Long-term exposure to traffic-related air pollution and diabetes-associated mortality: a cohort study

TY - JOUR

T1 - Long-term exposure to traffic-related air pollution and diabetes-associated mortality: a cohort study

AU - Raaschou-Nielsen, O

AU - Sørensen, M

AU - Ketzel, Matthias

AU - Hertel, O

AU - Loft, S

AU - Tjønneland, A

AU - Overvad, K

AU - Andersen, Zorana Jovanovic

PY - 2013/1

Y1 - 2013/1

N2 - Aims/hypothesis: The aim of this study was to investigate whether air pollution from traffic at a residence is associated with mortality related to type 1 or type 2 diabetes. Methods: We followed up 52,061 participants in the Danish Diet, Cancer and Health cohort for diabetes-related mortality in the nationwide Register of Causes of Death, from baseline in 1993-1997 up to the end of 2009, and traced their residential addresses since 1971 in the Central Population Registry. We used dispersion-modelled concentration of nitrogen dioxide (NO2) since 1971 and amount of traffic at the baseline residence as indicators of traffic-related air pollution and used Cox regression models to estimate mortality-rate ratios (MRRs) with adjustment for potential confounders. Results: Mean levels of NO2 at the residence since 1971 were significantly associated with mortality from diabetes. Exposure above 19.4 μg/m3 (upper quartile) was associated with a MRR of 2.15 (95% CI 1.21, 3.83) when compared with below 13.6 μg/m3 (lower quartile), corresponding to an MRR of 1.31 (95% CI 0.98, 1.76) per 10 μg/m3 NO2 after adjustment for potential confounders. Conclusions/ interpretation: This study suggests that traffic-related air pollution is associated with mortality from diabetes. If confirmed, reduction in population exposure to traffic-related air pollution could be an additional strategy against the global public health burden of diabetes.

AB - Aims/hypothesis: The aim of this study was to investigate whether air pollution from traffic at a residence is associated with mortality related to type 1 or type 2 diabetes. Methods: We followed up 52,061 participants in the Danish Diet, Cancer and Health cohort for diabetes-related mortality in the nationwide Register of Causes of Death, from baseline in 1993-1997 up to the end of 2009, and traced their residential addresses since 1971 in the Central Population Registry. We used dispersion-modelled concentration of nitrogen dioxide (NO2) since 1971 and amount of traffic at the baseline residence as indicators of traffic-related air pollution and used Cox regression models to estimate mortality-rate ratios (MRRs) with adjustment for potential confounders. Results: Mean levels of NO2 at the residence since 1971 were significantly associated with mortality from diabetes. Exposure above 19.4 μg/m3 (upper quartile) was associated with a MRR of 2.15 (95% CI 1.21, 3.83) when compared with below 13.6 μg/m3 (lower quartile), corresponding to an MRR of 1.31 (95% CI 0.98, 1.76) per 10 μg/m3 NO2 after adjustment for potential confounders. Conclusions/ interpretation: This study suggests that traffic-related air pollution is associated with mortality from diabetes. If confirmed, reduction in population exposure to traffic-related air pollution could be an additional strategy against the global public health burden of diabetes.

U2 - 10.1007/s00125-012-2698-7

DO - 10.1007/s00125-012-2698-7

M3 - Journal article

C2 - 22918192

SN - 0012-186X

VL - 56

SP - 36

EP - 46

JO - Diabetologia

JF - Diabetologia

IS - 1

ER -