Is Environmental and Occupational Particulate Air Pollution Exposure Related to Type-2 Diabetes and Dementia? A Cross-Sectional Analysis of the UK Biobank
Abstract
:1. Introduction
2. Materials and Methods
2.1. Population and Study Design
2.2. Disease Categories
2.3. Environmental and Occupational Variables
2.4. Occupational Variables and ACE JEM
2.5. Covariates
2.6. Statistical Analyses
2.7. Sensitivity Analyses
3. Results
3.1. Characteristics of the Study Population
3.2. Association between Particulate Air Pollution (PM2.5) and T2DM and Dementia
3.3. Association between Occupational Exposure and T2DM and Dementia
3.4. Sensitivity Analyses
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Baseline Variable | Grouping | All Subjects | Dementia | Type 2 Diabetes Mellitus | ||||||
---|---|---|---|---|---|---|---|---|---|---|
n | % (with NA’s) | % | n | % (Out of 502,504) | % (Out of the Diseased) | n | % (Out of 502,504) | % (Out of the Diseased) | ||
Sex | ||||||||||
All | 502,504 | 100 | 100 | 534 | 0.11 | 100 | 21,560 | 4.30 | 100 | |
Male | 273,382 | 45.60 | 45.60 | 309 | 0.06 | 57.87 | 13,036 | 2.60 | 60.46 | |
Female | 229,122 | 54.40 | 54.40 | 225 | 0.04 | 42.13 | 8524 | 1.70 | 39.54 | |
Missing | - | - | - | - | - | - | - | - | - | |
Age recruitment | ||||||||||
All | 502,504 | 100 | 100 | 534 | 0.11 | 100 | 21,560 | 4.30 | 100 | |
(36–46) | 77,177 | 15.36 | 15.36 | 30 | 0.01 | 5.62 | 1132 | 0.23 | 5.25 | |
(46–56) | 151,241 | 30.10 | 30.10 | 81 | 0.02 | 15.17 | 4704 | 0.94 | 21.82 | |
(56–66) | 220,407 | 43.86 | 43.86 | 275 | 0.05 | 51.50 | 11,597 | 2.31 | 53.79 | |
(66–73) | 53,679 | 10.68 | 10.68 | 148 | 0.03 | 27.71 | 4127 | 0.82 | 19.14 | |
Missing | - | - | - | - | - | - | - | - | - | |
Ethnicity | ||||||||||
(All-Missing) | 501,606 | |||||||||
All | 502,504 | 100 | 100 | 533 | 0.11 | 100 | 21,559 | 4.13 | 100 | |
White | 472,695 | 94.24 | 94.24 | 504 | 0.10 | 94.55 | 18,828 | 3.75 | 87.33 | |
Mixed | 2958 | 0.59 | 0.59 | 4 | 0.00 | 0.75 | 137 | 0.03 | 0.64 | |
Asian | 11,456 | 2.28 | 2.28 | 5 | 0.00 | 0.94 | 1442 | 0.28 | 6.69 | |
Black | 8061 | 1.61 | 1.61 | 10 | 0.00 | 1.87 | 684 | 0.13 | 3.17 | |
Others | 6436 | 1.28 | 1.28 | 10 | 0.00 | 1.87 | 468 | 0.09 | 2.17 | |
Missing | 898 | 0.17 | - | 1 | 0.00 | - | 1 | 0.00 | - | |
SES | ||||||||||
(All-Missing) | 501,881 | |||||||||
All | 502,504 | 100 | 100 | 533 | 0.09 | 100 | 21,529 | 4.28 | 100 | |
1 | 100,658 | 20.03 | 20.10 | 85 | 0.02 | 15.95 | 3215 | 0.64 | 14.93 | |
2 | 100,098 | 19.92 | 19.90 | 71 | 0.01 | 13.32 | 3586 | 0.71 | 16.66 | |
