Effect of long-term exposure to ambient particulate matter on prevalence of type 2 diabetes and hypertension in Iranian adults: an ecologic study

Abstract

Air pollution is considered as an environmental risk to health worldwide. Current evidence is mostly from Western populations exposed to lower levels of pollutants. This study was to explore the association of type 2 diabetes (T2D) and hypertension prevalence with exposure to high levels of air pollution in Iranian adults. The air pollution data were obtained from the air quality monitoring stations of five large cities in Iran from 2006 to 2011. The air quality monitoring stations could only detect ambient particulate matter_10 (PM₁₀) during the study period; therefore, the average PM₁₀ concentration was considered for comparison. We grouped the cities as group 1 (Tehran, Shiraz) with PM₁₀ concentration < 100 μg/m³, and group 2 (Kermanshah, Ahwaz, Esfahan) with PM₁₀ concentration > 100 μg/m³. Data from the Surveillance of Risk Factors of Non-Communicable Disease (SuRFNCD) study were used to calculate the prevalence of T2D and hypertension. We assessed the association between air pollution and the prevalence of T2D using logistic regression models. Odds ratios (ORs) with 95% CI for each outcome were calculated after adjusting for age, sex, BMI, physical activity, and other covariates. The 5-year average of PM₁₀ concentration was higher in group 2 (120.15 ± 6.81 μg/m³) compared to group 1 (83.95 ± 7.81 μg/m³). The prevalence of T2D in group 2 was 13.8%, while it was 10.7% in group 1 (p = 0.01), OR = 1.32 (95% CI 1.03–1.69). Similarly, hypertension was more prevalent in group 2 (15.7 vs. 11.9%, p = 0.005, OR = 1.55, 95% CI 1.20–1.99). PM₁₀ is associated with higher prevalence of T2D and hypertension in Iranian adults.