title: Long-term exposure to fine particulate matter and incidence of type 2 diabetes mellitus in a cohort study: effects of total and traffic-specific air pollution.
abstract: BACKGROUND
  Studies investigating the link between long-term exposure to air pollution and incidence of diabetes are still scarce and results are inconsistent, possibly due to different compositions of the particle mixture. We investigate the long-term effect of traffic-specific and total particulate matter (PM) and road proximity on cumulative incidence of diabetes mellitus (mainly type 2) in a large German cohort.
  
  
  METHODS
  We followed prospectively 3607 individuals without diabetes at baseline (2000-2003) from the Heinz Nixdorf Recall Study in Germany (mean follow-up time 5.1 years). Mean annual exposures to total as well as traffic-specific PM10 and PM2.5 at residence were estimated using a chemistry transport model (EURAD, 1 km(2) resolution). Effect estimates for an increase of 1 μg/m(3) in PM were obtained with Poisson regression adjusting for sex, age, body mass index, lifestyle factors, area-level and individual-level socio-economic status, and city.
  
  
  RESULTS
  331 incident cases developed. Adjusted RRs for total PM10 and PM2.5 were 1.05 (95%-CI: 1.00;1.10) and 1.03 (95%-CI: 0.95;1.12), respectively. Markedly higher point estimates were found for local traffic-specific PM with RRs of 1.36 (95%-CI: 0.98;1.89) for PM10 and 1.36 (95%-CI: 0.97;1.89) for PM2.5. Individuals living closer than 100 m to a busy road had a more than 30% higher risk (1.37;95%-CI: 1.04;1.81) than those living further than 200 m away.
  
  
  CONCLUSIONS
  Long-term exposure to total PM increases type two diabetes risk in the general population, as does living close to a major road. Local traffic-specific PM was related to higher risks for type two diabetes than total PM.
authors.affiliation: IUF - Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany. gudrun.weinmayr@uni-duesseldorf.de.|Medical School, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany. gudrun.weinmayr@uni-duesseldorf.de.
authors.forename: Gudrun
authors.initials: G
authors.lastname: Weinmayr
authors.affiliation: IUF - Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany. frauke.hennig@iuf-duesseldorf.de.
authors.forename: Frauke
authors.initials: F
authors.lastname: Hennig
authors.affiliation: IUF - Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany. kateryna.fuks@iuf-duesseldorf.de.
authors.forename: Kateryna
authors.initials: K
authors.lastname: Fuks
authors.affiliation: Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany. Michael.Nonnemacher@uk-essen.de.
authors.forename: Michael
authors.initials: M
authors.lastname: Nonnemacher
authors.affiliation: Rhenish Institute for Environmental Research at the University of Cologne, Cologne, Germany. Hermann.Jakobs@eurad.uni-koeln.de.
authors.forename: Hermann
authors.initials: H
authors.lastname: Jakobs
authors.affiliation: Department of Cardiology, West German Heart Centre of Essen, University of Duisburg-Essen, Essen, Germany. Stefan.Moehlenkamp@uk-essen.de.
authors.forename: Stefan
authors.initials: S
authors.lastname: Möhlenkamp
authors.affiliation: Department of Cardiology, West German Heart Centre of Essen, University of Duisburg-Essen, Essen, Germany. Raimund.Erbel@uk-essen.de.
authors.forename: Raimund
authors.initials: R
authors.lastname: Erbel
authors.affiliation: Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany. k-h.Joeckel@uk-essen.de.
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Jöckel
authors.affiliation: IUF - Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany. b.hoffmann@uni-duesseldorf.de.|Medical School, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany. b.hoffmann@uni-duesseldorf.de.
authors.forename: Barbara
authors.initials: B
authors.lastname: Hoffmann
authors.affiliation: Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany. Susanne.Moebus@uk-essen.de.
authors.forename: Susanne
authors.initials: S
authors.lastname: Moebus
mesh_terms: D000367:Age Factors; D000368:Aged; D000393:Air Pollutants / Q000009:adverse effects* / Q000032:analysis*; D000397:Air Pollution / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000139:chemically induced*; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000139:chemically induced* / Q000453:epidemiology; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D052638:Particulate Matter / Q000009:adverse effects / Q000032:analysis; D011446:Prospective Studies; D012737:Sex Factors; D013997:Time Factors; D001335:Vehicle Emissions / Q000032:analysis*
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter; D001335:Vehicle Emissions