Long-term air pollution exposure and diabetes risk in American older adults: A national secondary data-based cohort study.

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Long-term air pollution exposure and diabetes risk in American older adults : A national secondary data-based cohort study. / Yitshak Sade, Maayan; Shi, Liuhua; Colicino, Elena; Amini, Heresh; Schwartz, Joel D.; Di, Qian; Wright, Robert O.

In: Environmental Pollution, Vol. 320, 121056, 2023.

Research output: Contribution to journalJournal articlepeer-review

Harvard

Yitshak Sade, M, Shi, L, Colicino, E, Amini, H, Schwartz, JD, Di, Q & Wright, RO 2023, 'Long-term air pollution exposure and diabetes risk in American older adults: A national secondary data-based cohort study.', Environmental Pollution, vol. 320, 121056. https://doi.org/10.1016/j.envpol.2023.121056

APA

Yitshak Sade, M., Shi, L., Colicino, E., Amini, H., Schwartz, J. D., Di, Q., & Wright, R. O. (2023). Long-term air pollution exposure and diabetes risk in American older adults: A national secondary data-based cohort study. Environmental Pollution, 320, [121056]. https://doi.org/10.1016/j.envpol.2023.121056

Vancouver

Yitshak Sade M, Shi L, Colicino E, Amini H, Schwartz JD, Di Q et al. Long-term air pollution exposure and diabetes risk in American older adults: A national secondary data-based cohort study. Environmental Pollution. 2023;320. 121056. https://doi.org/10.1016/j.envpol.2023.121056

Author

Yitshak Sade, Maayan ; Shi, Liuhua ; Colicino, Elena ; Amini, Heresh ; Schwartz, Joel D. ; Di, Qian ; Wright, Robert O. / Long-term air pollution exposure and diabetes risk in American older adults : A national secondary data-based cohort study. In: Environmental Pollution. 2023 ; Vol. 320.

Bibtex

@article{b4ae92b8322e4fedbe035e05d8cf611b,
title = "Long-term air pollution exposure and diabetes risk in American older adults: A national secondary data-based cohort study.",
abstract = "Type 2 diabetes is a major public health concern. Several studies have found an increased diabetes risk associated with long-term air pollution exposure. However, most current studies are limited in their generalizability, exposure assessment, or the ability to differentiate incidence and prevalence cases. We assessed the association between air pollution and first documented diabetes occurrence in a national U.S. cohort of older adults to estimate diabetes risk. We included all Medicare enrollees 65 years and older in the fee-for-service program, part A and part B, in the contiguous United States (2000–2016). Participants were followed annually until the first recorded diabetes diagnosis, end of enrollment, or death (264, 869, 458 person-years). We obtained annual estimates of fine particulate matter (PM2.5), nitrogen dioxide (NO2), and warm-months ozone (O3) exposures from highly spatiotemporally resolved prediction models. We assessed the simultaneous effects of the pollutants on diabetes risk using survival analyses. We repeated the models in cohorts restricted to ZIP codes with air pollution levels not exceeding the national ambient air quality standards (NAAQS) during the study period. We identified 10, 024, 879 diabetes cases of 41, 780, 637 people (3.8% of person-years). The hazard ratio (HR) for first diabetes occurrence was 1.074 (95% CI 1.058; 1.089) for 5 μg/m3 increase in PM2.5, 1.055 (95% CI 1.050; 1.060) for 5 ppb increase in NO2, and 0.999 (95% CI 0.993; 1.004) for 5 ppb increase in O3. Both for NO2 and PM2.5 there was evidence of non-linear exposure-response curves with stronger associations at lower levels (NO2 ≤ 36 ppb, PM2.5 ≤ 8.2 μg/m3). Furthermore, associations remained in the restricted low-level cohorts. The O3-diabetes exposure-response relationship differed greatly between models and require further investigation. In conclusion, exposures to PM2.5 and NO2 are associated with increased diabetes risk, even when restricting the exposure to levels below the NAAQS set by the U.S. EPA.",
keywords = "Air pollution, Diabetes incidence, NO, O, PM",
author = "{Yitshak Sade}, Maayan and Liuhua Shi and Elena Colicino and Heresh Amini and Schwartz, {Joel D.} and Qian Di and Wright, {Robert O.}",
note = "Publisher Copyright: {\textcopyright} 2023 The Authors",
year = "2023",
doi = "10.1016/j.envpol.2023.121056",
language = "English",
volume = "320",
journal = "Environmental Pollution",
issn = "0269-7491",
publisher = "Pergamon Press",

}

RIS

TY - JOUR

T1 - Long-term air pollution exposure and diabetes risk in American older adults

T2 - A national secondary data-based cohort study.

