The Association Between PM(2.5) Exposure and Diabetes Mellitus Among Thai Army Personnel

OBJECTIVES: This study investigated the association between baseline exposures to particulate matter with a diameter <2.5 microns (PM(2.5)) and subsequent temporal changes in PM(2.5) exposure with the incidence of type 2 diabetes among Royal Thai Army personnel. METHODS: A retrospective cohort study was conducted using nationwide health check-up data from 21 325 Thai Army personnel between 2018 and 2021. Multilevel mixed-effects parametric survival statistics were utilized to analyze the relationship between baseline (i.e., PM(2.5)-baseline) and subsequent changes (i.e., PM(2.5)-change) in PM(2.5) exposure and the occurrence of type 2 diabetes. Hazard ratios (HRs) and 95% confidence intervals (CIs) were employed to assess this association while considering covariates. RESULTS: There was a significant association between both PM(2.5) baseline and PM(2.5)-change and the incidence of type 2 diabetes in a dose-response manner. Compared to quartile 1, the HRs for quartiles 2 to 4 of PM(2.5)-baseline were 1.11 (95% CI, 0.74 to 1.65), 1.51 (95% CI, 1.00 to 2.28), and 1.77 (95% CI, 1.07 to 2.93), respectively. Similarly, the HRs for quartiles 2 to 4 of PM(2.5)-change were 1.41 (95% CI, 1.14 to 1.75), 1.43 (95% CI, 1.13 to 1.81) and 2.40 (95% CI, 1.84 to 3.14), respectively. CONCLUSIONS: Our findings contribute to existing evidence regarding the association between short-term and long-term exposure to PM(2.5) and the incidence of diabetes among personnel in the Royal Thai Army.