Urinary trichloroacetic acid levels and semen quality: a hospital-based cross-sectional study in Wuhan, China.
Toxicological studies indicate an association between exposure to disinfection by-products (DBPs) and impaired male reproductive health in animals. However, epidemiological evidence in humans is still limited. We conducted a hospital-based cross-sectional study to investigate the effect of exposure to DBPs on semen quality in humans. Between May 2008 and July 2008, we recruited 418 male partners in sub-fertile couples seeking infertility medical instruction or assisted reproduction services from the Tongji Hospital in Wuhan, China. Major semen parameters analyzed included sperm concentration, motility, and morphology. Exposure to DBPs was estimated by their urinary creatinine-adjusted trichloroacetic (TCAA) concentrations that were measured with the gas chromatography/electron capture detection method. We used linear regression to assess the relationship between exposure to DBPs and semen quality. According to the World Health Organization criteria (<20 million/mL for sperm concentration and <50% motile for sperm motility) and threshold value recommended by Guzick (<9% for sperm morphology), there were 265 men with all parameters at or above the reference values, 33 men below the reference sperm concentration, 151 men below the reference sperm motility, and 6 men below the reference sperm morphology. The mean (median) urinary creatinine-adjusted TCAA concentration was 9.2 (5.1) μg/g creatinine. Linear regression analyses indicated no significant association of sperm concentration, sperm count, and sperm morphology with urinary TCAA levels. Compared with those in the lowest quartile of creatinine-adjusted urinary TCAA concentrations, subjects in the second and third quartiles had a decrease of 5.1% (95% CI: 0.6%, 9.7%) and 4.7% (95% CI: 0.2%, 9.2%) in percent motility, respectively. However, these associations were not significant after adjustment for age, abstinence time, and smoking status. The present study provides suggestive but inconclusive evidence of the relationship between decreased sperm motility and increased urinary TCAA levels. The effect of exposure to DBPs on human male reproductive health in Chinese populations still warrants further investigations.
Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, 430030 Wuhan, People's Republic of China.
Shao-Hua
SH
Xie
Yu-Feng
YF
Li
Yin-Feng
YF
Tan
Dan
D
Zheng
Ai-Lin
AL
Liu
Hong
H
Xie
Wen-Qing
WQ
Lu
D000328:Adult; D015415:Biomarkers / Q000652:urine; D002681:China; D003404:Creatinine / Q000652:urine; D003430:Cross-Sectional Studies; D004202:Disinfectants / Q000633:toxicity / Q000652:urine*; D004781:Environmental Exposure / Q000032:analysis / Q000706:statistics & numerical data; D006761:Hospitals; D006801:Humans; D008297:Male; D012661:Semen / Q000187:drug effects*; D055101:Semen Analysis; D011795:Surveys and Questionnaires; D014238:Trichloroacetic Acid / Q000633:toxicity / Q000652:urine*
D015415:Biomarkers; D004202:Disinfectants; D014238:Trichloroacetic Acid; D003404:Creatinine