Ambient ozone and incident diabetes: A prospective analysis in a large cohort of African American women.
Ozone is a ubiquitous air pollutant with increasing concentrations in many populous regions. Toxicological studies show that ozone can cause oxidative stress and increase insulin resistance. These pathways may contribute to metabolic changes and diabetes formation. In this paper, we investigate the association between ozone and incident type 2 diabetes in a large cohort of African American women.



We used Cox proportional hazards models to calculate hazard ratios (HRs) for incident type 2 diabetes associated with exposure to ozone in a cohort of 45,231 African American women living in 56 metropolitan areas across the United States. Ozone levels were estimated using the U.S. EPA Models-3/Community Multiscale Air Quality (CMAQ) predictions fused with ground measurements at a resolution of 12km for the years 2007-2008.



The HR per interquartile range increment of 6.7ppb of ozone was 1.18 (95% CI 1.04-1.34) for incident diabetes in adjusted models. This association was unaltered in models that controlled for fine particulate matter with diameter <2.5μm (PM2.5). Associations were modified by nitrogen dioxide (NO2) levels, such that HRs for ozone levels were larger in areas of lower NO2.



Our results provide initial evidence of a positive association between O3and incident diabetes in African American women. Given the ubiquity of ozone exposure and the importance of diabetes on quality of life and survival, these results may have important implications for the protection of public health.
Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles, United States. Electronic address: mjerrett@ucla.edu.
Michael
M
Jerrett
Division of Cardiovascular Medicine, University of Michigan Medical School, United States.
Robert
R
Brook
Department of Biostatistics, Boston University School of Public Health, United States.
Laura F
LF
White
Population Studies Division, Health Canada, Ottawa, Ontario, Canada.
Richard T
RT
Burnett
Slone Epidemiology Center at Boston University, United States.
Jeffrey
J
Yu
Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, United States.
Jason
J
Su
Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, United States.
Edmund
E
Seto
Department of Civil and Environmental Engineering, University of Washington, United States.
Julian
J
Marshall
Slone Epidemiology Center at Boston University, United States.
Julie R
JR
Palmer
Slone Epidemiology Center at Boston University, United States.
Lynn
L
Rosenberg
Slone Epidemiology Center at Boston University, United States.
Patricia F
PF
Coogan
D000328:Adult; D001741:Black or African American; D000368:Aged; D000393:Air Pollutants / Q000032:analysis*; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000208:ethnology; D005260:Female; D006801:Humans; D019570:Inhalation Exposure / Q000032:analysis*; D008875:Middle Aged; D009585:Nitrogen Dioxide / Q000032:analysis; D010126:Ozone / Q000032:analysis*; D052638:Particulate Matter / Q000032:analysis*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014481:United States; D055815:Young Adult
D000393:Air Pollutants; D052638:Particulate Matter; D010126:Ozone; D009585:Nitrogen Dioxide
African American women; Air pollution; Diabetes; Exposure; Ozone