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Evidence of Air Pollution Effects on Menstrual Cycle Health Using Multi-Country Data from a Mobile Health App
16 Pages Posted: 29 Mar 2024
More...Abstract
Background: Toxicological evidence suggests that the endocrine-disrupting properties of ambient air pollution can impact menstrual cycle functioning, an important marker of women’s health. This is the first study to evaluate the impact of short- and long-term PM2.5 exposures on menstrual cycle outcomes across the United States, Brazil, and Mexico.
Methods: We leveraged de-identified self-tracked data of 2,220,281 menstrual cycles between 2016-2020 corresponding to 92,550 users from a popular mobile health-tracking app. Regression analyses were used to evaluate associations between long-term PM2.5, averaged between 2016-2020, and city-level outcomes (% of cycles in each city of abnormal lengths, and % of users in each city with abnormal age-specific cycle variation) after controlling for potential confounders. Conditional logistic regression models were used to evaluate associations between cycle-specific PM2.5 and if a cycle was of abnormal length within an individual in the dataset, after controlling for time-varying factors.
Findings: Significant associations were observed between long-term PM2.5 and the % of cycles with abnormal length: OR: 1.023 (95% CI: 1.013, 1.033) and with the % of users with abnormal cycle variation: OR: 1.165 (95% CI: 1.103, 1.231) for every 10 μg/m3 increase in PM2.5. Associations between short-term PM2.5 concentrations and abnormal cycle length were not significant. Our findings were robust to several sensitivity analyses.
Interpretation: Our work suggests that PM2.5 exposure impacts menstrual cycle outcomes. More work is needed to better elucidate the biological mechanisms through which it impacts menstrual cycle health.
Funding: None.
Declaration of Interest: AS and VV work for Biowink which provided the data used in this study.
Ethical Approval: The CLUE data are not collected specifically for this study and no one on the study team has access to identifiers linked to the data. These activities do not meet the regulatory definition of human subjects research. This study received an exemption from CU Denver’s IRB.
Keywords: menstrual health, women's health, mHealth, air pollution, multi-country
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