Association between exposure to ambient air pollution and semen quality: A systematic review and meta-analysis

Abstract

Background: Accumulating evidence has linked exposure to ambient air pollution to a reduction in semen quality; however, the exposure-response associations are yet to be synthesized.

Objective: To summarize the exposure-response associations between air pollution and semen quality.

Methods: We systematically searched PubMed, Embase, and Web of Science for relevant studies published before April 20, 2022. Studies investigating the exposure-response association of PM_2.5, PM₁₀, SO₂, NO₂, CO, and O₃ with semen quality written in English were included. Semen quality parameters included semen volume, sperm concentration, total sperm number, total motility, progressive motility, and normal forms. Random-effects and fixed-effects models were performed to synthesize associations in the meta-analysis.

Results: The search returned 850 studies, 11 of which were eligible for meta-analysis. Each 10 μg/m³ increase of exposure to PM₁₀ and SO₂ was respectively associated with a 2.18 % (95 % confidence interval [CI]: 0.10 %-4.21 %) and 8.61 % (1.00 %-15.63 %) reduction in sperm concentration, and a 2.76 % (0.10 %-5.35 %) and 9.52 % (5.82 %-13.93 %) reduction in total sperm number. Each 10 μg/m³ increase of exposure to PM_2.5 and PM₁₀ was respectively associated with a 1.06 % (95 % CI: 0.31 %-1.82 %) and 0.75 % (0.43 %-1.08 %) reduction in total motility, and a 0.55 % (0.09 %-1.01 %) and 0.31 % (0.06 %-0.56 %) reduction in progressive motility. No association was observed for PM_2.5 or PM₁₀ with semen volume; PM_2.5, NO₂, CO, or O₃ with sperm concentration or total sperm number; and gaseous air pollutants with total or progressive motility. The association between air pollution and normal forms was not summarized due to insufficient number of studies. No significant publication bias was detected.

Conclusions: Exposure to ambient PM_2.5, PM₁₀, and SO₂ was inversely associated with sperm concentration, total sperm number, total motility, and/or progressive motility. Our findings add to the evidence that air pollution may lead to adverse effects on male reproductive system and suggest that reducing exposure to air pollution may help maintain better semen quality.

Keywords: Particulate matter; Progressive motility; Sperm concentration; Sulfur dioxide; Total motility; Total sperm number.