GBD 2019 Diabetes and Air Pollution Collaborators (Including:

). (2022) Estimates, trends, and drivers of the global burden of type 2 diabetes attributable to PM2·5 air pollution, 1990–2019 : an analysis of data from the Global Burden of Disease Study 2019. The Lancet Planetary Health, 6 (7). e586-e600. doi:10.1016/S2542-5196(22)00122-X ISSN 2542-5196.

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Abstract

Background
Experimental and epidemiological studies indicate an association between exposure to particulate matter (PM) air pollution and increased risk of type 2 diabetes. In view of the high and increasing prevalence of diabetes, we aimed to quantify the burden of type 2 diabetes attributable to PM2·5 originating from ambient and household air pollution.
Methods
We systematically compiled all relevant cohort and case-control studies assessing the effect of exposure to household and ambient fine particulate matter (PM2·5) air pollution on type 2 diabetes incidence and mortality. We derived an exposure–response curve from the extracted relative risk estimates using the MR-BRT (meta-regression—Bayesian, regularised, trimmed) tool. The estimated curve was linked to ambient and household PM2·5 exposures from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019, and estimates of the attributable burden (population attributable fractions and rates per 100 000 population of deaths and disability-adjusted life-years) for 204 countries from 1990 to 2019 were calculated. We also assessed the role of changes in exposure, population size, age, and type 2 diabetes incidence in the observed trend in PM2·5-attributable type 2 diabetes burden. All estimates are presented with 95% uncertainty intervals.
Findings
In 2019, approximately a fifth of the global burden of type 2 diabetes was attributable to PM2·5 exposure, with an estimated 3·78 (95% uncertainty interval 2·68–4·83) deaths per 100 000 population and 167 (117–223) disability-adjusted life-years (DALYs) per 100 000 population. Approximately 13·4% (9·49–17·5) of deaths and 13·6% (9·73–17·9) of DALYs due to type 2 diabetes were contributed by ambient PM2·5, and 6·50% (4·22–9·53) of deaths and 5·92% (3·81–8·64) of DALYs by household air pollution. High burdens, in terms of numbers as well as rates, were estimated in Asia, sub-Saharan Africa, and South America. Since 1990, the attributable burden has increased by 50%, driven largely by population growth and ageing. Globally, the impact of reductions in household air pollution was largely offset by increased ambient PM2·5.
Interpretation
Air pollution is a major risk factor for diabetes. We estimated that about a fifth of the global burden of type 2 diabetes is attributable PM2·5 pollution. Air pollution mitigation therefore might have an essential role in reducing the global disease burden resulting from type 2 diabetes.

Item Type:	Journal Article
Subjects:	R Medicine > RA Public aspects of medicine
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Diabetes, World health, Air -- Pollution -- Health aspects, Environmental toxicology, Air -- Pollution -- Measurement, Aerosols -- Health aspects, Particles -- Health aspects
Journal or Publication Title:	The Lancet Planetary Health
Publisher:	Elsevier
ISSN:	2542-5196
Official Date:	6 July 2022
Dates:	Date Event 6 July 2022 Published 1 July 2022 Accepted
Volume:	6
Number:	7
Page Range:	e586-e600
DOI:	10.1016/S2542-5196(22)00122-X
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
Copyright Holders:	© 2022 The Author(s). Published by Elsevier Ltd.
Date of first compliant deposit:	29 July 2022
Date of first compliant Open Access:	29 July 2022
RIOXX Funder/Project Grant:	Project/Grant ID RIOXX Funder Name Funder ID UNSPECIFIED Bill and Melinda Gates Foundation http://dx.doi.org/10.13039/100000865 221854/Z/20/Z Wellcome Trust http://dx.doi.org/10.13039/100010269 MR/S011676/1 [MRC] Medical Research Council http://dx.doi.org/10.13039/501100000265

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