National study finds strong link between diabetes and air pollution - Public release date: 29-Sep-2010

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*Full Text of this New Study Can Be Found at this Link:

http://care.diabetesjournals.org/content/33/10/2196.full*

**

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*Public release date: 29-Sep-2010*

Contact: Keri Stedman

keri.stedman@...

Children's Hospital Boston

National study finds strong link between diabetes and air pollution

Findings unchanged after adjustment for obesity and other diabetes

risk factors

Boston, Mass. -- A national epidemiologic study finds a strong,

consistent correlation between adult diabetes and particulate air

pollution that persists after adjustment for other risk factors like

obesity and ethnicity, report researchers from Children's Hospital

Boston. The relationship was seen even at exposure levels below the

current EPA safety limit.

The report, published in the October issue of /Diabetes Care/, is among

the first large-scale population-based studies to link diabetes

prevalence with air pollution. It is consistent with prior laboratory

studies finding an increase in insulin resistance, a precursor to

diabetes, in obese mice exposed to particulates, and an increase in

markers of inflammation (which may contribute to insulin resistance) in

both the mice and obese diabetic patients after particulate exposure.

Like the laboratory studies, the current study focused on fine

particulates of 0.1-2.5 nanometers in size (known as PM2.5), a main

component of haze, smoke and motor vehicle exhaust. The investigators,

led by Pearson and Brownstein, PhD, of the Children's Hospital

Informatics Program, obtained county-by-county data on PM2.5 pollution

from the Environmental Protection Agency (EPA), covering every county in

the contiguous United States for 2004 and 2005.

They then combined the EPA data with data from the Centers for Disease

Control (CDC) and the U.S. Census to ascertain the prevalence of adult

diabetes and to adjust for known diabetes risk factors, including

obesity, exercise, geographic latitude, ethnicity and population density

(a measure of urbanization).

" We wanted to do everything possible to reduce confounding and ensure

the validity of our findings, " says Pearson, the study's first author.

In all analyses, there was a strong and consistent association between

diabetes prevalence and PM2.5 concentrations. For every 10 ?g/m3

increase in PM2.5 exposure, there was a 1 percent increase in diabetes

prevalence. This finding was seen in both 2004 and 2005, and remained

consistent and significant when differing estimates of PM2.5 exposure

were used.

" We didn't have data on individual exposure, so we can't prove

causality, and we can't know exactly the mechanism of these peoples'

diabetes, " acknowledges Brownstein. " But pollution came across as a

significant predictor in all our models. "

Even among counties falling within EPA limits for exposure, those with

highest versus the lowest levels of PM2.5 pollution had a more than 20

percent increase in diabetes prevalence, which remained after

controlling for diabetes risk factors.

" From a policy perspective, the findings suggest that the current EPA

limits on exposure may not be adequate to prevent negative public health

outcomes from particulate matter exposure, " Brownstein says.

" Many environmental factors may contribute to the epidemic of diabetes

in the United States and worldwide, " notes Goldfine, MD, head of

clinical research at the Joslin Diabetes Center and a coauthor on the

study. " While a lot of attention has correctly been attributed to

caloric excess and sedentary behaviors, additional factors may provide

novel approaches to diabetes prevention. "

Based on their findings, the researchers call for more study of

environmental factors in diabetes, including basic research on the

inflammatory mechanisms in diabetes and the role of PM2.5.

" We would like to access better individual-level data on diabetes and

exposure, " adds Brownstein. " We also have an interest in investigating

this finding internationally where standards may be less stringent. "

The study was funded by the National Center for Biomedical Computing of

the National Institutes of Health.

Children's Hospital Boston is home to the world's largest research

enterprise based at a pediatric medical center, where its discoveries

have benefited both children and adults since 1869. More than 1,100

scientists, including nine members of the National Academy of Sciences,

12 members of the Institute of Medicine and 13 members of the

Medical Institute comprise Children's research community. Founded

as a 20-bed hospital for children, Children's Hospital Boston today is a

392-bed comprehensive center for pediatric and adolescent health care

grounded in the values of excellence in patient care and sensitivity to

the complex needs and diversity of children and families. Children's

also is the primary pediatric teaching affiliate of Harvard Medical

School. For more information about the hospital and its research visit:

www.childrenshospital.org/newsroom.

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