title: Maternal exposure to air pollution and type 1 diabetes--Accounting for genetic factors.
abstract: BACKGROUND
  Genetic and non-genetic factors probably act together to initiate and accelerate development of type 1 diabetes [T1D]. One suggested risk factor contributing to development of T1D is air pollution.
  
  
  OBJECTIVE
  The aim of the study was to investigate whether maternal exposure during pregnancy to air pollution, measured as nitrogen oxides [NOx] and ozone, in a low-dose exposure area was associated with the child developing T1D.
  
  
  METHODS
  In Scania (Skåne), the most southern county in Sweden, 84,039 infants were born during the period 1999-2005. By the end of April 2013, 324 of those children had been diagnosed with T1D. For each of those T1D children three control children were randomly selected and matched for HLA genotype and birth year. Individually modelled exposure data at residence during pregnancy were assessed for nitrogen oxides [NOx], traffic density and ozone.
  
  
  RESULTS
  Ozone as well as NOx exposures were associated with T1D. When the highest exposure group was compared to the lowest group an odds ratios of 1.62 (95% confidence interval [CI] 0.99-2.65) was observed for ozone in the second trimester and 1.58 (95% CI 1.06-2.35) for NOx in the third trimester.
  
  
  CONCLUSIONS
  This study indicates that living in an area with elevated levels of air pollution during pregnancy may be a risk factor for offspring T1D.
authors.affiliation: Division of Occupational and Environmental Medicine, Lund University, SE-221 85 Lund, Sweden. Electronic address: Ebba.Malmqvist@med.lu.se.
authors.forename: Ebba
authors.initials: E
authors.lastname: Malmqvist
authors.affiliation: Department of Clinical Sciences-Paediatrics, University Hospital MAS, SE-205 02 Malmö, Sweden.
authors.forename: Helena Elding
authors.initials: HE
authors.lastname: Larsson
authors.affiliation: Department of Clinical Sciences-Paediatrics, University Hospital MAS, SE-205 02 Malmö, Sweden.
authors.forename: Ida
authors.initials: I
authors.lastname: Jönsson
authors.affiliation: Division of Occupational and Environmental Medicine, Lund University, SE-221 85 Lund, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Rignell-Hydbom
authors.affiliation: Department of Clinical Sciences-Paediatrics, University Hospital MAS, SE-205 02 Malmö, Sweden.
authors.forename: Sten-Anders
authors.initials: SA
authors.lastname: Ivarsson
authors.affiliation: Division of Occupational and Environmental Medicine, Lund University, SE-221 85 Lund, Sweden.
authors.forename: Håkan
authors.initials: H
authors.lastname: Tinnerberg
authors.affiliation: Division of Occupational and Environmental Medicine, Lund University, SE-221 85 Lund, Sweden.
authors.forename: Emilie
authors.initials: E
authors.lastname: Stroh
authors.affiliation: Division of Occupational and Environmental Medicine, Lund University, SE-221 85 Lund, Sweden.
authors.forename: Ralf
authors.initials: R
authors.lastname: Rittner
authors.affiliation: Division of Occupational and Environmental Medicine, Lund University, SE-221 85 Lund, Sweden.
authors.forename: Kristina
authors.initials: K
authors.lastname: Jakobsson
authors.affiliation: Division of Nuclear Physics, Lund University, SE-221 85 Lund, Sweden.
authors.forename: Erik
authors.initials: E
authors.lastname: Swietlicki
authors.affiliation: Division of Occupational and Environmental Medicine, Lund University, SE-221 85 Lund, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Rylander
mesh_terms: D000397:Air Pollution; D002648:Child; D015986:Confounding Factors, Epidemiologic; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology / Q000209:etiology* / Q000235:genetics; D005260:Female; D006801:Humans; D008297:Male; D018811:Maternal Exposure; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D013548:Sweden / Q000453:epidemiology
keywords: Air pollution; Diabetes mellitus type 1; Maternal exposure; Nitrogen oxides; Ozone; Type 1 diabetes mellitus