Association of PM2.5with diabetes, asthma, and high blood pressure incidence in Canada: A spatiotemporal analysis of the impacts of the energy generation and fuel sales.
Numerous studies have reported an association between fine particulate matter (PM2.5) and human health. Often these relationships are influenced by environmental factor that varies spatially and/or temporally. To our knowledge, there are no studies in Canada that have considered energy generation and fuel sales as PM2.5effects modifiers. Determining exposure and disease-specific risk factors over space and time is crucial for disease prevention and control. In this study, we evaluated the association of PM2.5with diabetes, asthma, and High Blood Pressure (HBP) incidence in Canada. Then we explored the impact of the energy generation and fuel sales on association changes. We fit an age-period-cohort as the study design, and we applied an over-dispersed Poisson regression model to estimate the risk. We conducted a sensitivity analysis to explore the impact of variation in clean energy rates and fuel sales on outcomes changes. The study included 117 health regions in Canada between 2007 and 2014. Our findings showed strong association of PM2.5with diabetes, asthma, and HBP incidence. A two-year increase of 10μg/m3in PM2.5was associated with an increased risk of 5.34% (95% CI: 2.28%; 12.53%) in diabetes incidence, 2.24% (95% CI: 0.93%; 5.38%) in asthma incidence, and 8.29% (95% CI: 3.44%; 19.98%) in HBP incidence. Our sensitivity analysis findings suggest higher risks of diabetes, asthma and HBP incidence when there is low clean energy generation. On the other hand, we found lower risk when we considered high rate of clean energy generation. For example, considering only diabetes incidence, we found that the risk in health regions with low rates of clean electricity is approximately 700% higher than the risk in health regions with high rates of clean electricity. Furthermore, our analysis suggested that the risk in regions with low fuel sales is 66% lower than the risk is health regions with low rates of clean electricity. Our study provides support for the creation of effective environmental health public policies that take into account the risk factors present in Canadians health regions.
School of Geography and Earth Sciences, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada. Electronic address: weeberb@gmail.com.
Weeberb J
WJ
Requia
Department of Geography and Environmental Studies, Ryerson University, Canada. Electronic address: adamsmd@ryerson.ca.
Matthew D
MD
Adams
Harvard T.H. Chan School of Public Health, Harvard University, United States. Electronic address: petros@hsph.harvard.edu.
Petros
P
Koutrakis
D000393:Air Pollutants / Q000009:adverse effects*; D001249:Asthma / Q000453:epidemiology*; D002170:Canada / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology*; D004781:Environmental Exposure / Q000009:adverse effects; D005648:Fuel Oils; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D015994:Incidence; D052638:Particulate Matter / Q000009:adverse effects; D059205:Renewable Energy; D062211:Spatio-Temporal Analysis
D000393:Air Pollutants; D005648:Fuel Oils; D052638:Particulate Matter
Air pollution; Asthma incidence; Diabetes incidence; Energy; Fuel; High blood pressure incidence; Particulate matter