Factors associated with erectile dysfunction in copper and cobalt miners: a cross-sectional study in the katanga province, dr congo

Abstract Introduction The African Copperbelt is a site of intense artisanal and industrial mining and refining of copper and cobalt. Based on a preliminary case-control study of erectile dysfunction among mineworkers in the former Katanga province of the Democratic Republic of Congo (Musa et al. Occupational and Environmental Medicine 2020), Objective We further investigated possible factors associated with erectile dysfunction in copper and cobalt miners in the Katanga province. Methods In a cross-sectional study of 138 miners and 140 controls (bakers), we administered questionnaires face-to-face in French or Swahili to obtain socio-demographic and occupational data, and to assess male sexual function [International Index of Erectile Function (IIEF-15)] and marital relation quality [Revised Dyadic Adjustment Scale (DAS)]. We measured trace metals in blood and urine and testosterone and thyroid hormones in serum. Results Miners and bakers had similar median (IQR) age [35.6 y (30.6–40.0)]. Miners had significantly lower scores than bakers for IIEF-15 [66 (49–73) vs 73 (66–74)] and for the three DAS domains (Consensus; Satisfaction; Cohesion). Miners had significantly lower free testosterone (8.1 ng/dL) and thyroxin (13.45 pmol/L) than bakers (9.3 and 14.75, respectively). Factors associated with IIEF- EF scores ≤ 22 were: mining-related job (aOR 2.09, 95% CI 1.14–3.81; p=0.016), work seniority in mining (aOR 1.07, 95% CI 1.02–1.13; p=0.005) and regular use of aphrodisiacs (aOR 2.80, 95% CI 1.56–5.02; p=0.001). Mediation analysis showed that consensus mediated by 50% the relation between work seniority in mining and erectile function. Conclusions Compared to controls, miners had poorer sexual function and marital relation, and lower free testosterone and thyroxin. This may be due to their high exposure to trace metals (especially Pb). Erectile dysfunction is found to be increased by lower consensus in couples possibly due to longer time spent working away from home. Disclosure No