Research published in July in Lancet Planetary Health highlights the risk of poor air quality and its potential link to increased risk of diabetes. Researchers conducted a longitudinal study that evaluated a cohort of 1.7 million U.S. veterans to determine whether exposure to air pollution increases disease risk. Data were extracted from various databases, and survival models were used to explore the potential association of air pollution on these veterans who had no previous history of diabetes.

The survival models and methods used were adjusted for sociodemographic and other health factors, and data from the models were reported as hazard ratios (HRs) and 95% confidence intervals. Lead author, Benjamin Bowe, MPH, who is affiliated with the Clinical Epidemiology Center, Research and Education Service, VA St. Louis Health Care System, and the Department of Epidemiology and Biostatistics, Saint Louis University, and his team evaluated the risk of all-cause mortality as well as negative exposure control and a negative outcome control (i.e., risk of lower limb fracture). The study team included researchers from the VA St. Louis Health Care System.

The research team points out that their study addresses a significant knowledge gap and “defines and quantifies the burden of diabetes attributable to air pollution,” adding that substantial risk exists at concentrations well below those outlined in the air-quality standards of the World Health Organization and other regulatory agencies. Although the association was nonlinear, the integrated exposure response function suggests that even a modest reduction in exposure decreases the risk of diabetes, which can be most significant in areas with the heaviest pollution.  

Additional variability was detected in geographic distribution, and higher risk was more skewed towards regions least prepared to address the consequences and challenges of this excess disease burden. The researchers also note that “The results will possibly be helpful to promote the public’s awareness about the effect of PM2.5 pollution on the risk of diabetes, and serve to inform and guide policy making aimed at addressing health consequences of environmental air pollution.”
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