Date on Master's Thesis/Doctoral Dissertation

12-2023

Document Type

Doctoral Dissertation

Degree Name

Ph. D.

Department

Epidemiology and Population Health

Degree Program

Public Health Sciences with a specialization in Epidemiology, PhD

Committee Chair

Taylor, Kira

Committee Co-Chair (if applicable)

DuPré, Natlie

Committee Member

DuPré, Natlie

Committee Member

Ali, T’shura

Committee Member

Gaskins, Jeremy

Committee Member

Yeager, Ray

Author's Keywords

Tear gas; epidemiology; male reproductive outcomes; VOCs; erectile dysfunction; testosterone deficiency

Abstract

Male sexual dysfunction comprises various conditions, including erectile dysfunction (ED) and ejaculatory dysfunction. Testosterone deficiency (TD), which has been linked to some of these sexual dysfunctions, is characterized by low production of testosterone by the testes. These male reproductive outcomes may develop due to exposure to various risk factors, including environmental exposures. These environmental exposures may include volatile organic compounds (VOCs) and tear gas. This dissertation aims to examine the effects of tear gas exposure and VOCs on male reproductive outcomes. The association between tear gas exposure and male reproductive outcomes was assessed using data obtained from an online anonymous questionnaire. Tear gas exposure was estimated using acute tear gas symptoms including eye, lung, skin, and heart effects, and were summed into composite scores ranging from 0 to 14. Male reproductive outcomes that were assessed include ED and ejaculation dysfunction. Odds ratios (OR) and 95% confidence intervals (CI) were obtained using logistic regression, controlling for potential confounders. Approximately 46% of the men (N=92) exposed to tear gas reported at least one reproductive issue. There was a significant association between v acute tear gas exposure score and higher odds of erectile dysfunction (OR 6.57; 95% CI 1.28-40.08). Weighted logistic regression and Bayesian kernel machine regression (BKMR) were used to assess the association between a selection of VOCs and ED or TD using NHANES data. The analysis was also performed among non-smokers. One of the analyzed VOCs, 1,4-dichlorobenzene, was associated with increased odds of ED; however, some VOCs, including benzene, toluene, and ethylene, were inversely associated with TD. No significant association was observed when the data was restricted to only non-smokers, pointing to possible confounding by smoking or related characteristics. In conclusion, this dissertation provides novel evidence for the potential effects of tear gas on male reproductive outcomes, and further elucidates the effects of VOCs on these outcomes. Educating the public, particularly health professionals and policymakers, on the health impacts of these environmental exposures may help reduce the burden of adverse male reproductive outcomes in the population.

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