TY - JOUR
T1 - Estimates, trends, and drivers of the global burden of type 2 diabetes attributable to PM2·5 air pollution, 1990–2019
T2 - an analysis of data from the Global Burden of Disease Study 2019
AU - GBD 2019 Diabetes and Air Pollution Collaborators
AU - Burkart, Katrin
AU - Causey, Kate
AU - Cohen, Aaron J.
AU - Wozniak, Sarah S.
AU - Salvi, Devashri Digvijay
AU - Abbafati, Cristiana
AU - Adekanmbi, Victor
AU - Adsuar, Jose C.
AU - Ahmadi, Keivan
AU - Alahdab, Fares
AU - Al-Aly, Ziyad
AU - Alipour, Vahid
AU - Alvis-Guzman, Nelson
AU - Amegah, Adeladza Kofi
AU - Andrei, Catalina Liliana
AU - Andrei, Tudorel
AU - Ansari, Fereshteh
AU - Arabloo, Jalal
AU - Aremu, Olatunde
AU - Aripov, Timur
AU - Babaee, Ebrahim
AU - Banach, MacIej
AU - Barnett, Anthony
AU - Bärnighausen, Till Winfried
AU - Bedi, Neeraj
AU - Behzadifar, Masoud
AU - Béjot, Yannick
AU - Bennett, Derrick A.
AU - Bensenor, Isabela M.
AU - Bernstein, Robert S.
AU - Bhattacharyya, Krittika
AU - Bijani, Ali
AU - Biondi, Antonio
AU - Bohlouli, Somayeh
AU - Breitner, Susanne
AU - Brenner, Hermann
AU - Butt, Zahid A.
AU - Cámera, Luis Alberto
AU - Cantu-Brito, Carlos
AU - Carvalho, Felix
AU - Cerin, Ester
AU - Chattu, Vijay Kumar
AU - Chauhan, Bal Govind
AU - Choi, Jee Young Jasmine
AU - Chu, Dinh Toi
AU - Dai, Xiaochen
AU - Dandona, Lalit
AU - Dandona, Rakhi
AU - Daryani, Ahmad
AU - Househ, Mowafa
N1 - Publisher Copyright:
© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
PY - 2022/7
Y1 - 2022/7
N2 - 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. Funding: Bill & Melinda Gates Foundation.
AB - 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. Funding: Bill & Melinda Gates Foundation.
UR - https://www.scopus.com/pages/publications/85134425745
U2 - 10.1016/S2542-5196(22)00122-X
DO - 10.1016/S2542-5196(22)00122-X
M3 - Article
C2 - 35809588
AN - SCOPUS:85134425745
SN - 2542-5196
VL - 6
SP - e586-e600
JO - The Lancet Planetary Health
JF - The Lancet Planetary Health
IS - 7
ER -