The exposure to formaldehyde in industries and health care centers: A systematic review and probabilistic health risk assessment

Carcinogenic formaldehyde in U.S. residential buildings: Mass inventories, human health impacts, and associated healthcare costs

Formaldehyde, a human carcinogen, is formulated into building materials in the U.S. and worldwide. We used literature information and mass balances to obtain order-of-magnitude estimates of formaldehyde inventories in U.S. residential buildings as well as associated exposures, excess morbidity, and healthcare costs along with other economic ramifications. Use of formaldehyde in building materials dates to the 1940s and continues today unabated, despite its international classification in 2004 as a human carcinogen. Global production of formaldehyde was about 32 million metric tons (MMT) in 2006. In the U.S., 5.7 ± 0.05 to 7.4 ± 0.125 MMT of formaldehyde were produced annually from 2006 to 2022, with 65 ± 5 % of this mass (3.7 ± 0.03 to 4.8 ± 0.08 MMT) entering building materials. For a typical U.S. residential building constructed in 2022, we determined an average total mass of formaldehyde containing chemicals of 48.2 ± 10.1 kg, equivalent to 207 ± 40 g of neat formaldehyde per housing unit. When extrapolated to the entire U.S. housing stock, this equates to 29,800 ± 5760 metric tons of neat formaldehyde. If the health threshold in indoor air of 0.1 mg/m3 is never surpassed in a residential building, safe venting of embedded formaldehyde would take years. Using reported indoor air exceedances, up to 645 ± 33 excess cancer cases may occur U.S. nationwide annually generating up to US$65 M in cancer treatment costs alone, not counting ~16,000 ± 1000 disability adjusted life-years. Other documents showed health effects of formaldehyde exist, but could not be quantified reliably, including sick building syndrome outcomes such as headache, asthma, and various respiratory illnesses. Opportunities to improve indoor air exposure assessments are discussed with special emphasis on monitoring of building wastewater. Safer alternatives to formaldehyde in building products exist and are recommended for future use.

Construction of a turn-on fluorescent probe for detecting formaldehyde in biological systems and real food samples

The monitoring of formaldehyde (FA) in biosystems and real foods is critical for ensuring human health and food safety. However, the development of effective and highly selective assays for sensing FA in organisms and real food samples remains challenging. Herein, a hydrophilic group-modified the probe (Nap-FA) was reported, which utilizes the specific chemical reaction between FA and hydrazino to trigger a "turn-on" fluorescence response. The probe Nap-FA displayed superior selectivity, high sensitivity, good photostability and a low detection limit in the reaction with FA. Notably, Nap-FA has been successfully used for imaging FA in cells, zebrafish, and plant root tissues. In addition, the rationally constructed probe Nap-FA could rapidly and visually detect FA in real food samples. This work provides a prospective approach for monitoring FA in complex biological systems and food fields.

The practical utility of ternary nickel-cobalt-manganese oxide-supported platinum catalysts for room-temperature oxidative removal of formaldehyde from the air

Formaldehyde (FA), a carcinogenic oxygenated volatile organic compound, is present ubiquitously in indoor air. As such, it is generally regarded as a critical target for air quality management. The oxidative removal of FA under dark and room-temperature (RT) conditions is of practical significance. A series of ternary nickel-cobalt-manganese oxide-supported platinum catalysts (Pt/NiCoMnO4) have been synthesized for FA oxidative removal at RT in the dark. Their RT conversion values for 50 ppm FA (XFA) at 5,964 h-1 gas hourly space velocity (GHSV) decrease in the following order: 1 wt% Pt/NiCoMnO4 (100 %) > 0.5 wt% Pt/NiCoMnO4 (25 %) > 0.05 wt% Pt/NiCoMnO4 (14 %) > NiCoMnO4 (6 %). The catalytic performance of 1 wt% Pt/NiCoMnO4 has been examined further under the control of various process variables (e.g., catalyst mass, flow rate, relative humidity, FA concentration, time on stream, and molecular oxygen content). The catalytic oxidation of FA at low temperatures (e.g., RT and 60 °C) is accounted for by Langmuir-Hinshelwood mechanism (single-site competitive-adsorption), while Mars van Krevelen kinetics is prevalent at higher temperatures. In situ diffuse-reflectance infrared Fourier-transform spectroscopy reveals that FA oxidation proceeds through a series of reaction intermediates such as DOM, HCOO-, and CO32-. Based on the density functional theory simulations, the unique electronic structures of the nearest surface atoms (platinum and nickel) are suggested to be responsible for the superior catalytic activity of Pt/NiCoMnO4.

