Association of PM2.5 and its components with endometriosis among women undergoing assisted reproductive technology: a case-control study in Anhui, China

There is limited research on the connection between exposure to PM2.5, particularly its components, and endometriosis. Consequently, our investigation seeks to discern the potential links between PM2.5, its components, and endometriosis. To achieve this, we performed a case-control study over eight years (2013–2020) at the reproductive center of China’s First Affiliated Hospital of Anhui Medical University, encompassing 1243 endometriosis patients and 8016 controls. We gauged three-year mean levels of PM2.5 and specific components at residential locations, and then employed logistic regression models to assess how PM2.5 and these components influenced the endometriosis prevalence. We evaluated their combined effects using weighted quantile sum (WQS) and quantitative g-computation (Qgcomp) models. The results exhibited an elevated odds ratio for endometriosis prevalence per standard deviation increase of PM2.5 average exposure and its components. Subgroup analyses also suggested greater susceptibility among women over 30, with dysmenorrhea, and living in urban. The positive correlation between endometriosis and the components of PM2.5 was confirmed in both WQS and Qgcomp models, and SO42− was identified as the most significant contributor. Sensitivity analyses showed that the positive association of SO42− with endometriosis risk remained stable. This study explains to which factors the association between PM2.5 and endometriosis is attributable and recommends that regulating sources of SO42− to reduce the impact of PM2.5-associated endometriosis provides clinical and public health guidance