Association between long-term exposure to ambient air pollution and diabetes mortality in the US

Chris C. Lim, Richard B. Hayes, Jiyoung Ahn, Yongzhao Shao, Debra T. Silverman, Rena R. Jones, Cynthia Garcia, George D. Thurston

Research output: Contribution to journalArticlepeer-review

45 Scopus citations

Abstract

Objective: Recent mechanistic and epidemiological evidence implicates air pollution as a potential risk factor for diabetes; however, mortality risks have not been evaluated in a large US cohort assessing exposures to multiple pollutants with detailed consideration of personal risk factors for diabetes. Research design and methods: We assessed the effects of long-term ambient air pollution exposures on diabetes mortality in the NIH-AARP Diet and Health Study, a cohort of approximately a half million subjects across the contiguous U.S. The cohort, with a follow-up period between 1995 and 2011, was linked to residential census tract estimates for annual mean concentration levels of PM 2.5 , NO 2 , and O 3 . Associations between the air pollutants and the risk of diabetes mortality (N = 3598) were evaluated using multivariate Cox proportional hazards models adjusted for both individual-level and census-level contextual covariates. Results: Diabetes mortality was significantly associated with increasing levels of both PM 2.5 (HR = 1.19; 95% CI: 1.03–1.39 per 10 μg/m 3 ) and NO 2 (HR = 1.09; 95% CI: 1.01–1.18 per 10 ppb). The strength of the relationship was robust to alternate exposure assessments and model specifications. We also observed significant effect modification, with elevated mortality risks observed among those with higher BMI and lower levels of fruit consumption. Conclusions: We found that long-term exposure to PM 2.5 and NO 2 , but not O 3 , is related to increased risk of diabetes mortality in the U.S, with attenuation of adverse effects by lower BMI and higher fruit consumption, suggesting that air pollution is involved in the etiology and/or control of diabetes.

Original languageEnglish (US)
Pages (from-to)330-336
Number of pages7
JournalEnvironmental Research
Volume165
DOIs
StatePublished - Aug 2018
Externally publishedYes

Keywords

  • Air pollution
  • Diabetes
  • NO
  • PM

ASJC Scopus subject areas

  • Biochemistry
  • Environmental Science(all)

Fingerprint

Dive into the research topics of 'Association between long-term exposure to ambient air pollution and diabetes mortality in the US'. Together they form a unique fingerprint.

Cite this