Comparative study of polycarboxylic acids for sustainable crosslinking of silk fabrics: Evaluating flame retardancy and physical performances

For protein fibers, polycarboxylic acids represent a green strategy to enhance durability without using formaldehyde. This study evaluated the physical and flame retardant properties of silk fabrics treated with three formaldehyde-free crosslinkers: citric acid (CA), 1,2,3,4-butanetetracarboxylic acid (BTCA), and 2-phosphonobutane-1,2,4-tricarboxylic acid (PBTCA). Results showed that these acids bond with silk protein through esterification and amidation, improving washing durability. Particularly, PBTCA integrates phosphorus into silk, boosting flame retardancy. While BTCA led to the highest weight gain and improved wrinkle recovery, it negatively impacted the tensile strength and softness of silk fabrics. Conversely, PBTCA adeptly balanced enhanced wrinkle resistance with minimal effects on tensile strength and softness, and least affected the silk fabrics' whiteness, thus preserving its aesthetic appeal. All crosslinkers improved flame retardancy, but PBTCA displayed superior performance, achieving a limiting oxygen index of 32.4 % at an 80 g/L concentration. In vertical burning tests, PBTCA treated silk fabrics showed reductions in damage length and demonstrated self-extinguishing properties, qualifying them for a higher flame retardant grade. Phosphorus in PBTCA promotes char formation during combustion, essential for effective flame retardation and smoke reduction. This research highlights the exceptional potential of silk treated with PBTCA, showcasing its suitability for demanding applications.

Multi-sensor monitoring and analysis of indoor pollutant emissions in response to laser cutter operating conditions

This study analyzed pollutant emissions from laser cutters used in modeling in a laboratory, which can have harmful effects on indoor air quality and health. Four conditions were tested: material thickness, laser cutter strength, minimum strength per thickness, and air purifier level. Four pollutants were analyzed: PM2.5, HCHO, VOCs, and CO2. The study found that the emissions of PM2.5, HCHO, and VOCs increased with paperboard thickness, while CO2 emissions were not significant. PM2.5 was more affected by laser cutting strength, while HCHO and VOCs were more affected by paperboard thickness. Additionally, we analyzed the PM2.5 emission rates based on the thickness of the paperboard and the laser cutting strength. Therefore, emission rates based on thickness and laser cutting strength ranged from 7275 to 18,783 μg/min. The air purifier significantly reduced PM2.5 but not HCHO and VOCs. To reduce these gaseous pollutants, combining mechanical ventilation or using an air purifier with a filter that adsorbs HCHO and VOCs is effective. This study highlights the importance of considering laser cutters as a potential source of indoor air pollutants and implementing measures to mitigate their harmful effects.

What are the DNA lesions underlying formaldehyde toxicity?

Formaldehyde is a highly reactive organic compound. Humans can be exposed to exogenous sources of formaldehyde, but formaldehyde is also produced endogenously as a byproduct of cellular metabolism. Because formaldehyde can react with DNA, it is considered a major endogenous source of DNA damage. However, the nature of the lesions underlying formaldehyde toxicity in cells remains vastly unknown. Here, we review the current knowledge of the different types of nucleic acid lesions that are induced by formaldehyde and describe the repair pathways known to counteract formaldehyde toxicity. Taking this knowledge together, we discuss and speculate on the predominant lesions generated by formaldehyde, which underly its natural toxicity.

Occupational exposure, carcinogenic and non-carcinogenic risk assessment of formaldehyde in the pathology labs of hospitals in Iran

