PART 1

CHAPTER IX

ENVIRONMENTAL FACTORS AND HABITS WITH POSSIBLE SEQUELS ON SEXUAL AND REPRODUCTIVE HEALTH

Environmental Factors

The place where people live and work, together with personal behavior affect their health in some obvious and not so obvious ways during their life span. A significant proportion of all human cancers, lung, heart and kidney diseases, as well as sexual and reproductive health problems is now thought to be environmentally caused. Environmental hazards have increased tremendously in the twentieth-century society. To the accidents, stress and communicable diseases, which people have always encountered in many countries all over the world, including Armenia, toxic chemicals and radioactive substances have been added to the list. Chemical substances that are in commercial use might affect people’s health through drinking water, food, air, clothing, homes and workplace. Low-level radiation from normally functioning nuclear power plants and weapons contaminates the environment and people’s bodies in slow stages. Waste from a nuclear reactor or weapons plant remains radioactive for as long as 250 centuries. Presently environmental hazards are widespread and nobody can totally avoid them. Some people, however, are involuntarily exposed to more concentrated and dangerous hazards at their workplace.

Reproductive health hazards have harmful effects on both male and female reproductive system and the development of a fetus. Research has shown that environmental toxins can disrupt the production of male hormones in the testes, causing loss of sex drive, impotence and disturbing sperm production. It was found that men exposed to lead have decreased fertility and malformed sperm. The pesticide, dibromochloropropane was found to cause decreased sperm counts in men who work with it. Many people who are exposed to environmental and occupational hazards have no idea about these hazards and their sequels on health. Many of those who know about these hazards do not know what to do about them. Environmental health is basically a community problem that is impossible to fight alone.    

Our research shows that more than 8% of Armenian men supposed that they have been exposed to the environmental and/or occupational hazards at their homes or workplace. More than 20% of respondents were not sure about the possible exposure, but more than 71% supposed that they live and work in a safe environment (Figure 1.9.1). Five men (0.4%) have been exposed in the past to the injuries of the genital organs.

1.9.1. Alcohol, Drug Abuse, Smoking and Other Harmful Habits

In daily lives people usually always encounter stress and or problems that make them unhappy. Some of them often respond to these pressures by pouring themselves a drink, lighting a cigarette or taking mood-altering drugs. There are also people, who develop these harmful habits only for fashion or diversion without understanding their consequences on health.

According to the self-appraisal of survey respondents, about 9% of the men were excessive alcohol users and 45% used it too much just on occasion. Spouses or partners of only 11 men (0.8%) are using alcohol regularly and about 9% just occasionally (Figure 1.9.2.).  Excessive drinking over a period of time not only leads to physical addiction but increases the risk of heart attack, stroke, brain damage and several cancers. Chronic alcohol abuse affects sexual and reproductive health of people through their influence on sexual function or giving birth to babies with fetal alcohol syndrome.

Several research studies indicate that drug abuse leads not only to physical addiction and mental degradation but also has serious consequences on reproductive health and fetal development. Cocaine exposure to males before conceiving is linked to abnormal development in offspring. The suspected cause is that cocaine binds with sperm, and therefore finds its way into the egg at fertilization.

Seven men (0.5%) among this survey admitted to being drug abusers and 40 (2.9%) occasionally tried narcotics. According to the men’s report, the partners of 2 men (0.1%) used narcotics regularly and of 5 men (0.4%) occasionally (Figure 1.9.3.).

More than 12% of men reported long-term use of medicine for different health-related problems. About 6% mentioned that their spouses or partners use some medicine to treat diseases or disorders. Among medicines mentioned were sedatives, tranquilizers and antidepressant, which are known as mood-altering drugs. 

Research data indicate that smoking is harmful to health. Smoker’s sperm counts are on average 13-17% lower than of nonsmoker’s. A study of three smokers who were followed for 5-15 months after stopping smoking reported that their sperm counts rose 50-800%, suggesting that toxic chemicals in the smoke are responsible, and any reduction in sperm count is reversible. Male smokers have an increase in sperm abnormalities, thereby suggesting a mutagenic effect. Passive smoking (exposure to the cigarette smoke of others) is a serious health risk, especially for children.

According to the results of this survey, the great majority of Armenian men (77%) and 2% of their partners are regular smokers (Figure 1.9.4.).      

On the average, of those who smoke each man smokes about 1 pack of cigarettes per day (Mean=21±9.43 cigarettes) and woman from 8 to 9 cigarettes per day (Mean = 8.6 ±4.25).

Taking into consideration the price of cigarettes in the Armenian market, it may be calculated that each man spends about 10 US$ per month and about 120US$ per year for buying cigarettes. On the country level Armenian men spend about 6 million US$ per month or 72 million US$ per year on cigarettes (supposing that there are approximately 800000 men of reproductive age in Armenia, and 77% of those are smokers).

According to the men’s report, about 2% of the partners are smokers. On a country level this would indicate about 16000 women smokers. Each woman is spending about 4 US$ per month or 48 US$ per year on cigarettes. On the country level, women spend about 64000 US$ per month or 768000US$ per year on cigarettes (Table 1.9.1. and Figure 1.9.5.).

The total reproductive age couples expenditures for cigarette smoking in Armenia is more than US $6 million per month and almost US$ 73 million per year. These figures are alarming! If this money would be spent for Public Health expenses, many deaths might be prevented. 

Some studies suggest that excessive use of the sauna bath might effect spermatogenesis and result in male infertility (6). The majority of respondents of this survey (77.5%) never used a sauna bath (Table 1.9.2.). Nine men (0.6%) used a sauna bath more than 3 times per week, 3% used it once a week and about 19%, occasionally.

The information provided above indicates that a significant proportion of Armenian men may have an unhealthy behavior, which may affect their sexual and reproductive health and result in long-term infertility. People need to be informed about the possible consequences of environmental factors and harmful habits on their health. In many cases with impaired fertility it might be corrected just by the healthy lifestyle.