Impacts of Air Pollution on Gynecologic Disease: Infertility, Menstrual Irregularity, Uterine Fibroids, and Endometriosis: a Systematic Review and Commentary
Purpose of Review
Air pollution is widely known to affect human cardiopulmonary health, but only recently has research begun to focus on understanding the association between ambient air pollution and reproductive health and gynecologic disease incidence. In this article, we conducted a systematic literature review to examine studies conducted to evaluate the association between air pollution and the heterogeneous gynecologic diseases of infertility, menstrual irregularity, uterine fibroids, and endometriosis. In this review, the authors discuss exposure assessment considerations, outcome definitions, statistical analyses, and relevant biological mechanisms, and also provide ideas for future directions of research.
Emerging literature evaluated associations between gynecologic diseases of infertility, menstrual irregularity, uterine fibroids, and endometriosis with air pollution exposures, specifically fine particulate matter (particles ≤ 2.5 μm in aerodynamic diameter [PM2.5]), coarse particulate matter (particles 2.5–10 μm in aerodynamic diameter [PM2.5–10]), traffic-related pollutants (NO2, NOx), and proximity to major roadways. Suggestive associations have been observed with distance to road and traffic exposures with incident infertility, fertility rates, and menstrual cycle irregularity. However, to date, the number of studies examining similar exposures and outcomes has been quite limited.
While initial studies suggest a potential relationship between air pollution and both infertility and menstrual irregularity, more studies need to be performed to validate these findings in other datasets and populations.
KeywordsAir pollution Uterine fibroids Infertility Endometriosis Menstrual irregularity Fine particulate matter
SM would like to acknowledge the Building Interdisciplinary Research Careers in Womens Health (HD043444 BIRCWH K12) and the Reproductive Scientist Development Program (HD000849 RSDP K12) for funding and support of the research team to conduct the series of papers noted in this review on air pollution and gynecologic disease incidence. SM would like to acknowledge the Boston University Superfund Research Program (BU SRP) for support during post-doctoral work on this topic. JEH was supported by P30 ES000002.
Compliance with Ethical Standards
Conflict of Interest
Shruthi Mahalingaiah, Kevin J. Lane, Chanmin Kim, J. Jojo Cheng, and Jaime E. Hart declare no conflicts of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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