Formaldehyde, a known carcinogenic compound, is commonly used in various medical settings. The objective of this study was to assess the carcinogenic and non-carcinogenic risks associated with occupational exposure to formaldehyde. This study was conducted in the pathology labs of four hospitals in Tehran. Cancer and non-cancer risks were evaluated using the quantitative risk assessment method proposed by the United States environmental protection agency (USEPA), along with its provided database known as the integrated risk information system (IRIS). Respiratory symptoms were assessed using the American thoracic society (ATS) questionnaire. The results indicated that 91.23% of exposure levels in occupational groups exceed the NIOSH standard of 0.016 ppm. Regarding carcinogenic risk, 41.03% of all the studied subjects were in the definite carcinogenic risk range (LCR > 10-4), 23.08% were in the possible carcinogenic risk range (10-5 < LCR < 10-4), and 35.90% were in the negligible risk range (LCR < 10-6). The highest index of occupational carcinogenesis was observed in the group of lab technicians with a risk number of 3.7 × 10-4, followed by pathologists with a risk number of 1.7 × 10-4. Furthermore, 23.08% of the studied subjects were within the permitted health risk range (HQ < 1.0), while 76.92% were within the unhealthy risk range (HQ > 1.0). Overall, the findings revealed significantly higher carcinogenic and non-carcinogenic risks among lab technicians and pathologists. Therefore, it is imperative to implement control measures across various hospital departments to mitigate occupational formaldehyde exposure levels proactively. These findings can be valuable for policymakers in the health sector, aiding in the elimination or reduction of airborne formaldehyde exposure in work environments.

Formaldehyde Exposure Racial Disparities in Southeast Texas

Formaldehyde (HCHO) exposures during a full year were calculated for different race/ethnicity groups living in Southeast Texas using a chemical transport model tagged to track nine emission categories. Petroleum and industrial emissions were the largest anthropogenic sources of HCHO exposure in Southeast Texas, accounting for 44% of the total HCHO population exposure. Approximately 50% of the HCHO exposures associated with petroleum and industrial sources were directly emitted (primary), while the other 50% formed in the atmosphere (secondary) from precursor emissions of reactive compounds such as ethylene and propylene. Biogenic emissions also formed secondary HCHO that accounted for 11% of the total population-weighted exposure across the study domain. Off-road equipment contributed 3.7% to total population-weighted exposure in Houston, while natural gas combustion contributed 5% in Beaumont. Mobile sources accounted for 3.7% of the total HCHO population exposure, with less than 10% secondary contribution. Exposure disparity patterns changed with the location. Hispanic and Latino residents were exposed to HCHO concentrations +1.75% above average in Houston due to petroleum and industrial sources and natural gas sources. Black and African American residents in Beaumont were exposed to HCHO concentrations +7% above average due to petroleum and industrial sources, off-road equipment, and food cooking. Asian residents in Beaumont were exposed to HCHO concentrations that were +2.5% above average due to HCHO associated with petroleum and industrial sources, off-road vehicles, and food cooking. White residents were exposed to below average HCHO concentrations in all domains because their homes were located further from primary HCHO emission sources. Given the unique features of the exposure disparities in each region, tailored solutions should be developed by local stakeholders. Potential options to consider in the development of those solutions include modifying processes to reduce emissions, installing control equipment to capture emissions, or increasing the distance between industrial sources and residential neighborhoods.

A novel low sampling rate and cost-efficient active sampler for medium/long-term monitoring of gaseous pollutants

Active sampling is a dependable approach for gaseous pollutants monitoring, offering high accuracy and precision that is unaffected by environmental factors such as wind and temperature in comparison to passive sampling. To measure long-term average concentrations while minimizing the use of materials, a reduced sampling rate is necessary. Thus, this study aims to develop a novel low sampling rate (down to 1 mL/min) and cost-efficient active sampler (LASP) for medium/long-term monitoring of gaseous pollutants. The LASP mainly consisted of a syringe pump, a Y-shaped fitting with two one-way valves, and a control unit for intermittent operation. Results showed that LASP can obtain a sampling rate of less than 1 mL/min and sampling rate exhibited a high level of stability. Daily average concentrations measurements for nitrogen dioxide and formaldehyde by LASP had normalized mean biases of 2.8% and 5.2%, respectively. These numbers were - 5.8% and 6.1% for weekly-average samplings. This study demonstrated applications of LASP in real outdoor (daily-average) and indoor (weekly-average) air quality measurements. It worked well with low noise levels, and without interfering with occupants' daily activities. LASP can assist in improving our ability to monitor air quality and pollutants emissions, thereby supporting health research and policy development. ENVIRONMENTAL IMPLICATION: Gaseous air pollution is an important hazardous factor threatening human health. Medium/long-term air quality monitoring is essential for outdoor and indoor air quality assessment and control. However, air sampler for medium/long-term sampling is lacking. This study developed a novel low sampling rate and cost-efficient active sampler and applied it to medium/long-term air sampling. The sampler can work at a sampling rate of less than 1 mL/min. This technology provides a feasible strategy for medium/long-term monitoring of gaseous air pollutants in both environments and emission hotspots.

