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Association Between Long-Term Ambient Air Pollution and Erectile Dysfunction in Taiwan: A Nationwide Cohort Study
Shu-Han Chuang1, Yu-Hsin Chen2, Yu-Pin Chen3,4
1Department of Ophthalmology, Changhua Christian Hospital, Changhua, Taiwan.
Andrology
|May 9, 2026
Summary
Long-term exposure to air pollution significantly increases erectile dysfunction (ED) risk in men. While most pollutants pose a threat, ozone may offer protective effects, suggesting complex environmental impacts on sexual health.
Area of Science:
- Environmental Health
- Men's Health
- Cardiovascular Health
Background:
- Erectile dysfunction (ED) is a common condition with significant vascular and systemic health implications.
- The link between air pollution and chronic diseases is established, but its specific association with ED requires further investigation.
Purpose of the Study:
- To examine the relationship between prolonged exposure to various ambient air pollutants and the incidence of ED in Taiwanese men.
- To identify specific air pollutants contributing to ED risk.
Main Methods:
- A retrospective nationwide cohort study utilized Taiwan's National Health Insurance Research Database (2000-2013).
- Ten-year cumulative exposures to 11 air pollutants were estimated based on residential postal codes.
- Cox regression models, adjusted for confounders, were employed to assess ED risk.
Main Results:
- Increased risk of ED was observed with higher cumulative exposure to sulfur dioxide (SO2), carbon monoxide (CO), particulate matter (PM10, PM2.5), nitrogen oxides (NOx, NO, NO2), and hydrocarbons (THC, NMHC, CH4).
- Each 1-SD increase in these pollutants was linked to significantly elevated ED risk (adjusted HRs 1.45-2.65).
- Ozone (O3) exposure showed an inverse association with ED risk (HR 0.45).
Conclusions:
- Chronic exposure to most ambient air pollutants is associated with an increased risk of ED.
- Potential mechanisms include vascular, endocrine, and inflammatory pathways.
- Ozone may have paradoxical protective effects, warranting further research into its role in men's sexual health.
