title: Metal Exposure and Risk of Diabetes and Prediabetes among Chinese Occupational Workers.
abstract: OBJECTIVE
  To study the association between metal exposure and risk of diabetes and prediabetes among Chinese workers exposed to metals.
  
  
  METHODS
  We used data obtained from the baseline survey of the Jinchang Cohort Study of workers in Jinchang Industry, the largest nickel production company in China. A total of 42,122 workers ⋝20 years of age were included in the study. A standardized, structured questionnaire was used to collect epidemiological information. Physical examinations and laboratory tests were conducted to evaluate the health status of the participants and to measure various biomarkers including blood sugar, lipids, and urinary metal concentrations. Logistic regression was used to study the association between occupational groups categorized according to the measured metal levels (office workers, low-level; mining/production workers, mid-level; and smelting/refining workers, high-level) and risk of diabetes and prediabetes.
  
  
  RESULTS
  The overall prevalence of diabetes and prediabetes was 7.5% and 16.8%, respectively. The adjusted odds ratios for diabetes among mining/production workers and smelting/refining workers compared to office workers were 1.5 (95% CI: 1.3, 1.7) and 3.8 (95% CI: 3.4, 4.3), respectively. No association was observed between these occupational groups and prediabetes in this study.
  
  
  CONCLUSIONS
  Occupations associated with higher levels of metal exposure were associated with an increased risk of diabetes in this cohort. More studies are needed to confirm this observed association.
authors.affiliation: Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, Gansu, China; Department of Epidemiology, School of Public Health, Brown University, Providence, RI 02912, USA.
authors.forename: Ai Min
authors.initials: AM
authors.lastname: Yang
authors.affiliation: Center of Medical Laboratory, Lanzhou University, Lanzhou 730000, Gansu, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Cheng
authors.affiliation: Workers' Hospital of Jinchuan Group Co., Ltd., Jinchang 730000, Gansu, China.
authors.forename: Hong Quan
authors.initials: HQ
authors.lastname: Pu
authors.affiliation: Department of Epidemiology, School of Public Health, Brown University, Providence, RI 02912, USA.
authors.forename: Si Min
authors.initials: SM
authors.lastname: Liu
authors.affiliation: Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, Gansu, China.
authors.forename: Juan Sheng
authors.initials: JS
authors.lastname: Li
authors.affiliation: Department of Environmental Health Sciences, School of Public Health, Yale University, New Haven, CT 06511, USA.
authors.forename: Bryan A
authors.initials: BA
authors.lastname: Bassig
authors.affiliation: Cancer Hospital, Chinese Academy of Medical Sciences, Beijing 100021, China.
authors.forename: Min
authors.initials: M
authors.lastname: Dai
authors.affiliation: Workers' Hospital of Jinchuan Group Co., Ltd., Jinchang 730000, Gansu, China.
authors.forename: Hai Yan
authors.initials: HY
authors.lastname: Li
authors.affiliation: Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, Gansu, China.
authors.forename: Xiao Bin
authors.initials: XB
authors.lastname: Hu
authors.affiliation: Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, Gansu, China.
authors.forename: Xiao Wei
authors.initials: XW
authors.lastname: Ren
authors.affiliation: Department of Epidemiology, School of Public Health, Brown University, Providence, RI 02912, USA.
authors.forename: Tong Zhang
authors.initials: TZ
authors.lastname: Zheng
authors.affiliation: Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou 730000, Gansu, China.
authors.forename: Ya Na
authors.initials: YN
authors.lastname: Bai
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D019216:Metals, Heavy / Q000633:toxicity* / Q000652:urine; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D011236:Prediabetic State / Q000139:chemically induced* / Q000453:epidemiology
chemical_list: D019216:Metals, Heavy
keywords: Diabetes; Metals; Occupational exposure; Prediabetes; Risk factors