The Impact of Long-Term Air Pollution Exposure on Type 1 Diabetes Mellitus-Related Mortality among U.S. Medicare Beneficiaries
Background: Little of the previous literature has investigated associations between air pollution exposure and type 1 diabetes mellitus (T1DM)-related mortality, despite a well-established link between air pollution exposure and other autoimmune diseases. Methods: In a cohort of 53 million Medicare...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-03-01
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| Series: | Toxics |
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| Online Access: | https://www.mdpi.com/2305-6304/11/4/336 |
| _version_ | 1797603343872294912 |
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| author | Trenton J. Honda Fatemeh Kazemiparkouhi Helen Suh |
| author_facet | Trenton J. Honda Fatemeh Kazemiparkouhi Helen Suh |
| author_sort | Trenton J. Honda |
| collection | DOAJ |
| description | Background: Little of the previous literature has investigated associations between air pollution exposure and type 1 diabetes mellitus (T1DM)-related mortality, despite a well-established link between air pollution exposure and other autoimmune diseases. Methods: In a cohort of 53 million Medicare beneficiaries living across the conterminous United States, we used Cox proportional hazard models to assess the association of long-term PM<sub>2.5</sub> and NO<sub>2</sub> exposures on T1DM-related mortality from 2000 to 2008. Models included strata for age, sex, race, and ZIP code and controlled for neighborhood socioeconomic status (SES); we additionally investigated associations in two-pollutant models, and whether associations were modified by participant demographics. Results: A 10 μg/m<sup>3</sup> increase in 12-month average PM<sub>2.5</sub> (HR: 1.183; 95% CI: 1.037–1.349) and a 10 ppb increase in NO<sub>2</sub> (HR: 1.248; 95% CI: 1.089–1.431) was associated with an increased risk of T1DM-related mortality in age-, sex-, race-, ZIP code-, and SES-adjusted models. Associations for both pollutants were consistently stronger among Black (PM<sub>2.5</sub>: HR:1.877, 95% CI: 1.386–2.542; NO<sub>2</sub>: HR: 1.586, 95% CI: 1.258–2.001) and female (PM<sub>2.5</sub>: HR:1.297, 95% CI: 1.101–1.529; NO<sub>2</sub>: HR: 1.390, 95% CI: 1.187–1.627) beneficiaries. Conclusions: Long-term NO<sub>2</sub> and, to a lesser extent, PM<sub>2.5</sub> exposure is associated with statistically significant elevations in T1DM-related mortality risk. |
| first_indexed | 2024-03-11T04:27:51Z |
| format | Article |
| id | doaj.art-2a70c2b671bd46ed9c3fae4e536a5c9e |
| institution | Directory Open Access Journal |
| issn | 2305-6304 |
| language | English |
| last_indexed | 2024-03-11T04:27:51Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Toxics |
| spelling | doaj.art-2a70c2b671bd46ed9c3fae4e536a5c9e2023-11-17T21:37:26ZengMDPI AGToxics2305-63042023-03-0111433610.3390/toxics11040336The Impact of Long-Term Air Pollution Exposure on Type 1 Diabetes Mellitus-Related Mortality among U.S. Medicare BeneficiariesTrenton J. Honda0Fatemeh Kazemiparkouhi1Helen Suh2School of Clinical and Rehabilitation Sciences, Northeastern University, Boston, MA 02115, USADepartment of Civil and Environmental Engineering, Tufts University, Medford, MA 02155, USADepartment of Civil and Environmental Engineering, Tufts University, Medford, MA 02155, USABackground: Little of the previous literature has investigated associations between air pollution exposure and type 1 diabetes mellitus (T1DM)-related mortality, despite a well-established link between air pollution exposure and other autoimmune diseases. Methods: In a cohort of 53 million Medicare beneficiaries living across the conterminous United States, we used Cox proportional hazard models to assess the association of long-term PM<sub>2.5</sub> and NO<sub>2</sub> exposures on T1DM-related mortality from 2000 to 2008. Models included strata for age, sex, race, and ZIP code and controlled for neighborhood socioeconomic status (SES); we additionally investigated associations in two-pollutant models, and whether associations were modified by participant demographics. Results: A 10 μg/m<sup>3</sup> increase in 12-month average PM<sub>2.5</sub> (HR: 1.183; 95% CI: 1.037–1.349) and a 10 ppb increase in NO<sub>2</sub> (HR: 1.248; 95% CI: 1.089–1.431) was associated with an increased risk of T1DM-related mortality in age-, sex-, race-, ZIP code-, and SES-adjusted models. Associations for both pollutants were consistently stronger among Black (PM<sub>2.5</sub>: HR:1.877, 95% CI: 1.386–2.542; NO<sub>2</sub>: HR: 1.586, 95% CI: 1.258–2.001) and female (PM<sub>2.5</sub>: HR:1.297, 95% CI: 1.101–1.529; NO<sub>2</sub>: HR: 1.390, 95% CI: 1.187–1.627) beneficiaries. Conclusions: Long-term NO<sub>2</sub> and, to a lesser extent, PM<sub>2.5</sub> exposure is associated with statistically significant elevations in T1DM-related mortality risk.https://www.mdpi.com/2305-6304/11/4/336type 1 diabetesair pollutionchronic exposureparticulate matternitrogen dioxide |
| spellingShingle | Trenton J. Honda Fatemeh Kazemiparkouhi Helen Suh The Impact of Long-Term Air Pollution Exposure on Type 1 Diabetes Mellitus-Related Mortality among U.S. Medicare Beneficiaries Toxics type 1 diabetes air pollution chronic exposure particulate matter nitrogen dioxide |
| title | The Impact of Long-Term Air Pollution Exposure on Type 1 Diabetes Mellitus-Related Mortality among U.S. Medicare Beneficiaries |
| title_full | The Impact of Long-Term Air Pollution Exposure on Type 1 Diabetes Mellitus-Related Mortality among U.S. Medicare Beneficiaries |
| title_fullStr | The Impact of Long-Term Air Pollution Exposure on Type 1 Diabetes Mellitus-Related Mortality among U.S. Medicare Beneficiaries |
| title_full_unstemmed | The Impact of Long-Term Air Pollution Exposure on Type 1 Diabetes Mellitus-Related Mortality among U.S. Medicare Beneficiaries |
| title_short | The Impact of Long-Term Air Pollution Exposure on Type 1 Diabetes Mellitus-Related Mortality among U.S. Medicare Beneficiaries |
| title_sort | impact of long term air pollution exposure on type 1 diabetes mellitus related mortality among u s medicare beneficiaries |
| topic | type 1 diabetes air pollution chronic exposure particulate matter nitrogen dioxide |
| url | https://www.mdpi.com/2305-6304/11/4/336 |
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