Air pollution and type 1 diabetes in children
Article first published online: 18 APR 2006
Volume 7, Issue 2, pages 81–87, April 2006
How to Cite
Hathout, E. H., Beeson, W. L., Ischander, M., Rao, R. and Mace, J. W. (2006), Air pollution and type 1 diabetes in children. Pediatric Diabetes, 7: 81–87. doi: 10.1111/j.1399-543X.2006.00150.x
- Issue published online: 18 APR 2006
- Article first published online: 18 APR 2006
- Submitted 3 December 2004. Accepted for publication 15 September 2005
- air pollution;
- type I diabetes
Background: Over the past decade, there has been a worldwide largely unexplained increase in the incidence of type 1 diabetes in young children. This study explores the quantitative role of exposure to specific air pollutants in the development of type 1 diabetes in children.
Methods: A total of 402 children were retrospectively studied. Zip code-related, time-specific birth-to-diagnosis exposure to five ambient air pollutants was obtained for 102 children with type 1 diabetes and 300 healthy children receiving care at a single hospital. Pollution exposure levels were created by summing up zip code-specific pollution data and dividing by months of exposure from birth to diagnosis. Analysis employed χ2, two-tailed independent sample t-test and unconditional logistic regression.
Results: Odds ratio (OR) was significantly high for cumulative exposure to ambient ozone (O3) and sulfate (SO4) in cases compared with controls, OR = 2.89 [95% confidence interval (CI) = 1.80–4.62] and OR = 1.65 (CI = 1.20–2.28), respectively, even after adjustment for several potential confounders. Passive smoking was more frequent in children with diabetes (30 vs. 10%, p = 0.001). Attending day care and breast feeding in infancy were less frequent in children with diabetes (14 vs. 23%, p = 0.025; 59 vs. 78%, p = 0.001). Family history of diabetes, autoimmune disease and drug abuse was more frequent in cases (p < 0.01).
Conclusion: Cumulative exposure to ozone and sulfate in ambient air may predispose to the development of type 1 diabetes in children. Early infant formula feeding and passive smoking in the household may precipitate or accelerate the onset of type 1 diabetes.