3 | 100,382 | 19.98 | 20.00 | 96 | 0.02 | 18.01 | 3978 | 0.79 | 18.48 | |
4 | 100,367 | 19.97 | 20.00 | 116 | 0.02 | 21.76 | 4499 | 0.89 | 20.89 | |
5 | 100,376 | 19.97 | 20.00 | 165 | 0.03 | 30.96 | 6251 | 1.24 | 29.04 | |
Missing | 623 | 0.12 | - | 1 | 0.00 | - | 31 | 0.01 | - | |
BMI | ||||||||||
(All-Missing) | 499,503 | |||||||||
All | 502,504 | 100 | 100 | 517 | 0.10 | 100 | 21,345 | 4.24 | 100 | |
< 18.5 | 2374 | 0.47 | 0.50 | 3 | 0.00 | 0.58 | 19 | 0.00 | 0.09 | |
18.5–24.9 | 157,631 | 31.37 | 31.60 | 144 | 0.03 | 27.85 | 2049 | 0.41 | 9.60 | |
25–29.9 | 214,485 | 42.68 | 42.90 | 230 | 0.05 | 44.49 | 7276 | 1.45 | 34.09 | |
≥ 30 | 125,013 | 24.88 | 25.00 | 140 | 0.03 | 27.08 | 12,001 | 2.40 | 56.22 | |
Missing | 3001 | 0.60 | - | 17 | 0.00 | - | 215 | 0.04 | - | |
BP | ||||||||||
(All-Missing) | 498,639 | |||||||||
All | 502,504 | 100 | 100 | 524 | 0.10 | 100 | 21,430 | 4.26 | 100 | |
No | 387,531 | 77.12 | 77.7 | 325 | 0.06 | 62.02 | 7308 | 1.45 | 34.10 | |
Unknown | 637 | 0.13 | 0.10 | 3 | 0.00 | 0.57 | 20 | 0.00 | 0.09 | |
Yes | 110,525 | 21.99 | 22.20 | 196 | 0.04 | 37.40 | 14,102 | 2.81 | 65.80 | |
Missing | 3811 | 0.76 | - | 10 | 0.00 | - | 130 | 0.00 | - | |
Diet changes | ||||||||||
(All-Missing) | 501,717 | |||||||||
All | 502,504 | 100 | 100 | 533 | 0.11 | 100 | 21,560 | 4.30 | 100 | |
No | 296,798 | 59.06 | 59.20 | 272 | 0.05 | 51.03 | 5474 | 1.09 | 25.39 | |
Unknown | 1443 | 0.29 | 0.30 | 4 | 0.00 | 0.75 | 78 | 1.02 | 0.36 | |
Yes, illness | 57,550 | 11.45 | 11.50 | 132 | 0.03 | 24.77 | 12,164 | 2.43 | 56.42 | |
Yes, other | 145,826 | 29.02 | 29.10 | 125 | 0.02 | 23.45 | 3844 | 0.77 | 17.83 | |
Missing | 887 | 0.18 | - | 1 | 0.00 | - | - | - | - | |
Physical activity | ||||||||||
(All-Missing) | 490,724 | |||||||||
All | 502,504 | 100 | 100 | 507 | 0.10 | 100 | 20,610 | 4.10 | 100 | |
Low | 163,988 | 32.63 | 33.40 | 232 | 0.05 | 45.76 | 8636 | 1.76 | 41.90 | |
Moderate | 203,130 | 40.42 | 41.40 | 161 | 0.03 | 31.75 | 7890 | 1.61 | 38.28 | |
High | 123,606 | 24.60 | 25.20 | 114 | 0.02 | 22.49 | 4084 | 0.83 | 19.82 | |
Missing | 11,780 | 2.34 | - | 27 | 0.00 | - | 950 | 0.19 | - |
T2DM | Dementia | |||
---|---|---|---|---|
OR (95% CI) ** | OR (95% CI) ** | OR (95% CI) ** | OR (95% CI) ** | |
Univariable Model 1 | Multivariable * Model 2 | Univariable Model 1 | Multivariable * Model 2 | |
PM2.5 | 1.13 (1.12–1.15) | 1.02 (1.00–1.03) | 1.18 (1.09–1.28) | 1.06 (0.96–1.16) |
Sex (female) a | ||||
Male | 1.88 (1.82–1.93) | 1.83 (1.77–1.89) | 1.64 (1.38–1.95) | 1.55 (1.28–1.89) |
Age | 1.06 (1.06–0.07) | 1.07 (1.07–1.08) | 1.09 (1.08–1.11) | 1.08 (1.07–1.10) |
