Inhaled toxins: A threat to male reproductive health

Exposure to air pollutants is known to be an important risk factor in reducing semen quality in men across the world. Poor semen quality results in decline in the global fertility rate and significant personal stress, dysfunctional sexual relationships, and psychosocial problems. Continuous monitoring and effective efforts to reduce air pollution in industries and the environment and making positive changes in daily lifestyle can prevent adverse effects on semen quality and reduce the high prevalence of men infertility. This review aims to summarize studies associating pollutant concentrations of polycyclic aromatic hydrocarbons (PAHs), formaldehyde (FA), and BTEX (benzene, toluene, ethyl-benzene, and xylene) on semen quality. In this systematic review, Scopus, PubMed and Web of Science databases were searched until November 13, 2022. The PECO statement was formulated to clarify the research question, and articles that did not satisfy the criteria outlined in this statement were excluded. Generally, 497 articles were obtained through searching databases, and after the investigations, 26 articles that met the entry criteria were extracted and finally considered in the systematic review. The results showed that occupational and environmental exposures to PAHs, formaldehyde, and BTEX were associated with increased metabolite concentration of toxic pollutants in body fluids. These toxin-associated pollutants directly or indirectly cause detrimental effects on sperm motility, vitality, DNA fragmentation, and morphology. There is evidence on the impact of PAHs, formaldehyde, and BTEX pollutants on the reduction of semen quality. Therefore, proving the relationship between air pollutants and testicular function in semen quality can play an effective role in macro policies and adopting stricter laws to reduce the emission of air pollutants and promote a healthy lifestyle to improve reproductive health in young men.