Author: Lauren Pinault, Michael Brauer, Daniel L. Crouse, Scott Weichenthal, Anders Erickson, Aaron van Donkelaar, Randall V. Martin, Shannon Charbonneau, Perry Hystad, Jeffrey R. Brook, Michael Tjepkema et al.
Year: 2018
Category:
Health Publications
Diabetes is infrequently coded as the primary cause of death but may contribute to cardiovascular disease (CVD) mortality in response to fine particulate matter (PM2.5) exposure. We analyzed all contributing causes of death to examine susceptibility of diabetics to CVD mortality from long-term exposure.
Among CanCHEC subjects, comention of diabetes on the death certificate increased the magnitude of association between CVD mortality and PM2.5 (HR = 1.51 [1.39–1.65] per 10 μg/m3) versus all CVD deaths (HR = 1.25 [1.21–1.29]) or CVD deaths without diabetes (HR = 1.20 [1.16–1.25]). Among CCHS subjects, diabetics who used insulin or medication (included as proxies for severity) had higher HR estimates for CVD deaths from PM2.5 (HR = 1.51 [1.08–2.12]) relative to the CVD death estimate for all respondents (HR = 1.31 [1.16–1.47]).
Mention of diabetes on the death certificate resulted in higher magnitude associations between PM2.5 and CVD mortality, specifically among those who manage their diabetes with insulin or medication. Analyses restricted to the primary cause of death likely underestimate the role of diabetes in air pollution–related mortality. See video abstract here.
