women were exposed to were 4.25 (±1.44) ppb, 20.41 (±6.65) ppb, 9.25 (±4.36) ppb, 20.99 (±3.33) ppb, and 30.85 (±6.16) μg/m³, respectively. Compared with the first-quartile levels of exposure, the fourth-quartile levels of exposure to SO₂, NOx, NO, NO₂, and PM_2.5 increased PCOS risk by 10.31 times (95% CI = 8.35-12.7), 3.37 times (95% CI = 2.86-3.96), 4.18 times (95% CI = 3.57-4.89), 7.46 times (95% CI = 6.38-8.71), and 3.56 times (95% CI = 3.05-4.15), respectively.

Conclusion: Women exposed to a high concentrations of air pollutants, namely SO₂, NO, NO₂, NOx, and PM_2.5, had a high PCOS risk.

Keywords: Taiwan air quality; air pollutants; monitoring database; polycystic ovary syndrome (PCOS).

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Air Pollutants / analysis*
Cohort Studies
Databases, Factual
Female
Humans
Middle Aged
Nitrogen Oxides / analysis*
Particulate Matter / analysis*
Polycystic Ovary Syndrome / epidemiology*
Sulfur Dioxide / analysis*
Taiwan / epidemiology
Young Adult

Substances

Air Pollutants
Nitrogen Oxides
Particulate Matter
Sulfur Dioxide