PM(2.5) exposure as a risk factor for type 2 diabetes mellitus in the Mexico City metropolitan area

BACKGROUND: Exposure to air pollution is the main risk factor for morbidity and mortality in the world. Exposure to particulate matter with aerodynamic diameter ≤ 2.5 μm (PM(2.5)) is associated with cardiovascular and respiratory conditions, as well as with lung cancer, and there is evidence to suggest that it is also associated with type II diabetes (DM). The Mexico City Metropolitan Area (MCMA) is home to more than 20 million people, where PM(2.5) levels exceed national and international standards every day. Likewise, DM represents a growing public health problem with prevalence around 12%. In this study, the objective was to evaluate the association between exposure to PM(2.5) and DM in adults living in the MCMA. METHODS: Data from the 2006 or 2012 National Health and Nutrition Surveys (ENSANUT) were used to identify subjects with DM and year of diagnosis. We estimated PM(2.5) exposure at a residence level, based on information from the air quality monitoring system (monitors), as well as satellite measurements (satellite). We analyzed the relationship through a cross-sectional approach and as a case - control study. RESULTS: For every 10 μg/m(3) increase of PM(2.5) we found an OR = 3.09 (95% CI 1.17–8.15) in the 2012 sample. These results were not conclusive for the 2006 data or for the case - control approach. CONCLUSIONS: Our results add to the evidence linking PM(2.5) exposure to DM in Mexican adults. Studies in low- and middle-income countries, where PM(2.5) atmospheric concentrations exceed WHO standards, are required to strengthen the evidence.