title: PM2.5 and Diabetes and Hypertension Incidence in the Black Women's Health Study.
abstract: BACKGROUND
  Clinical studies have shown that exposure to fine particulate matter (PM2.5) can increase insulin resistance and blood pressure. The epidemiologic evidence for an association of PM2.5 exposure with the incidence of type 2 diabetes or hypertension is inconsistent. Even a modest association would have great public health importance given the ubiquity of exposure and high prevalence of the conditions.
  
  
  METHODS
  We used Cox proportional hazards models to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident type 2 diabetes and hypertension associated with exposure to PM2.5 in a large cohort of African American women living in 56 metropolitan areas across the US, using data from the Black Women's Health Study. Pollutant levels were estimated at all residential locations over follow-up with a hybrid model incorporating land use regression and Bayesian Maximum Entropy techniques.
  
  
  RESULTS
  During 1995 to 2011, 4,387 cases of diabetes and 9,570 cases of hypertension occurred. In models controlling for age, questionnaire cycle, and metro area, there were positive associations with diabetes (HR = 1.13, 95% CI = 1.04, 1.24) and hypertension (HR = 1.06, 95% CI = 1.00, 1.12) per interquartile range of PM2.5 (2.9 μg/m). Multivariable HRs, however, were 0.99 (95% CI = 0.90, 1.09) for diabetes and 0.99 (95% CI = 0.93, 1.06) for hypertension.
  
  
  CONCLUSIONS
  Our results provide little support for an association of PM2.5 with diabetes or hypertension incidence.
authors.affiliation: aSlone Epidemiology Center at Boston University, Boston, MA; bDepartment of Biostatistics, Boston University School of Public Health, Boston, MA; cHealthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Canada; dDepartment of Occupational and Environmental Health Sciences, University of Washington School of Public Health, Seattle, WA; eDivision of Cardiovascular Medicine, University of Michigan Medical School, Ann Arbor, MI; and fDivision of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA.
authors.forename: Patricia F
authors.initials: PF
authors.lastname: Coogan
authors.forename: Laura F
authors.initials: LF
authors.lastname: White
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Yu
authors.forename: Richard T
authors.initials: RT
authors.lastname: Burnett
authors.forename: Edmund
authors.initials: E
authors.lastname: Seto
authors.forename: Robert D
authors.initials: RD
authors.lastname: Brook
authors.forename: Julie R
authors.initials: JR
authors.lastname: Palmer
authors.forename: Lynn
authors.initials: L
authors.lastname: Rosenberg
authors.forename: Michael
authors.initials: M
authors.lastname: Jerrett
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000397:Air Pollution / Q000706:statistics & numerical data*; D001499:Bayes Theorem; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D004781:Environmental Exposure / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D015994:Incidence; D008137:Longitudinal Studies; D008875:Middle Aged; D052638:Particulate Matter; D016016:Proportional Hazards Models; D011446:Prospective Studies; D014505:Urban Population / Q000706:statistics & numerical data
chemical_list: D052638:Particulate Matter