AU - Yitshak Sade, Maayan

AU - Shi, Liuhua

AU - Colicino, Elena

AU - Amini, Heresh

AU - Schwartz, Joel D.

AU - Di, Qian

AU - Wright, Robert O.

N1 - Publisher Copyright: © 2023 The Authors

PY - 2023

Y1 - 2023

N2 - Type 2 diabetes is a major public health concern. Several studies have found an increased diabetes risk associated with long-term air pollution exposure. However, most current studies are limited in their generalizability, exposure assessment, or the ability to differentiate incidence and prevalence cases. We assessed the association between air pollution and first documented diabetes occurrence in a national U.S. cohort of older adults to estimate diabetes risk. We included all Medicare enrollees 65 years and older in the fee-for-service program, part A and part B, in the contiguous United States (2000–2016). Participants were followed annually until the first recorded diabetes diagnosis, end of enrollment, or death (264, 869, 458 person-years). We obtained annual estimates of fine particulate matter (PM2.5), nitrogen dioxide (NO2), and warm-months ozone (O3) exposures from highly spatiotemporally resolved prediction models. We assessed the simultaneous effects of the pollutants on diabetes risk using survival analyses. We repeated the models in cohorts restricted to ZIP codes with air pollution levels not exceeding the national ambient air quality standards (NAAQS) during the study period. We identified 10, 024, 879 diabetes cases of 41, 780, 637 people (3.8% of person-years). The hazard ratio (HR) for first diabetes occurrence was 1.074 (95% CI 1.058; 1.089) for 5 μg/m3 increase in PM2.5, 1.055 (95% CI 1.050; 1.060) for 5 ppb increase in NO2, and 0.999 (95% CI 0.993; 1.004) for 5 ppb increase in O3. Both for NO2 and PM2.5 there was evidence of non-linear exposure-response curves with stronger associations at lower levels (NO2 ≤ 36 ppb, PM2.5 ≤ 8.2 μg/m3). Furthermore, associations remained in the restricted low-level cohorts. The O3-diabetes exposure-response relationship differed greatly between models and require further investigation. In conclusion, exposures to PM2.5 and NO2 are associated with increased diabetes risk, even when restricting the exposure to levels below the NAAQS set by the U.S. EPA.

AB - Type 2 diabetes is a major public health concern. Several studies have found an increased diabetes risk associated with long-term air pollution exposure. However, most current studies are limited in their generalizability, exposure assessment, or the ability to differentiate incidence and prevalence cases. We assessed the association between air pollution and first documented diabetes occurrence in a national U.S. cohort of older adults to estimate diabetes risk. We included all Medicare enrollees 65 years and older in the fee-for-service program, part A and part B, in the contiguous United States (2000–2016). Participants were followed annually until the first recorded diabetes diagnosis, end of enrollment, or death (264, 869, 458 person-years). We obtained annual estimates of fine particulate matter (PM2.5), nitrogen dioxide (NO2), and warm-months ozone (O3) exposures from highly spatiotemporally resolved prediction models. We assessed the simultaneous effects of the pollutants on diabetes risk using survival analyses. We repeated the models in cohorts restricted to ZIP codes with air pollution levels not exceeding the national ambient air quality standards (NAAQS) during the study period. We identified 10, 024, 879 diabetes cases of 41, 780, 637 people (3.8% of person-years). The hazard ratio (HR) for first diabetes occurrence was 1.074 (95% CI 1.058; 1.089) for 5 μg/m3 increase in PM2.5, 1.055 (95% CI 1.050; 1.060) for 5 ppb increase in NO2, and 0.999 (95% CI 0.993; 1.004) for 5 ppb increase in O3. Both for NO2 and PM2.5 there was evidence of non-linear exposure-response curves with stronger associations at lower levels (NO2 ≤ 36 ppb, PM2.5 ≤ 8.2 μg/m3). Furthermore, associations remained in the restricted low-level cohorts. The O3-diabetes exposure-response relationship differed greatly between models and require further investigation. In conclusion, exposures to PM2.5 and NO2 are associated with increased diabetes risk, even when restricting the exposure to levels below the NAAQS set by the U.S. EPA.

KW - Air pollution

KW - Diabetes incidence

KW - NO

KW - O

KW - PM

U2 - 10.1016/j.envpol.2023.121056

DO - 10.1016/j.envpol.2023.121056

M3 - Journal article

C2 - 36634862

AN - SCOPUS:85147121824

VL - 320

JO - Environmental Pollution

JF - Environmental Pollution

SN - 0269-7491

M1 - 121056

ER -

ID: 337205476