3. Conclusion

In 2010, Rubes while assessing seasonal differences of exposure of police officers who worked in the Centre of Prague (Czech Republic), found that sperm DNA fragmentation was significantly higher in winter (high exposure) rather than in spring (low exposure) in samples of all men, including non-smokers [161]. Also in the metropolitan area of Naples studies support the relationship between low sperm motility and high environmental exposure to emissions of traffic or heavy metals [162]. In addition, significantly higher level of sperm DNA damage, measured by means two different techniques, was found in healthy male volunteers living in HIP area as compared with that measured in volunteers living in LIP [118]. Human semen sensitivity to pollution-induced alteration of semen redox status was recently confirmed in a recently published study [26]. In particular, it was demonstrated that semen is more susceptible than blood plasma to pollution-associated alteration of redox status and that STL, but not LTS, was significantly influenced by the environmental impact [134] Certainly, the possibility for measuring simultaneously in human semen the presence of environmental contaminants and checking in vivo effects on sperm cells, readily available, with sensitive features to environmental pollutants such as motility, morphology, integrity of DNA strand, semen redox status, sperm aneuploidies, STL, make it an ideal way to assess the adverse effects of environmental exposure for measuring the environmental impact on human health. In conclusion, human semen seems an earlier and sensitive source of biomarkers than blood to monitor high environmental pressure on human health, hence useful for innovative prevention programs

The spermatogenesis cycle is extremely complex and vulnerable to endogenous and exogenous stress, so it is not surprising that it can be an important indicator of the state of well-being of the organism. Recent studies have demonstrated the association between semen quality and state of health, correlating the semen quality with either chronic degenerative diseases,

In a first study of Eisenberg [53] a group of 9387 men was examined, average age 38 years, which had been evaluated for infertility issues between 1994 and 2011. Within the group, 44% had at least one medical diagnosis not related to infertility. Using the Charlson Comorbidity Index, researchers have shown that men with a higher index of chronic conditions had a lower count of sperm volume and motility, of total number of sperms and of normal shape. Sperm abnormalities rates were significantly higher among men with endocrine-metabolic, circulatory or genitourinary disorders and skin diseases, compared to other men without these conditions. Vascular hypertension, cerebrovascular disease and ischemic heart disease were associated with higher rates of sperm abnormalities. On the other hand, about 15% of all human genes are directly involved in reproduction and the majority of these genes may also

In a second study of Eisenberg [42] 2238 men recruited in an infertility clinic of Texas were analyzed: 451 of which with azoospermia and 1787. It was compared the incidence of cancer on with that on the general population of Texas. At the first evaluation of infertility, the average age was 35.7 years. After a 6–7 years follow-up, it was shown that 29 of the infertile

and health surveillance, especially in risk areas.

188 Spermatozoa - Facts and Perspectives

comorbidities and even mortality [36, 42, 43, 51–53].

play an important role in other parts of the body.

2.5. The semen as an early marker of health (health sentinel)

A certain number of regions in all the world experience a higher incidence of health disorders (reproductive, pediatric, cancer, etc.) due to environmental pollution: the societal costs associated with poor health and the interventions to reduce pollution are stirring debates and concerns. It is important a science-based guidance for preventing/reducing health risks in many high environmental pressure areas.

Information about levels of exposure to contaminants (chemical, physical) is critical to evaluate and to manage environmental and professional risks and, as a result, as much as possible, to measure the biological risk expressed in terms of probability of reaching potential harm through the exposure to certain chemical and/or physical stress. There are new analytical tools today that first identify and measure biomarkers, quantitative end-point and intermediate pathways of biological tissue/fluid fluids to identify early signs of functional or structural modification before clinical damage. Therefore, in order to have greater preventive efficacy and raise the level of attention and protection especially to populations living in areas with greater environmental exposure, it is important consider to organofunctional "sentinel" systems more susceptible to endogenous and exogenous modifications, those that suffer effects before others. For this reason and in relation to the new primary prevention approaches, the endocrine-metabolic system, and in particular the male reproductive, considering "double function" of human semen (Health and Environmental marker), represent an ideal tool for investigating and promoting health surveillance. Human semen seems to be a time-effective, sensitive and informative source of biomarkers, providing information about the presence of biologically active exposures, useful for innovative prevention programs and health surveillance, especially in environmental risk areas. Furthermore, maintaining a good semen quality and fertility is a prevention coverage. Bad lifestyles and environmental contaminants can impair reproductive health and overall health, encouraging the development of chronic degenerative diseases affecting the adult and, through the sperm epigenome changes, future generations. Environmental health should consider reproductive health and development, from intrauterine life to childhood and puberty: these are both vulnerable targets and high-value protection goals, inasmuch as they represent the future of our societies, in particular, biomarkers of reproductive health should be exploited as early signals of environmental pressure and increased risk of adverse chronic health effects. Hence, the use of reproductive biomarkers for early detection and prevention of environmental health risks represents a useful initiative for public health. Thus, identifying risk factors to improve the management of human wellness and health throughout standardized analysis, which correlates the toxic bioaccumulation of the seminal fluid with the multiple semen parameters, might be the main objective to be considered in the agenda of public prevention policies.

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The Role of Human Semen as an Early and Reliable Tool of Environmental Impact Assessment on Human Health

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