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 Academic Article uri icon

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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.

    Funding

    Bill & Melinda Gates Foundation.

authors

  • Burkart, Katrin
  • Causey, Kate
  • Cohen, Aaron J
  • Wozniak, Sarah S
  • Salvi, Devashri Digvijay
  • Abbafati, Cristiana
  • Adekanmbi, Victor
  • Adsuar, Jose C
  • Ahmadi, Keivan
  • Alahdab, Fares
  • Al-Aly, Ziyad
  • Alipour, Vahid
  • Alvis-Guzman, Nelson
  • Amegah, Adeladza Kofi
  • Andrei, Catalina Liliana
  • Andrei, Tudorel
  • Ansari, Fereshteh
  • Arabloo, Jalal
  • Aremu, Olatunde
  • Aripov, Timur
  • Babaee, Ebrahim
  • Banach, Maciej
  • Barnett, Anthony
  • Bärnighausen, Till Winfried
  • Bedi, Neeraj
  • Behzadifar, Masoud
  • Béjot, Yannick
  • Bennett, Derrick A
  • Bensenor, Isabela M
  • Bernstein, Robert S
  • Bhattacharyya, Krittika
  • Bijani, Ali
  • Biondi, Antonio
  • Bohlouli, Somayeh
  • Breitner, Susanne
  • Brenner, Hermann
  • Butt, Zahid A
  • Cámera, Luis Alberto
  • Cantu-Brito, Carlos
  • Carvalho, Felix
  • Cerin, Ester
  • Chattu, Vijay Kumar
  • Chauhan, Bal Govind
  • Choi, Jee-Young Jasmine
  • Chu, Dinh-Toi
  • Dai, Xiaochen
  • Dandona, Lalit
  • Dandona, Rakhi
  • Daryani, Ahmad
  • Davletov, Kairat
  • de Courten, Barbora
  • Demeke, Feleke Mekonnen
  • Denova-Gutiérrez, Edgar
  • Dharmaratne, Samath Dhamminda
  • Dhimal, Meghnath
  • Diaz, Daniel
  • Djalalinia, Shirin
  • Duncan, Bruce B
  • El Sayed Zaki, Maysaa
  • Eskandarieh, Sharareh
  • Fareed, Mohammad
  • Farzadfar, Farshad
  • Fattahi, Nazir
  • Fazlzadeh, Mehdi
  • Fernandes, Eduarda
  • Filip, Irina
  • Fischer, Florian
  • Foigt, Nataliya A
  • Freitas, Marisa
  • Ghashghaee, Ahmad
  • Gill, Paramjit Singh
  • Ginawi, Ibrahim Abdelmageed
  • Gopalani, Sameer Vali
  • Guo, Yuming
  • Gupta, Rajat Das
  • Habtewold, Tesfa Dejenie
  • Hamadeh, Randah R
  • Hamidi, Samer
  • Hankey, Graeme J
  • Hasanpoor, Edris
  • Hassen, Hamid Yimam
  • Hay, Simon I
  • Heibati, Behzad
  • Hole, Michael K
  • Hossain, Naznin
  • Househ, Mowafa
  • Irvani, Seyed Sina Naghibi
  • Jaafari, Jalil
  • Jakovljevic, Mihajlo
  • Jha, Ravi Prakash
  • Jonas, Jost B
  • Jozwiak, Jacek Jerzy
  • Kasaeian, Amir
  • Kaydi, Neda
  • Khader, Yousef Saleh
  • Khafaie, Morteza Abdullatif
  • Khan, Ejaz Ahmad
  • Khan, Junaid
  • Khan, Md Nuruzzaman
  • Khatab, Khaled
  • Khater, Amir M
  • Kim, Yun Jin
  • Kimokoti, Ruth W
  • Kisa, Adnan
  • Kivimäki, Mika
  • Knibbs, Luke D
  • Kosen, Soewarta
  • Koul, Parvaiz A
  • Koyanagi, Ai
