Ambient air pollution and incidence of early-onset paediatric type 1 diabetes: A retrospective population-based cohort study.
This study contributes to the growing body of evidence suggesting that environmental exposures, particularly to air pollution, may be linked to the development of autoimmune diseases like type 1 diabetes in children.
The identification of O3 exposure during a critical developmental period as a potential risk factor underscores the importance of addressing air quality to protect vulnerable populations, including pregnant women and young children.
College of Health researcher(s)
Abstract
BACKGROUND: Studies have reported increasing incidence rates of paediatric diabetes, especially among those aged 0-5 years. Epidemiological evidence linking ambient air pollution to paediatric diabetes remains mixed.
OBJECTIVE: This study investigated the association between maternal and early-life exposures to common air pollutants (NO, PM, O, and oxidant capacity [Ox; the redox-weighted average of O and NO]) and the incidence of paediatric diabetes in children up to 6 years of age.
METHODS: All registered singleton births in Ontario, Ca nada occurring between April 1st 2006 and March 31st 2012 were included through linkage from health administrative data. Monthly exposures to NO, PM, O, and O were estimated across trimesters, the entire pregnancy period and during childhood. Random effects Cox proportional hazards models were used to assess the relationships with paediatric diabetes incidence while controlling for important covariates. We also modelled the shape of concentration-response (CR) relationships.
RESULTS: There were 1094 children out of a cohort of 754,698 diagnosed with diabetes before the age of six. O exposures during the first trimester of pregnancy were associated with paediatric diabetes incidence (hazard ratio (HR) per interquartile (IQR) increase = 2.00, 95% CI: 1.04-3.86). The CR relationship between O during the first trimester and paediatric diabetes incidence appeared to have a risk threshold, in which there was little-to-no risk below 25 ppb of O, while above this level risk increased sigmoidally. No other associations were observed.
CONCLUSION: O exposures during a critical period of development were associated with an increased risk of paediatric diabetes incidence.