Endocrine Disruptors and Men's Reproductive Health: A randomized behavioral intervention to increase environmental health literacy and reduce exposures among men with low semen quality - ABSTRACT Endocrine disrupting chemicals (EDCs), due in part to their ubiquity, have become a major public health concern.3,4 Biomonitoring data shows that over 90% of US adults have common EDCs (e.g. bisphenol A (BPA) and phthalates) in their urine.5,6 EDCs have been shown to disrupt reproductive function in animals,10 and contribute to infertility in both women and men8,9 through several mechanisms.9,10 In men, sperm count has been decreasing for the past 50 years by more than 50%, globally.11 This reduction in semen quality is likely due to exposure to toxic environmental chemicals/EDCs,12 as corroborated by animal13 and human studies.9,14 Thus, reducing daily exposure to EDCs is essential for men seeking to conceive, but also for any male seeking a long and healthy life, as EDC exposures have been linked to male-related disease and longevity.15 While EDC exposure occurs in both men and women, most research regarding exposures/interventions have been in women, likely due to a focus on female beauty products and reproductive health,16–20 and possibly, greater self-motivation in women to reduce exposures.21 Million Marker (MM) provides at-home, mail-in EDC testing with report-back and personalized exposure reduction recommendations. We have found that informing participants of their exposure to harmful chemicals increases environmental health literacy and exposure reduction behavior in a sample predominantly of women.21 However, it is unclear to what extent the testing and intervention program reduces these exposures in men, and by extension, the effects this EDC reduction has on semen quality. In this proposal, we aim to test our EDC testing and report-back, including an environmental health literacy (EHL) intervention program, in a population of men with low semen quality by 1) measuring male participants’ urinary levels of EDCs and semen quality before and after report-back and EDC reduction intervention and assessing change, 2) assessing the extent to which MM’s program (testing, curriculum, and report-back) alters participant environmental health literacy, readiness to change, and product/lifestyle choices, and 3) testing the feasibility and acceptability of MM’s program to male participants. We hypothesize that our report-back and intervention program will increase environmental health literacy and EDC-reduction behavior, reduce urinary EDCs, and increase semen quality in a sample of US men with low semen quality. Further, we believe our intervention program will have a larger effect than report-back only.23 We expect our program will be well-received by men as a tool for improved male health and wellness. If completed, this study will prepare us for the Phase II SBIR and allow us to further test this EDC intervention program in larger populations and men seeking to improve fertility, in preparation for commercialization of the EDC testing and intervention program among clinics, employee wellness programs and large healthcare systems and insurers.