Ethnic background (White) | ||||
Asian | 3.47 (3.28–3.68) | 3.80 (3.52–4.09) | - | - |
Black | 2.24 (2.06–2.42) | 1.64 (1.48–1.81) | - | - |
Mixed | 1.17 (0.98–1.38) | 1.38 (1.11–1.70) | - | - |
Other | 1.89 (1.72–2.08) | 1.64 (1.48–1.81) | - | - |
Townsend deprivation (1) | ||||
2 | 1.13 (1.07–1.18) | 1.06 (1.01–1.12) | 0.84 (0.61–1.15) | 0.76 (0.54–1.08) |
3 | 1.25 (1.19–1.31) | 1.13 (1.07–1.19) | 1.13 (0.85–1.52) | 1.02 (0.74–1.41) |
4 | 1.42 (1.36–1.49) | 1.18 (1.11–1.24) | 1.37 (1.04–1.82) | 1.38 (1.02–1.89) |
5 (most deprived) | 2.02 (1.94–2.11) | 1.37 (1.29–1.44) | 1.95 (1.50–2.54) | 1.79 (1.31–2.46) |
BMI (< 18.5) | ||||
≥ 30 | 13.15 (8.64–21.43) | 12.53 (7.64–22.44) | - | - |
25–29.9 | 4.35 (2.85–7.08) | 4.70 (2.86–8.42) | - | - |
18.5–24.9 | 1.63 (1.07–2.66) | 2.23 (1.35–3.99) | - | - |
Dietary changes (No) | ||||
Unknown | 3.05 (2.40–3.80) | 2.08 (1.52–2.77) | 3.03 (0.93–7.12) | 1.76 (0.29–5.67) |
Yes, because of illness | 14.26 (13.80–14.75) | 11.22 (10.81–11.65) | 2.51 (2.03–3.08) | 1.86 (1.46–2.35) |
Yes, because of other | 1.44 (1.38–1.50) | 1.36 (1.30–1.43) | 0.94 (0.75–1.15) | 0.96 (0.75–1.20) |
Physical activity (Low) | ||||
High | 0.61 (0.59–0.64 | 0.76 (0.73–0.79) | 0.94 (0.75–1.15) | 0.96 (0.75–1.20) |
Moderate | 0.73 (0.70–0.75) | 0.88 (0.85–0.91) | 0.94 (0.75–1.15) | 0.96 (0.75–1.20) |
Father’s history (No) | ||||
Do not know | 1.71 (1.62–1.80) | 1.23 (1.16–1.31) | 2.23 (1.68–2.90) | 1.65 (1.20–2.23) |
Prefer not to answer | 1.86 (1.34–2.52) | 1.07 (0.66–1.65) | 3.28 (0.54–10.20) | 1.98 (0.29–7.65) |
Yes | 2.35 (2.27–2.44) | 2.37 (2.27–2.48) | 1.23 (0.82–1.77) | 1.30 (0.85–1.91) |
Mother’s history (No) | ||||
Do not know | 1.63 (1.53–1.74) | 1.06 (0.97–1.15) | 1.67 (1.10–2.43) | 0.99 (0.60–1.53) |
Prefer not to answer | 1.78 (1.24–2.47) | 0.93 (0.54–1.53) | 6.00 (1.49–15.72) | 5.07 (1.10–15.59) |
Yes | 1.06 (1.03–1.09) | 1.08 (1.05–1.12) | 1.03 (0.77–1.37) | 1.07 (0.77–1.45) |
T2DM | ||
---|---|---|
(P × L) *** | OR (95% CI) Univariable | OR (95% CI) Multivariable * |
Dust a | 1.11 (1.00–1.22) | 0.93 (0.88–0.98) |
Fumes a | 1.60 (1.29–1.96) | 1.01 (0.95–1.07) |
Diesel a | 27.69 (13.47–55.35) | 1.07 (0.99–1.15) |
Mineral Dust a | 1.35 (1.16–1.57) | 0.91 (0.86–0.97) |
Biological Dust a | 0.78 (0.78–1.13) | 0.95 (0.89–1.02) |
DEMENTIA | ||
(P × L) *** | OR (95% CI) Univariable | OR (95% CI) Multivariable ** |
Dust a | 1.51 (0.73–2.72) | 1.02 (0.71–1.45) |
Fumes a | 1.80 (0.26–5.98) | 1.25 (0.84–1.84) |
Diesel a | 1.22 (0.00–414.36) | 0.98 (0.56–1.62) |
Mineral Dust a | 1.69 (0.49–4.08) | 1.02 (0.66–1.51) |
