OBJECTIVE— Recent studies have drawn attention to the adverse effects of ambient airpollutants such as particulate matter 2.5 (PM2.5) on human health. We evaluated the associationbetween PM2.5 exposure and diabetes prevalence in the U.S. and explored factors that mayinfluence this relationship.RESEARCH DESIGN AND METHODS— The relationship between PM2.5 levels anddiagnosed diabetes prevalence in the U.S. was assessed by multivariate regression models at thecounty level using data obtained from both the Centers for Disease Control and Prevention(CDC) and U.S. Environmental Protection Agency (EPA) for years 2004 and 2005. Covariatesincluding obesity rates, population density, ethnicity, income, education, and health insurancewere collected from the U.S. Census Bureau and the CDC.RESULTS— Diabetes prevalence increases with increasing PM2.5 concentrations, with a 1%increase in diabetes prevalence seen with a 10 g/m3 increase in PM2.5 exposure (2004: 0.77 [95% CI 0.39 –1.25], P0.001; 2005:0.81 [0.48 –1.07], P0.001). This finding wasconfirmed for each study year in both univariate and multivariate models. The relationshipremained consistent and significant when different estimates of PM2.5 exposure were used. Evenfor counties within guidelines for EPA PM2.5 exposure limits, those with the highest exposureshowed a 20% increase in diabetes prevalence compared with that for those with the lowestlevels of PM2.5, an association that persisted after controlling for diabetes risk factors.CONCLUSIONS— Our results suggest PM2.5 may contribute to increased diabetes prevalencein the adult U.S. population. These findings add to the growing evidence that air pollutionis a risk factor for diabetes.
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