title: Long-term air pollution exposure and diabetes in a population-based Swiss cohort.
abstract: Air pollution is an important risk factor for global burden of disease. There has been recent interest in its possible role in the etiology of diabetes mellitus. Experimental evidence is suggestive, but epidemiological evidence is limited and mixed. We therefore explored the association between air pollution and prevalent diabetes, in a population-based Swiss cohort. We did cross-sectional analyses of 6392 participants of the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults [SAPALDIA], aged between 29 and 73 years. We used estimates of average individual home outdoor PM10 [particulate matter <10μm in diameter] and NO2 [nitrogen dioxide] exposure over the 10 years preceding the survey. Their association with diabetes was modeled using mixed logistic regression models, including participants' study area as random effect, with incremental adjustment for confounders. There were 315 cases of diabetes (prevalence: 5.5% [95% confidence interval (CI): 2.8, 7.2%]). Both PM10 and NO2 were associated with prevalent diabetes with respective odds ratios of 1.40 [95% CI: 1.17, 1.67] and 1.19 [95% CI: 1.03, 1.38] per 10μg/m(3) increase in the average home outdoor level. Associations with PM10 were generally stronger than with NO2, even in the two-pollutant model. There was some indication that beta blockers mitigated the effect of PM10. The associations remained stable across different sensitivity analyses. Our study adds to the evidence that long term air pollution exposure is associated with diabetes mellitus. PM10 appears to be a useful marker of aspects of air pollution relevant for diabetes. This association can be observed at concentrations below air quality guidelines.
authors.affiliation: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
authors.forename: Ikenna C
authors.initials: IC
authors.lastname: Eze
authors.affiliation: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Schaffner
authors.affiliation: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Fischer
authors.affiliation: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; IUF - Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany.
authors.forename: Tamara
authors.initials: T
authors.lastname: Schikowski
authors.affiliation: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Adam
authors.affiliation: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
authors.forename: Medea
authors.initials: M
authors.lastname: Imboden
authors.affiliation: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
authors.forename: Ming
authors.initials: M
authors.lastname: Tsai
authors.affiliation: Division of Cardiology, Geneva University Hospital, Geneva, Switzerland.
authors.forename: David
authors.initials: D
authors.lastname: Carballo
authors.affiliation: Institute of Clinical Chemistry, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Arnold
authors.initials: A
authors.lastname: von Eckardstein
authors.affiliation: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
authors.forename: Nino
authors.initials: N
authors.lastname: Künzli
authors.affiliation: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Schindler
authors.affiliation: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland. Electronic address: Nicole.Probst@unibas.ch.
authors.forename: Nicole
authors.initials: N
authors.lastname: Probst-Hensch
mesh_terms: D000328:Adult; D000368:Aged; D000393:Air Pollutants / Q000009:adverse effects* / Q000032:analysis; D000397:Air Pollution / Q000009:adverse effects* / Q000032:analysis; D001786:Blood Glucose / Q000378:metabolism; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000378:metabolism; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D019570:Inhalation Exposure; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009585:Nitrogen Dioxide / Q000009:adverse effects / Q000032:analysis; D052638:Particulate Matter / Q000009:adverse effects / Q000032:analysis; D012307:Risk Factors; D013557:Switzerland / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000393:Air Pollutants; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D009585:Nitrogen Dioxide; D052638:Particulate Matter
keywords: Air pollution; Association analysis; Epidemiology; NO(2); PM(10); Type 2 diabetes