Risk of Incident Diabetes in Relation to Long-term Exposure to Fine Particulate Matter in Ontario, Canada


BACKGROUND Laboratory studies suggest that fine particulate matter (≤ 2.5 µm in diameter; PM(2.5)) can activate pathophysiological responses that may induce insulin resistance and type 2 diabetes. However, epidemiological evidence relating PM2.5 and diabetes is sparse, particularly for incident diabetes. OBJECTIVES We conducted a population-based cohort study to determine whether long-term exposure to ambient PM(2.5) is associated with incident diabetes. METHODS We assembled a cohort of 62,012 nondiabetic adults who lived in Ontario, Canada, and completed one of five population-based health surveys between 1996 and 2005. Follow-up extended until 31 December 2010. Incident diabetes diagnosed between 1996 and 2010 was ascertained using the Ontario Diabetes Database, a validated registry of persons diagnosed with diabetes (sensitivity = 86%, specificity = 97%). Six-year average concentrations of PM2.5 at the postal codes of baseline residences were derived from satellite observations. We used Cox proportional hazards models to estimate the associations, adjusting for various individual-level risk factors and contextual covariates such as smoking, body mass index, physical activity, and neighborhood-level household income. We also conducted multiple sensitivity analyses. In addition, we examined effect modification for selected comorbidities and sociodemographic characteristics. RESULTS There were 6,310 incident cases of diabetes over 484,644 total person-years of follow-up. The adjusted hazard ratio for a 10-µg/m(3) increase in PM(2.5) was 1.11 (95% CI: 1.02, 1.21). Estimated associations were comparable among all sensitivity analyses. We did not find strong evidence of effect modification by comorbidities or sociodemographic covariates. CONCLUSIONS This study suggests that long-term exposure to PM2.5 may contribute to the development of diabetes.

DOI: 10.1289/ehp.1205958

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@inproceedings{Chen2013RiskOI, title={Risk of Incident Diabetes in Relation to Long-term Exposure to Fine Particulate Matter in Ontario, Canada}, author={Hong Chen and Richard T. Burnett and Jeffrey C. Kwong and Paul J . Villeneuve and Mark S. Goldberg and Robert D . Brook and Aaron van Donkelaar and Michael Jerrett and Randall V. Martin and Jeffrey R. Brook and Ray A Copes}, booktitle={Environmental health perspectives}, year={2013} }