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Association of residential air pollution and green space with all-cause and cause-specific mortality in individuals with diabetes: an 11-year prospective cohort study
Links between air pollution, green space, and death rates in people with diabetes over 11 years
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Abstract
During a median follow-up of 7.9 years, 22,205 deaths were recorded among 174,063 individuals with type 2 diabetes mellitus.
- Higher exposure to fine particulate matter (PM) was significantly associated with increased risks for all mortality outcomes.
- The strongest links between PM exposure and mortality were found for diabetes-related peripheral vascular diseases (hazard ratio: 2.70) and gastrointestinal cancer (hazard ratio: 2.44).
- Nitrogen dioxide (NO) exposure became significantly associated with mortality at concentrations above approximately 45 Ī¼g/mĀ³, particularly for lung cancer (hazard ratio: 1.20) and gastrointestinal cancer (hazard ratio: 1.19).
- Each interquartile range increase in green space exposure (measured by NDVI) was linked to reduced mortality risks, with hazard ratios ranging from 0.76 to 1.00.
- The relationship between greenness and mortality was partly mediated by reductions in PM (23.80%) and NO (26.60%).
- A significant negative interaction was observed between NO and greenness, while no interaction was found between PM and greenness.
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