Association of atmospheric pollution exposure with menstrual cycle length among fertile women
FENG Xiao-qin1,2, LUO Jin-hong3, XIE Wo-long3, WANG Na3, QIN Guo-hua1
1. College of Environment and Resource, Research Center of Environment and Health, Shanxi University, Taiyuan 030006, China; 2. Department of Reproductive Medicine, Shanxi Provincial People's Hospital, Taiyuan 030012, China; 3. Shanxi Consulting Service Center for Eco-Environmental Protection, Shanxi Academy for Environmental Planning, Taiyuan 030002, China
Abstract: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. SO2 exposure level in Q4 group 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 SO2 exposure was particularly on the prolongation of follicular phase. Similarly, NO2 exposure 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). PM2.5 exposure 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, O3 exposure 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.
Srám R J, Binková B, Dejmek J, et al. Ambient air pollution and pregnancy outcomes:a review of the literature[J]. Environ. Health Perspect., 2005,113(4):375-382.
[2]
Klepac P, Locatelli I, Korošec S, et al. Ambient air pollution and pregnancy outcomes:A comprehensive review and identification of environmental public health challenges[J]. Environ. Res., 2018,167:144-159.
[3]
Mahalingaiah S, Missmer S E, Cheng J J, et al. Perimenarchal air pollution exposure and menstrual disorders[J]. Hum. Reprod., 2018, 33(3):512-519.
[4]
Mahalingaiah S, Hart J E, Laden F, et al. Adult air pollution exposure and risk of infertility in the Nurses' Health Study II[J]. Hum. Reprod., 2016,31(3):638-647.
[5]
Giorgis-Allemand L, Thalabard J C, Rosetta L, et al. Can atmospheric pollutants influence menstrual cycle function?[J]. Environ. Pollut., 2020,257:113605.
[6]
Li H, Hart JE, Mahalingaiah S, et al. Long-term exposure to particulate matter and roadway proximity with age at natural menopause in the Nurses' Health Study II Cohort[J]. Environ. Pollut., 2021,269:116216.
[7]
Hwang S, Hood RB, Hauser R, et al. Using follicular fluid metabolomics to investigate the association between air pollution and oocyte quality[J]. Environ. Int., 2022,169:107552.
[8]
Feng X, Luo J, Wang X, et al. Association of exposure to ambient air pollution with ovarian reserve among women in Shanxi province of north China[J]. Environ. Pollut., 2021,278:116868.
[9]
谢幸,孔北华,段涛.妇产科学[M]. 北京:人民卫生出版社, 2018:22-29. Xie X, Kong B H, Duan T. Obstetrics and gynecology[M]. Beijing:People's Medical Press, 2018:22-29.
[10]
Baerwald A R, Adams G P, Pierson R A. Ovarian antral folliculogenesis during the human menstrual cycle:a review[J]. Hum. Reprod. Update, 2012,18(1):73-91.
[11]
Liang Z, Xu C, Fan Y N, et al. Association between air pollution and menstrual disorder outpatient visits:A time-series analysis[J]. Ecotoxicol. Environ. Saf., 2020,192:110283.
[12]
Shen G, Tao S, Wei S, et al. Field measurement of emission factors of PM, EC, OC, parent, nitro-, and oxy- polycyclic aromatic hydrocarbons for residential briquette, coal cake, and wood in rural Shanxi, China[J]. Environ. Sci. Technol., 2013,47(6):2998-3005.
[13]
李洋,唐伟,杜谨宏,等."2+26"城市秋冬季大气污染治理措施效果评估[J]. 中国环境科学, 2021,41(10):4484-4494. Li Y, Tang W, Du J H, et al. Assessment on air pollution control measures during autumn and winter seasons in "2+26" cities[J]. China Environmental Science, 2021,41(10):4484-4494.
[14]
中华人民共和国生态环境部.2020中国生态环境状况公报[EB/OL]. https://www.mee.gov.cn/hjzl/sthjzk/zghjzkgb/202105/P020210526572756184785. MEE of PRC. 2020 Bulletin of the State of China's Ecological Environment[EB/OL]. https://www.mee.gov.cn/hjzl/sthjzk/zghjzkgb/202105/P020210526572756184785.
[15]
Younis J S, Iskander R, Fauser B C J M, et al. Does an association exist between menstrual cycle length within the normal range and ovarian reserve biomarkers during the reproductive years? A systematic review and meta-analysis[J]. Hum. Reprod. Update, 2020, 26(6):904-928.
[16]
Campbell L R, Scalise A L, DiBenedictis B T, et al. Menstrual cycle length and modern living:a review[J]. Curr. Opin. Endocrinol. Diabetes Obes., 2021,28(6):566-573.
[17]
Liu Z, Lei Y, Xue W, et al. Mitigating China's ozone pollution with more balanced health benefits[J]. Environ. Sci. Technol., 2022,19.
[18]
HEI. State of Global Air 2020[EB/OL]. https://www.stateofglobalair.org/.
[19]
Li X, Jin L, Kan H m, et al. Air pollution:a global problem needs local fixes[J]. Nature, 2019,570(7762):437-439.
[20]
Weagle C L, Snider G, Li C, et al. Global sources of fine particulate matter:interpretation of PM2.5 chemical composition observed by SPARTAN using a global chemical transport model[J]. Environ. Sci. Technol., 2018,52(20):11670-11681.
[21]
Deng J, Wang X, Wei Z, et al. A review of NOx and SOx emission reduction technologies for marine diesel engines and the potential evaluation of liquefied natural gas fuelled vessels[J]. Sci. Total Environ., 2021,766:144319.
[22]
Mikhael S, Punjala-Patel A, Gavrilova-Jordan L. Hypothalamic- pituitary-ovarian axis disorders impacting female fertility[J]. Biomedicines, 2019,7(1):5.
[23]
Wang L, Luo D, Liu X, et al. Effects of PM2.5 exposure on reproductive system and its mechanisms[J]. Chemosphere, 2021, 264(1):128436.
[24]
Luderer U, Christensen F, Johnson W O, et al. Associations between urinary biomarkers of polycyclic aromatic hydrocarbon exposure and reproductive function during menstrual cycles in women[J]. Environ. Int., 2017,100:110-120.
[25]
Takeda K, Tsukue N, Yoshida S. Endocrine-disrupting activity of chemicals in diesel exhaust and diesel exhaust particles[J]. Environ. Sci., 2004,11(1):33-45.
[26]
Gai H F, An J X, Qian X Y, et al. Ovarian damages produced by aerosolized fine particulate matter (PM2.5) pollution in mice:Possible protective medications and mechanisms[J]. Chin. Med. J. (Engl), 2017,130(12):1400-1410.
[27]
Niu Y, Chen R, Xia Y, et al. Fine particulate matter constituents and stress hormones in the hypothalamus-pituitary-adrenal axis[J]. Environ. Int., 2018,119:186-192.
[28]
Fuentes N, Cabello N, Nicoleau M, et al. Modulation of the lung inflammatory response to ozone by the estrous cycle[J]. Physiol. Rep., 2019,7(5):e14026.
[29]
Peixoto M S, de Oliveira Galvão M F, Batistuzzo de Medeiros S R. Cell death pathways of particulate matter toxicity[J]. Chemosphere, 2017,188:32-48.