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Background  Little is known about the association between air pollution and erectile dysfunction (ED), a disorder occurring in 64% of men over the age of 70, and to date, no studies have been published. To address this significant knowledge gap, we explored the relationship between ED and air pollution in a group of older men who were part of the National Social Life, Health, and Aging Project (NSHAP), a nationally representative cohort study of older Americans.    Methods  We obtained incident ED status and participant data for 412 men (age 57–85). Fine particulate matter (PM 2.5 ) exposures were estimated using spatio-temporal models based on participants’ geocoded addresses, while nitrogen dioxide (NO 2 ) and ozone (O 3 ) concentrations were estimated using nearest measurements from the Environmental Protection Agency’s Air Quality System. The association between air pollution and incident ED (newly developed in Wave 2) was examined and logistic regression models were run with adjusted models controlling for race, education, season, smoking, obesity, diabetes, depression, and median household income of census tract.    Results  We found positive, although statistically insignificant, associations between PM 2.5 , NO 2 , and O 3  exposures and odds of incident ED for each of our examined exposure windows, including 1 to 7 year moving averages. Odds ratios (OR) for 1 and 7 year moving averages equaled 1.16 (95% CI: 0.87, 1.55) and 1.16 (95% CI: 0.92, 1.46), respectively, for an IQR increase in PM 2.5  exposures. Observed associations were robust to model specifications and were not significantly modified by any of the examined risk factors for ED.    Conclusions  We found associations between PM 2.5 , NO 2 , and O 3  exposures and odds of developing ED that did not reach nominal statistical significance, although exposures to each pollutant were consistently associated with higher odds of developing ED. While more research is needed, our findings suggest a relationship between air pollutant exposure and incident cases of ED, a common condition in older men.    Electronic supplementary material  The online version of this article (doi:10.1186/s12940-017-0216-6) contains supplementary material, which is available to authorized users.

Erectile dysfunction and exposure to ambient air pollution in a nationally representative cohort of older men