A pilot study about infertile men’s awareness of their reprotoxic exposures and the intervention of occupational medicine to assess them

Abstract

BackgroundMale infertility related to professional reprotoxic exposure has been assessed in several studies. Collaboration between occupational physicians and patients can yield information about the preventive measures that can be taken to avoid such exposure. The use of preventive measures is determined by the collaboration between reproductive medicine and occupational medicine and also by the patient’s awareness of reprotoxic occupational exposures. Our andrology laboratory developed a systematic environmental interview that an occupational physician administers before semen analysis to assess patients’ occupational reprotoxic chemical and physical exposures. This observational prospective study evaluated patients’ feelings regarding this interview. The main outcome measure was the participants’ score to determine their general reprotoxicant knowledge. The study also evaluated the patients’ satisfaction about the interview with occupational physician and their attitude about reproductive toxicants.ResultsThe mean score for general knowledge of reprotoxicants was 9.6 ± 2.7/16. The most frequently underestimated reprotoxic factor was excessive heat (34.7 % correct responses). In cases of semen parameter abnormalities AND recognized occupational reprotoxic exposure, 63.2 % of the patients said they would use individual protective devices, and 55.1 % said they would temporarily adapt their workstation. Regarding the interview with the laboratory’s occupational physician, 80.7 % considered it moderately or very useful. Of the interviewed patients, 46.2 % reported having changed their living habits 2 months after the interview, and 88.5 % were satisfied or very satisfied with the care they received. All of the respondents said it would be useful to extend the interview to include their wives.ConclusionsThe data suggest that patients’ knowledge about reprotoxic exposures can be improved, particularly knowledge related to physical exposure. The vast majority of patients were satisfied with the introduction of this new collaboration between reproductive and occupational medicine.

Subfertile patients underestimate their risk factors of reprotoxic exposure

“…There are many existing studies on the knowledge and perceptions of women concerning their exposure to teratogenic agents during pregnancy, reporting a low level of knowledge [ 24 – 28 ]. However, there is no corresponding data on men and couples in general, especially subfertile ones, besides the pilot study of Christiaens et al [ 19 ] suggesting that most of subfertile men were unaware of their exposure to environmental reprotoxic agents.…”

“…Other factors associated with a high desire of subfertile women to reduce their exposure were medical factors (decreased ovarian reserve), education (preconception directives) and financial factors [ 21 ]. Regarding subfertile men, we previously suggested that the most common reasons for exposure modification were related to semen parameters impairment and known professional exposure [ 19 ].…”

“…Notably, in our study, 35% of subfertile patients did not intend to ask for medical help to reduce their environmental exposure, which may be due to the reluctance of patients to declare and discuss their fertility problems on their place of work, particularly with their enterprise’s physician. In previous studies, this attitude was associated with a lack of knowledge of the role and the competencies of the enterprise’s physician and uncertainty about information confidentially with respect to patients’ employer [ 19 , 32 ].…”

“…Nevertheless, the knowledge and perception of subfertile patients regarding their exposure to environmental reprotoxic agents are not very well developed, as previously shown in a study suggesting that subfertile men underestimate their exposure to reprotoxic agents [ 19 ]. Subfertile patients can act on their fertility by modifying some daily life habits, as suggested by several publications showing that numerous patients undergoing assisted reproduction were eager to change their habits and wish to be counseled to decrease their exposure to reprotoxic agents [ 19 – 21 ]. However, to endorse daily habit and lifestyle changes, patients must be informed and fully conscious of the reprotoxic risk factors.…”