Short-term exposure to wildfire-specific PM_2.5 and hospitalization for diabetes morbidity: a study in multiple countries/territories

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posted on 2024-07-16, 16:26 authored by Yiwen Zhang Msci, Rongbin Xu, Wenzhong Huang, Lidia Morawska, Fay H. Johnston, Michael Abramson, Luke Knibbs, Patricia Matus, Tingting Ye, Wenhua Yu, Simon Hales, Geoffrey Morgan, Zhengyu Yang, Yanming Liu, Ke Ju, Pei Yu, Eric Lavigne, Yao Wu, Bo Wen, Yuxi Zhang, Jane Heyworth, Guy Marks, Paulo H. N. Saldiva, Micheline S. Z. S. Coelho, Yue Leon Guo, Jiangning Song, Yuming Guo, Shanshan Li

Objective

To evaluate associations of wildfire fine particulate matter (PM2.5) with diabetes across multi-countries/territories.

Research Design and Methods

We collected 3,612,135 diabetes hospitalization data across 1008 locations in Australia, Brazil, Canada, Chile, New Zealand, Thailand, and Taiwan during 2000‒2019. Daily wildfire-specific PM2.5 were estimated through chemical transport models and machine learning calibration. Quasi-Poisson regression with distributed lag non-linear models and random-effects meta-analysis were applied to estimate associations between wildfire-specific PM2.5 and diabetes hospitalization. Subgroup analyses were by age, sex, location income-level, and country/territory. Diabetes hospitalizations attributable to wildfire-specific PM2.5 and non-wildfire PM2.5 were compared.

Results

Each 10 µg/m3 increase in wildfire-specific PM2.5 over the current and previous three days was associated with relative risks of 1.017 (95% confidence interval [CI]: 1.011‒1.022), 1.023 (1.011‒1.035), 1.023 (1.015‒1.032), 0.962 (0.823‒1.032), 1.033 (1.001‒1.066), 1.013 (1.004‒1.022) for all-cause, type 1, type 2, malnutrition-related, other specified, and unspecified diabetes hospitalization, respectively. Stronger associations were observed for all-cause, type 1, and type 2 diabetes in Thailand, Australia, and Brazil; unspecified diabetes in New Zealand; and type 2 diabetes in high-income locations. 0.67% (0.16%‒1.18%) all-cause and 1.02% (0.20%‒1.81%) type 2 diabetes hospitalizations were attributable to wildfire-specific PM2.5. Wildfire-specific PM2.5 posed greater risks of all-cause, type 1, and type 2 diabetes than non-wildfire PM2.5, responsible for 38.7% of PM2.5-related diabetes hospitalizations.

Conclusions

We show the relatively underappreciated links between diabetes and wildfire air pollution, which can lead to a non-negligible proportion of PM2.5¬-related diabetes hospitalizations. Precision prevention and mitigation should be developed for those in advantaged communities, or Thailand/Australia/Brazil