Exposure to Ambient Air Pollution Associated with Increased Risk of Incident Diabetes Mellitus: A Population-Based Cohort Study

Background/Aim: Diabetes research has recently taken into consideration the potential influence of air pollution on diabetes risk. However, epidemiologic evidence linking air pollution to diabetes remains inconsistent. This study sought to assess the relationship between selected air pollutants (NO2, PM2.5, O3, and Ox [oxidant capacity]) and the incidence of diabetes.Methods: Our cohort consisted of ~4.8M adults aged 35 to 85 who were long-term Ontario residents prior to cohort inception in 2001. The cohort was followed until 2015. Long-term exposure to NO2, PM2.5, and O3 was estimated using satellite-based remote sensing, land-use regression model, and fusion-based approach, respectively, and was assigned to subjects’ annual postal code addresses. Ox was calculated as the redox-weighted average of O3 and NO2. Diabetes incidence was ascertained using population-based health administrative data with a validated algorithm. For each air pollutant, we estimated its association with diabetes using standa...