Abstract
BACKGROUND: The decline in birth rates and the increasing prevalence of infertility worldwide have become significant public health concerns. Research on the adverse effects of ambient air pollution, particularly particulate matter (PM), on male reproductive health has yielded somewhat inconsistent results. METHODS: A cross-sectional study including 1,180 male participants aged 18–45 years was conducted from February 1, 2024, to January 31, 2025, at the Andrology Clinic of Foshan Fosun Chancheng Hospital, Foshan. To determine whether exposure to ambient PM(2.5) (particles with aerodynamic diameter ≤ 2.5 μm), which constitutes a major component of ambient inhalable particulate matter (PM(10), particles with aerodynamic diameter ≤ 10 μm) during different stages of sperm development is associated with alterations in semen quality, and to assess the potential modifying effects of socioeconomic status and lifestyle factors. RESULTS: Exposure to ambient PM(2.5) and PM(10) during the 61–90 days before semen collection was associated with alterations in semen quality, with odds ratios (ORs) of 1.02 (95% CI, 1.00–1.04) and 1.01 (95% CI, 1.00–1.02) per 1 µg/m(3) increase, respectively. Combined exposure to ambient PM and gaseous pollutants (e.g., CO and NO₂) further increased the risk of abnormal semen quality. Significant effect modification by education was observed for exposure to ambient PM(10). Further analysis indicated that men with a lower socioeconomic status and unhealthy behaviours were more susceptible to the adverse effects of ambient PM exposure. CONCLUSION: Exposure to ambient particulate pollutants is associated with impaired semen quality. Men with a lower socioeconomic status and unhealthy lifestyles appear to be more vulnerable to these effects. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-025-24600-4.