Biological Dust a | 2.74 (1.07–5.57) | 0.97 (0.58–1.52) |
T2DM | Dementia | |
---|---|---|
(P × L) *** | OR (95% CI) Multivariable * | OR (95% CI) Multivariable ** |
Dust a | 1.01 (0.96–1.06) | 1.14 (0.79–1.61) |
Fumes | 1.24 (1.17–1.31) | 1.57 (1.06–2.27) |
Diesel | 1.31 (1.22–1.41) | 1.26 (0.72–2.05) |
Mineral Dust | 1.11 (1.04–1.17) | 1.26 (0.83–1.86) |
Biological Dust | 0.90 (0.84–0.96) | 0.95 (0.55–1.44) |
T2DM * | Dementia ** | |
---|---|---|
OR (95% CI) | OR (95% CI) | |
(PL-max) *** | 1.10 (1.05–1.15) | 1.40 (1.00–1.95) |
(PL-max) | 0.96 (0.91–1.01) | 1.20 (0.85–1.69) |
Workplace very dusty | 1.01 (0.93–1.09) | 1.04 (0.48–2.24) |
Workplace with fumes | 0.95 (0.87–1.03) | 1.15 (0.48–2.54) |
Workplace with diesel | 0.99 (0.90–1.09) | 1.54 (0.58–3.67) |
Cumulative Occupational Exposure Over Years—Standardised Values (Standardised (P × L) * Years) *** | T2DM OR (95% CI) Univariable | T2DM OR (95% CI) Multivariable * | Dementia OR (95% CI) Univariable | Dementia OR (95% CI) Multivariable ** |
---|---|---|---|---|
Dust | 1.09 (1.06–1.11) | 1.00 (0.97–1.03) | 1.00 (0.54–1.23) | 0.95 (0.49–1.21) |
Fumes | 1.07 (1.04–1.09) | 0.98 (0.95–1.01) | 0.99 (0.46–1.19) | 0.95 (0.42–1.18) |
Diesel engine exhaust | 1.07 (1.05–1.09) | 0.98 (0.94–1.01) | 1.10 (0.86–1.20) | 1.08 (0.83–1.18) |
Mineral dust | 1.08 (1.05–1.10) | 1.01 (0.97–1.03) | 1.07 (0.73–1.23) | 1.05 (0.69–1.22) |
Biological dust | 1.05 (1.02–1.07) | 1.00 (0.97–1.03) | 0.12 (0.00–0.58) | 0.02 (0.00–4.70) |
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Dimakakou, E.; Johnston, H.J.; Streftaris, G.; Cherrie, J.W. Is Environmental and Occupational Particulate Air Pollution Exposure Related to Type-2 Diabetes and Dementia? A Cross-Sectional Analysis of the UK Biobank. Int. J. Environ. Res. Public Health 2020, 17, 9581. https://doi.org/10.3390/ijerph17249581
Dimakakou E, Johnston HJ, Streftaris G, Cherrie JW. Is Environmental and Occupational Particulate Air Pollution Exposure Related to Type-2 Diabetes and Dementia? A Cross-Sectional Analysis of the UK Biobank. International Journal of Environmental Research and Public Health. 2020; 17(24):9581. https://doi.org/10.3390/ijerph17249581
Chicago/Turabian StyleDimakakou, Eirini, Helinor J. Johnston, George Streftaris, and John W. Cherrie. 2020. "Is Environmental and Occupational Particulate Air Pollution Exposure Related to Type-2 Diabetes and Dementia? A Cross-Sectional Analysis of the UK Biobank" International Journal of Environmental Research and Public Health 17, no. 24: 9581. https://doi.org/10.3390/ijerph17249581