Evaluation of a Novel Fixative Solution for Liquid-Based Cytology in Diagnostic Cytopathology

Since its introduction in the early 2000s, liquid-based cytology (LBC) has been increasingly used for gynecologic and non-gynecologic cytology, and its multiple advantages have been widely recognized. The aim of this study was to investigate the use of a new fixative and pre-analytical method for morphological diagnosis in cytological samples. In particular, we evaluated the effect of a novel preservative solution on the preparation of diagnostic slides by comparing it with the standard reference used globally in cytology laboratories. This study included both gynecological (n = 139) and non-gynecological (n = 183) samples. Several morphologic variables were then identified and evaluated. Using this approach, we were then able to demonstrate the suitability of the new system, with improved safety, to be integrated within current pathology clinical practice. Overall, using a safer preservative solution, the study shows no statistical difference (and then non-inferiority) in the new fixation protocol compared with the standard reference used in routine practice in terms of diagnostic adequacy, evaluated both in clinically relevant gyn and non-gyn datasets.

The impact of operational factors on degradation of formaldehyde as a human carcinogen using Ag3 PO4 /TiO2 photocatalyst

Background: The International Agency for Research on Cancer (IARC) identified formaldehyde as a carcinogen in 2004, yet formaldehyde is widely used in health care settings and various industries. In recent years, photocatalytic oxidation has been developed as a potential technique for removing pollutants arising from organic chemical agents and consequently promoting the health indices. This study investigated the effect of operational factors in optimizing formaldehyde removal from the air using Ag₃ PO₄ /TiO₂ photocatalyst. Methods: An experimental study was designed to investigate the effect of operational factors on the efficiency of formaldehyde degradation. The variables investigated in this study include pollutant retention time, initial pollutant concentration and relative humidity. Sol-gel method was used to synthesize the nano-composite photocatalyst. An ideal experimental design was carried out based on Box-Behnken design (BBD) with response surface methodology (RSM). The sample size in this study includes all the glasses coated with Ag₃ PO₄ /TiO₂ photocatalyst. Results: The maximum formaldehyde degradation of 32% was obtained at the initial concentration of 2 ppm, 20% relative humidity, and 90 minutes of retention time. Based on the statistical results, the correlation coefficient of the present study for the impact of operational factors on formaldehyde degradation was 0.9635, which means that there is only 3.65% probability of error in the model. Conclusion: The operational factors examined in this study (retention time, relative humidity, and initial formaldehyde concentration) were significantly influential in the degradation efficiency of formaldehyde by the photocatalyst. Due to the high exposure of employees and clients of health and treatment centers to formaldehyde as a carcinogenic substance, the results of this study can be used in ventilation systems to remove environmental pollutants in health care centers and other occupational settings.

Formaldehyde exacerbates asthma in mice through the potentiation of HIF-1α-mediated pro-inflammatory responses in pulmonary macrophages

Exposure to formaldehyde (FA) has been indicated to be positively correlated with increased incidence of allergic asthma in many epidemiological and experimental studies. However, few studies have ever addressed the molecular basis of the correlation. In the present study, it was found that inhaling 2.0 mg/m³ FA for 2 weeks could exacerbate the pulmonary inflammation and mucus over-accumulation in OVA-induced murine asthmatic model. The pro-inflammatory cytokines, such as IL-1β, TNF-α, IL-6 and IL-8, were increased in lung and serum of FA-exposed asthmatic mice. The contribution of HIF-1α signaling in FA-exacerbated allergic asthma was confirmed by bioinformatic analysis. HIF-1α and its downstream proteins, which are known as mediators of glycolysis, were found to be upregulated by 50 μM FA, and the FA-enhanced of glycolysis was reversed by inhibition of HIF-1α with PX-478 in vitro and YC-1 in vivo. Furthermore, it was confirmed that inhibition of HIF-1α signaling could restrain the macrophagic inflammatory responses and asthma exacerbation induced by FA. Collectively, these results revealed that FA could exacerbate asthma through the potentiation of HIF-1α-mediated inflammatory responses in macrophages, which also indicated the universal roles of FA-triggered macrophage metabolic and functional alterations in inflammatory or allergic diseases.

