Assessing air pollution as a risk factor for early menopause in Korea

Abstract

Backgrounds Ambient air pollution has become a serious public health issue that affects fertility rates in women worldwide. Therefore, there is a need to evaluate the risk factors associated with menopause to be able to inform women of the associated health risks. Methods We collected data from KHANES (The Korea National Health and Nutrition Examination Survey) between 2010 and 2020, from the Korean Center for Disease Control and Prevention, Ministry of Health and Welfare, and linked it with summary pollution data from AiMS-CREATE (AI-Machine Learning and Statistics Collaborative Research Ensemble for Air Pollution, Temperature, and All Types of Environmental Exposures) from 2002 to 2020. This summary data encapsulates the monthly average air pollution predictions for 226 si-gun-gu (cities, counties, and districts) in Korea. A total of 8,616 participants who had experienced menopause (early menopause: 20–45 years, N = 679; normal menopause: 46–60 years, N = 7,937) between 2002 and 2020 were included in the analysis. We employed survey logistic regression analyses to determine the associations between ambient air pollution and menopause after adjusting for covariates. Results There was an association between particulate matter 2.5 (PM2.5) and early menopause (adjusted odds ratio [aOR]: 1.27, 95% confidence interval [CI]: 1.23–1.32), between particulate matter 10 (PM10) and early menopause (aOR: 1.17, 95% confidence interval [CI]: 1.15–1.20), and between nitrogen dioxide (NO2) and early menopause (aOR: 1.05, 95% confidence interval [CI]: 1.02–1.09). Conclusion Our results are consistent with the proposed hypothesis regarding an association between exposure to ambient air pollution and early menopause. This study provides substantial quantitative evidence that further supports the need for public health interventions to improve air quality, which is a risk in promoting early menopause.