The Impact Of Air Pollution On The Death Of Residents From Diabetes

BackgroudIn recent years,prevalence and incidence of diabetes in the residents of our country have been increased continuously with improvement of people’s living standards,and China has become a country with the most populous patients with diabetes all over the world.Evidence from epidemiological studies indicated that ambient air pollution associated with incidence and prevalence of diabetes,however,studies on whether it correlated to diabetes-related deaths are very limited.ObjectiveThis study aims to analyze association between air concentrations of several major pollutants(PM10,NO2,SO2)and diabetes-related deaths in the local residents of the three cities(Beijing,Chengdu of Sichuan,and Nanjing of Jiangsu)in China with bi-directional case-crossover design.MethodsData of air concentrations of several pollutants,meteorological factors,and diabetes-related deaths in the local residents of Beijing,Chengdu,Nanjing during January 1,2008 to December 31,2010 were collected.A bi-directional case-crossover design was adopted.Relationship between concentrations of air pollutants(PM10,NO2 and SO2)and diabetes-related deaths in the local residents of Beijing,Chengdu and Nanjing was explored,respectively,adjusted for meteorological factors(atmospheric temperature,relative humidity,wind speed and length of sunshine time)using conditional regression analysis,with case-period defined as the date of diabetes death,and control-period as 7 days and 14 days before and after the date of death.Meanwhile,stratified analysis was performed according to age,gender and season.Finally,meta-analysis was conducted to pool the results of the three cities to evaluate association between air pollutants(PM10,NO2,SO2)and diabetes-related mortality in local residents.Results(1)Air pollution was serious in Beijing,Chengdu and Nanjing during 2008 to 2010 with daily average concentrations of air PM10 and NO2 exceeding the second-grade of the national standards.(2)Short-term increases in daily air concentrations of PM10,NO2 and SO2 significantly associated with diabetes-related mortality in the local residents.(3)There was significant variation in such associations among the three cities.(4)There existed time delays in the associations between daily concentrations of air PMio,NO2 and SO2 and diabetes-related deaths in the local residents with lags from zero to three days.And,(5)Results of subgroup analysis showed that NO2,SO2 showed significantly association with death from diabetes in the males and SO2 were significant in those aged 65 years over.Also,we found that PM10,NO2,SO2 showed significantly association with death from diabetes in cold season.ConclusionsDiabetes-related mortality in local residents was positively correlated with daily concentrations of several major air pollutants(PM10,NO2,SO2)in Beijing,Chengdu of Sichuan and Nanjing of Jiangsu,China,with a little variation among them.In order to testify and complement the relationship of ambient air pollution and diabetes related deaths,further epidemiological evidences were required.