Electrochemical and Optical Sensors for the Detection of Chemical Carcinogens Causing Leukemia

The incidence and mortality due to neoplastic diseases have shown an increasing tendency over the years. Based on GLOBOCAN 2020 published by the International Agency for Research on Cancer (IARC), leukemias are the thirteenth most commonly diagnosed cancer in the world, with 78.6% of leukemia cases diagnosed in countries with a very high or high Human Development Index (HDI). Carcinogenesis is a complex process initiated by a mutation in DNA that may be caused by chemical carcinogens present in polluted environments and human diet. The IARC has identified 122 human carcinogens, e.g., benzene, formaldehyde, pentachlorophenol, and 93 probable human carcinogens, e.g., styrene, diazinone. The aim of the following review is to present the chemical carcinogens involved or likely to be involved in the pathogenesis of leukemia and to summarize the latest reports on the possibility of detecting these compounds in the environment or food with the use of electrochemical sensors.

A multistage fractal-like tree network model to predict VOC diffusion characteristic of indoor fabrics

Understanding the coupling mechanism between multi-material pollution sources and sinks is key to predicting the pollution load. Indoor fabric materials strongly adsorb volatile organic compounds (VOCs) owing to their high loading rates and large specific surface areas. The secondary source effects generated by their desorption easily aggravates indoor air pollution and prolongs the pollution period. The existing research conclusions on the VOC mass-transfer properties of building materials are difficult to apply directly to fabrics due to their multilayered anisotropic fiber-interlaced structure. In this study, the triple porous structure of the fabrics was characterized, and the mass-transfer network were analyzed. Moreover, a multistage fractal-like tree network model was proposed to characterize the fabric's pore structure and establish a theoretical prediction model of the VOC diffusion coefficient. Subsequently, the mass-transfer characteristic parameters of the fabrics were measured at different ambient temperatures through loading and emission experiments of formaldehyde, benzene, toluene, ethylbenzene, and xylene (BTEX) on typical indoor fabrics. A comparison of the experimentally determined and theoretically predicted values revealed that the proposed model could accurately predict the diffusion coefficient of fabrics. This study can help understand the dynamic source and sink characteristics of fabrics in an indoor environment.

Sapropel as a Binding Material for Wood Processing Waste in the Development of Thermal Insulation Biocomposite

When developing new innovative building materials, their performance characteristics as well as their environmental friendliness are important. It is difficult to produce a fully ecological material for building envelopes, because there is a lack of ecological binding materials on the market, good binding materials are very expensive, and cheaper ones have poorer adhesive properties and performance characteristics. In this work, natural organic sapropel was used as an ecological binder. Before use, an organic sapropel was additionally mechanically activated. Its activation efficiency was evaluated on the basis of consistency and tensile strength. Sapropel activation increased its consistency from 112 to 168 mm and its tensile strength from 466 to 958 kPa. Wood processing waste was used as a filler for the thermal insulation biocomposite. Additionally, the wood waste was chopped to regulate the density and main performance properties of the biocomposite. The density of the biocomposite was also regulated using different amounts of sapropel and the degree of compaction of the composite mixture. In this work, the influence of the amount of sapropel, the level of compression of the biocomposite mixture, and the size of the wood waste particles on the thermal conductivity and compressive stress of the biocomposite was analyzed. It was found that the compression level had the greatest influence on both the compressive stress and thermal conductivity, up to 12 times and 43.3%, respectively.

Formaldehyde causes an increase in blood pressure by activating ACE/AT1R axis

Previous studies suggest some link between formaldehyde exposure and harmful cardiovascular effects. But whether exposure to formaldehyde can cause blood pressure to rise, and if so, what the underlying mechanism is, remains unclear. In this study, C57BL/6 male mice were exposed to 0.1, 0.5, 2.5 mg/m³ of gaseous formaldehyde for 4 h daily over a three-week period. The systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP) and heart rate (HR) of the mice were measured by tail-cuff plethysmography, and any histopathological changes in the target organs of hypertension were investigated. The results showed that exposure to formaldehyde did cause a significant increase in blood pressure and heart rate, and resulted in varying degrees of damage to the heart, aortic vessels and kidneys. To explore the underlying mechanism, a specific inhibitor of angiotensin converting enzyme (ACE) was used to block the ACE/AT1R axis. We observed the levels of ACE and angiotensin II type 1 receptor (AT1R), as well as the bradykinin (BK) in cardiac cytoplasm. The data suggest that exposure to formaldehyde induced an increase in the expression of ACE and AT1R, and decreased the levels of BK. Strikingly, treatment with 5 mg/kg/d ACE inhibitor can attenuate the increase in blood pressure and the pathological changes caused by formaldehyde exposure. This result has improved our understanding of whether, and how, formaldehyde exposure affects the development of hypertension.

