title: Risk of erectile dysfunction induced by arsenic exposure through well water consumption in Taiwan.
abstract: BACKGROUND
  Erectile dysfunction (ED) has a profound impact on the quality of life of many men. Many risk factors are associated with ED, such as aging, sex hormone levels, hypertension, cardiovascular diseases, and diabetes mellitus. Arsenic exposure could damage peripheral vessels and increase the risk of cardiovascular disease. However, the relationship between arsenic exposure and ED has seldom been evaluated.
  
  
  OBJECTIVE
  In this study we aimed to investigate whether exposure to arsenic enhances the risk of ED.
  
  
  METHODS
  We recruited 177 males >or= 50 years of age through health examinations conducted in three hospitals in Taiwan. We used a questionnaire (International Index of Erectile Function-5) to measure the level of erectile function. Sex hormones, including total testosterone and sex hormone-binding globulin, were determined by radioimmunoassay. We used another standardized questionnaire to collect background and behavioral information (e.g., cigarette smoking; alcohol, tea, or coffee drinking; and physical activity).
  
  
  RESULTS
  The prevalence of ED was greater in the arsenic-endemic area (83.3%) than in the non-arsenic-endemic area (66.7%). Subjects with arsenic exposure > 50 ppb had a significantly higher risk of developing ED than those with exposure <or= 50 ppb, after adjusting for age, cigarette smoking, diabetes mellitus, hypertension, and cardiovascular disease [odds ratio (OR) = 3.4]. Results also showed that the risk of developing severe ED was drastically enhanced by arsenic exposure (OR = 7.5), after adjusting for free testosterone and traditional risk factors of ED.
  
  
  CONCLUSIONS
  Results suggested that chronic arsenic exposure has a negative impact on erectile function.
authors.affiliation: School of Public Health, Topnotch Stroke Research Center, Taipei Medical University, Taipei 110, Taiwan.
authors.forename: Fang-I
authors.initials: FI
authors.lastname: Hsieh
authors.forename: Ti-Sheng
authors.initials: TS
authors.lastname: Hwang
authors.forename: Yi-Chen
authors.initials: YC
authors.lastname: Hsieh
authors.forename: Hsiu-Chiung
authors.initials: HC
authors.lastname: Lo
authors.forename: Chien-Tien
authors.initials: CT
authors.lastname: Su
authors.forename: Hui-Shing
authors.initials: HS
authors.lastname: Hsu
authors.forename: Hung-Yi
authors.initials: HY
authors.lastname: Chiou
authors.forename: Chien-Jen
authors.initials: CJ
authors.lastname: Chen
mesh_terms: D000368:Aged; D001151:Arsenic / Q000633:toxicity*; D004781:Environmental Exposure / Q000009:adverse effects*; D007172:Erectile Dysfunction / Q000139:chemically induced / Q000453:epidemiology*; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment; D013624:Taiwan / Q000453:epidemiology; D014874:Water Pollutants, Chemical / Q000633:toxicity*; D014881:Water Supply
chemical_list: D014874:Water Pollutants, Chemical; D001151:Arsenic