  • Kuate Defo, Barthelemy
  • Kugbey, Nuworza
  • Lauriola, Paolo
  • Lee, Paul H
  • Leili, Mostafa
  • Lewycka, Sonia
  • Li, Shanshan
  • Lim, Lee-Ling
  • Linn, Shai
  • Liu, Yong
  • Lorkowski, Stefan
  • Mahasha, Phetole Walter
  • Mahotra, Narayan B
  • Majeed, Azeem
  • Maleki, Afshin
  • Malekzadeh, Reza
  • Mamun, Abdullah A
  • Manafi, Navid
  • Martini, Santi
  • Meharie, Birhanu Geta
  • Menezes, Ritesh G
  • Mestrovic, Tomislav
  • Miazgowski, Bartosz
  • Miazgowski, Tomasz
  • Miller, Ted R
  • Mini, GK
  • Mirica, Andreea
  • Mirrakhimov, Erkin M
  • Mohajer, Bahram
  • Mohammed, Shafiu
  • Mohan, Viswanathan
  • Mokdad, Ali H
  • Monasta, Lorenzo
  • Moraga, Paula
  • Morrison, Shane Douglas
  • Mueller, Ulrich Otto
  • Mukhopadhyay, Satinath
  • Mustafa, Ghulam
  • Muthupandian, Saravanan
  • Naik, Gurudatta
  • Nangia, Vinay
  • Ndwandwe, Duduzile Edith
  • Negoi, Ruxandra Irina
  • Ningrum, Dina Nur Anggraini
  • Noubiap, Jean Jacques
  • Ogbo, Felix Akpojene
  • Olagunju, Andrew
  • Onwujekwe, Obinna E
  • Ortiz, Alberto
  • Owolabi, Mayowa O
  • P A, Mahesh
  • Panda-Jonas, Songhomitra
  • Park, Eun-Kee
  • Pashazadeh Kan, Fatemeh
  • Pirsaheb, Meghdad
  • Postma, Maarten J
  • Pourjafar, Hadi
  • Radfar, Amir
  • Rafiei, Alireza
  • Rahim, Fakher
  • Rahimi-Movaghar, Vafa
  • Rahman, Muhammad Aziz
  • Rai, Rajesh Kumar
  • Ranabhat, Chhabi Lal
  • Raoofi, Samira
  • Rawal, Lal
  • Renzaho, Andre MN
  • Rezapour, Aziz
  • Ribeiro, Daniela
  • Roever, Leonardo
  • Ronfani, Luca
  • Sabour, Siamak
  • Saddik, Basema
  • Sadeghi, Ehsan
  • Saeedi Moghaddam, Sahar
  • Sahebkar, Amirhossein
  • Sahraian, Mohammad Ali
  • Salimzadeh, Hamideh
  • Salvi, Sundeep Santosh
  • Samy, Abdallah M
  • Sanabria, Juan
  • Sarmiento-Suárez, Rodrigo
  • Sathish, Thirunavukkarasu
  • Schmidt, Maria Inês
  • Schutte, Aletta Elisabeth
  • Sepanlou, Sadaf G
  • Shaikh, Masood Ali
  • Sharafi, Kiomars
  • Sheikh, Aziz
  • Shigematsu, Mika
  • Shiri, Rahman
  • Shirkoohi, Reza
  • Shuval, Kerem
  • Soyiri, Ireneous N
  • Tabarés-Seisdedos, Rafael
  • Tefera, Yonatal Mesfin
  • Tehrani-Banihashemi, Arash
  • Temsah, Mohamad-Hani
  • Thankappan, Kavumpurathu Raman
  • Topor-Madry, Roman
  • Tudor Car, Lorainne
  • Ullah, Irfan
  • Vacante, Marco
  • Valdez, Pascual R
  • Vasankari, Tommi Juhani
  • Violante, Francesco S
  • Waheed, Yasir
  • Wolfe, Charles DA
  • Yamada, Tomohide
  • Yonemoto, Naohiro
  • Yu, Chuanhua
  • Zaman, Sojib Bin
  • Zhang, Yunquan
  • Zodpey, Sanjay
  • Lim, Stephen S
  • Stanaway, Jeffrey D
  • Brauer, Michael

publication date

  • July 2022