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

Burkart, Katrin and Causey, Kate and Cohen, Aaron J and Wozniak, Sarah S and Salvi, Devashri Digvijay and Abbafati, Cristiana and Adekanmbi, Victor and Adsuar, Jose C and Ahmadi, Keivan and Alahdab, Fares and Al-Aly, Ziyad and Alipour, Vahid and Alvis-Guzman, Nelson and Amegah, Adeladza Kofi and Andrei, Catalina Liliana and Andrei, Tudorel and Ansari, Fereshteh and Arabloo, Jalal and Aremu, Olatunde and Aripov, Timur and Babaee, Ebrahim and Banach, Maciej and Barnett, Anthony and Bärnighausen, Till Winfried and Bedi, Neeraj and Behzadifar, Masoud and Béjot, Yannick and Bennett, Derrick A and Bensenor, Isabela M and Bernstein, Robert S and Bhattacharyya, Krittika and Bijani, Ali and Biondi, Antonio and Bohlouli, Somayeh and Breitner, Susanne and Brenner, Hermann and Butt, Zahid A and Cámera, Luis Alberto and Cantu-Brito, Carlos and Carvalho, Felix and Cerin, Ester and Chattu, Vijay Kumar and Chauhan, Bal Govind and Choi, Jee-Young Jasmine and Chu, Dinh-Toi and Dai, Xiaochen and Dandona, Lalit and Dandona, Rakhi and Daryani, Ahmad and Davletov, Kairat and de Courten, Barbora and Demeke, Feleke Mekonnen and Denova-Gutiérrez, Edgar and Dharmaratne, Samath Dhamminda and Dhimal, Meghnath and Diaz, Daniel and Djalalinia, Shirin and Duncan, Bruce B and El Sayed Zaki, Maysaa and Eskandarieh, Sharareh and Fareed, Mohammad and Farzadfar, Farshad and Fattahi, Nazir and Fazlzadeh, Mehdi and Fernandes, Eduarda and Filip, Irina and Fischer, Florian and Foigt, Nataliya A and Freitas, Marisa and Ghashghaee, Ahmad and Gill, Paramjit Singh and Ginawi, Ibrahim Abdelmageed and Gopalani, Sameer Vali and Guo, Yuming and Gupta, Rajat Das and Habtewold, Tesfa Dejenie and Hamadeh, Randah R and Hamidi, Samer and Hankey, Graeme J and Hasanpoor, Edris and Hassen, Hamid Yimam and Hay, Simon I and Heibati, Behzad and Hole, Michael K and Hossain, Naznin and Househ, Mowafa and Irvani, Seyed Sina Naghibi and Jaafari, Jalil and Jakovljevic, Mihajlo and Jha, Ravi Prakash and Jonas, Jost B and Jozwiak, Jacek Jerzy and Kasaeian, Amir and Kaydi, Neda and Khader, Yousef Saleh and Khafaie, Morteza Abdullatif and Khan, Ejaz Ahmad and Khan, Junaid and Khan, Md Nuruzzaman and Khatab, Khaled and Khater, Amir M and Kim, Yun Jin and Kimokoti, Ruth W and Kisa, Adnan and Kivimäki, Mika and Knibbs, Luke D and Kosen, Soewarta and Koul, Parvaiz A and Koyanagi, Ai and Kuate Defo, Barthelemy and Kugbey, Nuworza and Lauriola, Paolo and Lee, Paul H and Leili, Mostafa and Lewycka, Sonia and Li, Shanshan and Lim, Lee-Ling and Linn, Shai and Liu, Yong and Lorkowski, Stefan and Mahasha, Phetole Walter and Mahotra, Narayan B and Majeed, Azeem and Maleki, Afshin and Malekzadeh, Reza and Mamun, Abdullah A and Manafi, Navid and Martini, Santi and Meharie, Birhanu Geta and Menezes, Ritesh G and Mestrovic, Tomislav and Miazgowski, Bartosz and Miazgowski, Tomasz and Miller, Ted R and Mini, GK and Mirica, Andreea and Mirrakhimov, Erkin M and Mohajer, Bahram and Mohammed, Shafiu and Mohan, V and Mokdad, Ali H and Monasta, Lorenzo and Moraga, Paula and Morrison, Shane Douglas and Mueller, Ulrich Otto and Mukhopadhyay, Satinath and Mustafa, Ghulam and Muthupandian, Saravanan and Naik, Gurudatta and Nangia, Vinay and Ndwandwe, Duduzile Edith and Negoi, Ruxandra Irina and Ningrum, Dina Nur Anggraini and Noubiap, Jean Jacques and Ogbo, Felix Akpojene and Olagunju, Andrew T and Onwujekwe, Obinna E and Ortiz, Alberto and Owolabi, Mayowa O and P A, Mahesh and Panda-Jonas, Songhomitra and Park, Eun-Kee and Pashazadeh Kan, Fatemeh and Pirsaheb, Meghdad and Postma, Maarten J and Pourjafar, Hadi and Radfar, Amir and Rafiei, Alireza and Rahim, Fakher and Rahimi-Movaghar, Vafa and Rahman, Muhammad Aziz and Rai, Rajesh Kumar and Ranabhat, Chhabi Lal and Raoofi, Samira and Rawal, Lal and Renzaho, Andre M N and Rezapour, Aziz and Ribeiro, Daniela and Roever, Leonardo and Ronfani, Luca and Sabour, Siamak and Saddik, Basema and Sadeghi, Ehsan and Saeedi Moghaddam, Sahar and Sahebkar, Amirhossein and Sahraian, Mohammad Ali and Salimzadeh, Hamideh and Salvi, Sundeep Santosh and Samy, Abdallah M and Sanabria, Juan and Sarmiento-Suárez, Rodrigo and Sathish, Thirunavukkarasu and Schmidt, Maria Inês and Schutte, Aletta Elisabeth and Sepanlou, Sadaf G and Shaikh, Masood Ali and Sharafi, Kiomars and Sheikh, Aziz and Shigematsu, Mika and Shiri, Rahman and Shirkoohi, Reza and Shuval, Kerem and Soyiri, Ireneous N and Tabarés-Seisdedos, Rafael and Tefera, Yonatal Mesfin and Tehrani-Banihashemi, Arash and Temsah, Mohamad-Hani and Thankappan, Kavumpurathu Raman and Topor-Madry, Roman and Tudor Car, Lorainne and Ullah, Irfan and Vacante, Marco and Valdez, Pascual R and Vasankari, Tommi Juhani and Violante, Francesco S and Waheed, Yasir and Wolfe, Charles D A and Yamada, Tomohide and Yonemoto, Naohiro and Yu, Chuanhua and Zaman, Sojib Bin and Zhang, Yunquan and Zodpey, Sanjay and Lim, Stephen S and Stanaway, Jeffrey D and Brauer, Michael (2022) 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. The Lancet Planetary Health, 6 (7). e586. ISSN 25425196



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.

Item Type:Article
Official URL/DOI:
Uncontrolled Keywords:Type 2 Diabetes, Global Burden
Subjects:Diabetes Epidemiology
Diabetology > Diabetes Mellitus Type 2
Divisions:Department of Epidemiology
Department of Diabetology
ID Code:1327
Deposited By:surendar radha
Deposited On:12 Oct 2022 11:51
Last Modified:12 Oct 2022 11:51

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