Health risk assessment of exposure to ambient formaldehyde in carpet manufacturing industries

Formaldehyde is categorized as a definitive carcinogen by the International Agency for Research on Cancer. To the best of our knowledge, no study has assessed the health risks of occupational exposure of workers in carpet manufacturing plants to formaldehyde. Therefore, this study assesses the health risks of the occupational exposure to formaldehyde of 67 male workers in carpet manufacturing plants in Iran in 2022. Exposure to formaldehyde was quantitatively determined after collecting personal exposure samples from the workers' respiratory zone and spectrophotometric analysis based on method number 3500 of the National Institute of Occupational Safety and Health. In the next step, the carcinogenic and noncarcinogenic risks based on personal exposure to formaldehyde were evaluated. Sensitivity analyses were employed using the Monte Carlo simulation method. The mean inhalation exposure of workers to formaldehyde was 0.636 mg m^-3. The inhalation cancer risk value based on the integrated risk information system for formaldehyde was 4.06×10^-4 ± 3.17×10^-5 (mean ± standard deviation), which exceeded the value reported by the US Environmental Protection Agency. An unacceptable carcinogenic risk level was found in 75.6% of workers. The highest mean inhalation cancer risk was 6.74×10^-4 (i.e., 6.74 additional cases per 10,000 employees exposed) was found in sizing post employees. The hazard quotient of formaldehyde was 0.311±0.024. The formaldehyde concentration had a considerable effect on the health risk. The findings of this study provide valuable scientific information that supports the development of future policies to enhance the health status of employees in carpet manufacturing plants.

Semen Quality Following Long-term Occupational Exposure to Formaldehyde in China

IMPORTANCE

The potential effects of long-term occupational exposure to formaldehyde (FA) on human semen quality is not clear.

OBJECTIVE

To assess whether long-term occupational exposure to FA is associated with semen quality.

DESIGN, SETTING, AND PARTICIPANTS

This population-based cohort study was conducted from June 1 to June 30, 2021, in Xi'an, China. Participants were adults aged 23 to 40 years who had lived in the study area for 24 months or longer. Data analysis was performed from September 1 to October 1, 2021.

EXPOSURES

Long-term occupational exposure to FA was measured using a formaldehyde detector, and the FA exposure index (FEI) was calculated as follows: FEI = final concentration of FA (mg/m3) × work time during a workday (hour) × cumulative workdays (year).

MAIN OUTCOMES AND MEASURES

Semen samples were collected by masturbation after 3 to 7 days of abstinence and were then assessed by the computer-automated semen analysis system, Baso-Papanicolaou staining, and sperm-chromatin structure assay.

RESULTS

A total of 205 men (mean [SD] age, 29.49 [3.64] years), with 124 individuals in the FA exposure group (mean [SD] FEI, 73.72 [54.86]) and 81 age-matched controls, were included in the final analysis. Long-term personal occupational exposure to FA was significantly associated with poor semen quality. Specifically, a 1-unit increase in FEI was associated with a change of -0.99% (95% CI, -1.00% to -0.98%) in total sperm motility, -0.99% (95% CI, -0.99% to -0.97%) in progressive sperm motility, -0.05% (95% CI, -0.08% to -0.02%) in curvilinear velocity, -0.07% (95% CI, -0.10% to -0.04%) in straight line velocity, -0.07% (95% CI, -0.10% to -0.04%) in time-average velocity, -0.98% (95% CI, -0.99% to -0.93%) in normal sperm morphology, -0.24% (95% CI, -0.35% to -0.11%) in seminal neutral glucosidase, -0.61% (95% CI, -0.66% to -0.56%) in seminal plasma zinc, 0.52% (95% CI, 0.15% to 1.02%) in beat cross frequency, and 0.10% (95% CI, 0.06% to 0.14%) in the DNA fragmentation index. These associations remained significant after adjusting for confounding factors. Furthermore, subgroup analysis found that high levels of oxidative stress might promote the associations between FA exposure and semen quality.

CONCLUSIONS AND RELEVANCE

This study found an association between long-term occupational exposure to FA and semen quality. This deterioration was dose and time dependent and might be induced by oxidative stress.