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Abstract(s)
Introdução: Evidência sugere um declínio global na qualidade espermática nas últimas décadas com redução da fertilidade masculina e consequentes implicações na natalidade, emergindo como um problema de saúde pública. Fatores potencialmente identificáveis e modificáveis relacionados com a exposição ocupacional contribuem para este cenário. Determinadas profissões podem ser consideradas de risco em termos de saúde reprodutiva masculina.
Objetivos: Determinar a associação entre exposição ocupacional, em diferentes categorias profissionais, e as variáveis relacionadas com a infertilidade e com o espermograma. Averiguar quais as categorias com maior incidência de alterações espermáticas, bem como analisar as diferenças nos parâmetros do espermograma entre as diversas categorias profissionais.
Material e Métodos: Trata-se de um estudo observacional, descritivo, analítico e retrospetivo. A população em estudo engloba o elemento masculino de 520 casais que recorreram à Unidade de Medicina Reprodutiva (UMR) do Centro Hospitalar Cova da Beira (CHCB) nos últimos cinco anos, concretamente de 1 de Março de 2013 a 28 de Fevereiro de 2018. Procedeu-se à caracterização da população em estudo incluindo variáveis relacionadas com infertilidade (tipo, duração e tratamento), elemento masculino do casal (idade, profissão e antecedentes) e espermograma. As 120 profissões observadas foram agrupadas em 27 categorias profissionais. Os resultados dos espermogramas, duração e tipo de infertilidade foram analisados tendo em conta as categorias profissionais, de forma a analisar o contributo de cada grupo ocupacional para as alterações observadas, bem como a existência de associação entre as variáveis ou diferença entre grupos.
Resultados: A profissão “Motorista” e a categoria profissional “Condutores de veículos e operadores de equipamentos móveis” são as mais frequentes. Infertilidade primária é o tipo mais frequente na maioria das categorias, com duração média de 35,65 ± 29,185 meses. A maioria dos indivíduos apresenta pelo menos um parâmetro do espermograma alterado. O parâmetro com maior percentagem de alterações é a morfologia (49.8% de teratozoospermia), sendo vitalidade o que apresenta menor (3.4% de necrozoospermia). Normozoospermia em 35.4% dos casos. Não se verificou associação estatisticamente significativa entre as variáveis estudadas. Porém, identificou-se tendência para existência de associação com o parâmetro motilidade (valor-p<0.1). Constatou-se diferenças estatisticamente significativas (valor-p<0.05) na distribuição do parâmetro volume entre as categorias profissionais, e uma tendência para existência de diferenças (valor-p<0.1) na distribuição do pH, do índice de múltiplas anomalias (MAI) e da duração da infertilidade entre os grupos.
Conclusão: Apesar de não se ter evidenciado associação entre exposição ocupacional e as características do espermograma, a evidência científica atual e as tendências descritas no estudo alertam para a relevância da temática exposição ocupacional e consequentes repercussões na saúde reprodutiva.
Introduction: Evidence suggests a global decline in sperm quality in the last decades with reduced male fertility and birth-related implications, emerging as a public health issue. Potentially identifiable and modifiable factors related with occupational exposure contribute to this scenario. Certain occupations can be considered at risk in terms of male reproductive health. Objectives: To determine association between occupational exposure in different occupation categories and variables related to infertility including semen analysis. To determine which categories have higher incidence of spermatic alterations, as well as the differences in sperm parameters among the different professional groups. Material and methods: This is an observational, descriptive, analytical and retrospective study. The study population comprises the male element of 520 couples who came to the reproductive medicine unit of Centro Hospitalar Cova da Beira in the last five years, between March 1st, 2013 and February 28th, 2018. The descriptive characterization of the population under study includes variables related to infertility (type, duration and treatment), male partner (age, occupation and medical history) and semen analysis. The 120 professions were grouped into 27 profession categories. The results of the semen analysis, duration and type of infertility were analysed considering the professional categories in order to ascertain the contribution of each occupation group to the observed changes, as well as the existence of association between the variables and the difference between groups. Results: The profession “Driver” and the category “Drivers of vehicles and operators of mobile equipment” are the most frequent. Primary infertility is the most frequent type in most categories, with a mean duration of 35.65 ± 29.185 months. The majority of the individuals has at least one altered parameter of the semen analysis. The parameter with the highest percentage of changes is morphology (49.8% teratozoospermia) and the lowest is vitality (3.4% necrozoospermia). Normozoospermia in 35.4% of cases. There were no significant association between the variables in study. However, there is a tendency of association in motility (p-value<0.1). There were statistically significant differences (p-value<0.05) in the distribution of the volume between the professional categories. A tendency towards the existence of differences between groups (p-value<0.1) in the distribution of pH, multiple anomaly index and duration of infertility was also identified. Conclusions: Despite lack of association between occupational exposure and semen analysis characteristics, the current scientific evidence and the trends described in the present study point to the relevance of occupational exposures and consequent repercussion on reproductive health.
Introduction: Evidence suggests a global decline in sperm quality in the last decades with reduced male fertility and birth-related implications, emerging as a public health issue. Potentially identifiable and modifiable factors related with occupational exposure contribute to this scenario. Certain occupations can be considered at risk in terms of male reproductive health. Objectives: To determine association between occupational exposure in different occupation categories and variables related to infertility including semen analysis. To determine which categories have higher incidence of spermatic alterations, as well as the differences in sperm parameters among the different professional groups. Material and methods: This is an observational, descriptive, analytical and retrospective study. The study population comprises the male element of 520 couples who came to the reproductive medicine unit of Centro Hospitalar Cova da Beira in the last five years, between March 1st, 2013 and February 28th, 2018. The descriptive characterization of the population under study includes variables related to infertility (type, duration and treatment), male partner (age, occupation and medical history) and semen analysis. The 120 professions were grouped into 27 profession categories. The results of the semen analysis, duration and type of infertility were analysed considering the professional categories in order to ascertain the contribution of each occupation group to the observed changes, as well as the existence of association between the variables and the difference between groups. Results: The profession “Driver” and the category “Drivers of vehicles and operators of mobile equipment” are the most frequent. Primary infertility is the most frequent type in most categories, with a mean duration of 35.65 ± 29.185 months. The majority of the individuals has at least one altered parameter of the semen analysis. The parameter with the highest percentage of changes is morphology (49.8% teratozoospermia) and the lowest is vitality (3.4% necrozoospermia). Normozoospermia in 35.4% of cases. There were no significant association between the variables in study. However, there is a tendency of association in motility (p-value<0.1). There were statistically significant differences (p-value<0.05) in the distribution of the volume between the professional categories. A tendency towards the existence of differences between groups (p-value<0.1) in the distribution of pH, multiple anomaly index and duration of infertility was also identified. Conclusions: Despite lack of association between occupational exposure and semen analysis characteristics, the current scientific evidence and the trends described in the present study point to the relevance of occupational exposures and consequent repercussion on reproductive health.
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Keywords
Centro Hospitalar Cova da Beira Espermograma Exposição Ocupacional Infertilidade Medicina Reprodutiva