Air pollution, road traffic noise and lack of greenness and risk of type 2 diabetes: A multi-exposure prospective study covering Denmark

Mette Sørensen; Aslak H Poulsen; Ulla A Hvidtfeldt; Jørgen Brandt; Lise M Frohn; Matthias Ketzel; Jesper H Christensen; Ulas Im; Jibran Khan; Thomas Münzel; Ole Raaschou-Nielsen

doi:10.1016/j.envint.2022.107570

Air pollution, road traffic noise and lack of greenness and risk of type 2 diabetes: A multi-exposure prospective study covering Denmark

Environ Int. 2022 Dec:170:107570. doi: 10.1016/j.envint.2022.107570. Epub 2022 Oct 6.

Authors

Affiliations

¹ Environment and Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark; Department of Natural Science and Environment, Roskilde University, Universitetsvej 1, 4000 Roskilde, Denmark. Electronic address: mettes@cancer.dk.
² Environment and Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark.
³ Department of Environmental Science, Aarhus University, Frederiksborgvej 399, 4000 Roskilde, Denmark; iClimate - interdisciplinary Centre for Climate Change, Aarhus University, Frederiksborgvej 399, 4000 Roskilde, Denmark.
⁴ Department of Environmental Science, Aarhus University, Frederiksborgvej 399, 4000 Roskilde, Denmark; Global Centre for Clean Air Research (GCARE), Department of Civil and Environmental Engineering, University of Surrey, Guildford, U.K.
⁵ Department of Environmental Science, Aarhus University, Frederiksborgvej 399, 4000 Roskilde, Denmark.
⁶ Department of Environmental Science, Aarhus University, Frederiksborgvej 399, 4000 Roskilde, Denmark; Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Frederiksborgvej 399, 4000 Roskilde, Denmark.
⁷ University Medical Center Mainz of the Johannes Gutenberg University, Center for Cardiology, Cardiology I, Mainz, Germany.
⁸ Environment and Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark; Department of Environmental Science, Aarhus University, Frederiksborgvej 399, 4000 Roskilde, Denmark.

PMID: 36334460
DOI: 10.1016/j.envint.2022.107570

Abstract

Objective: Air pollution, road traffic noise and lack of greenness coexist in urban environments and have all been associated with type 2 diabetes. We aimed to investigate how these co-exposures were associated with type 2 diabetes in a multi-exposure perspective.

Methods: We estimated 5-year residential mean exposure to fine particles (PM_2.5), ultrafine particles (UFP), elemental carbon (EC), nitrogen dioxide (NO₂) and road traffic noise at the most (LdenMax) and least (LdenMin) exposed facade for all persons aged > 50 years living in Denmark in 2005 to 2017. For each air pollutant, we estimated total concentrations and traffic contributions. Based on land use maps, we estimated proportion of green and non-green space within 150 and 1000 m of all residences. In total, 1.9 million persons were included and 128,358 developed type 2 diabetes during follow-up. We performed analyses using Cox proportional hazards models, with adjustment for individual and neighborhood-level sociodemographic co-variates.

Results: In single-pollutant models, all air pollutants, noise and lack of green space were associated with higher risk of diabetes. In two-, three- and four-pollutant analyses of the air pollutants, only UFP and NO₂ remained associated with higher diabetes risk in all models. LdenMax, LdenMin and the two proxies of green space remained associated with diabetes in two-pollutant models of, respectively, noise and green space. In a multi-pollutant analysis, we found hazard ratios (95 % confidence intervals) per interquartile range of 1.021 (1.005; 1.038) for UFP, 1.012 (0.996; 1.028) for NO₂, 1.022 (1.012; 1.033) for LdenMin, 1.013 (1.004; 1.022) for LdenMax, and 1.038 (1.031; 1.044) and 1.018 (1.010; 1.025) for lack of green space within, respectively, 150 m and 1000 m, and a cumulative risk index of 1.131 (1.113; 1.149).

Conclusions: Air pollution, road traffic noise and lack of green space were independently associated with higher risk of type 2 diabetes.

Keywords: Air pollution; Green space; Multi-pollutant; Road traffic noise; Type 2 diabetes.

MeSH terms

Air Pollutants* / adverse effects
Air Pollution* / adverse effects
Diabetes Mellitus, Type 2* / epidemiology
Humans
Prospective Studies

Substances

Air Pollutants