Iranian Journal of Public Health 2017. 46(3):293-300.

Gender-dependent Differences in the Relationship between Diabetes Mellitus and Ambient Air Pollution among Adults in South Korean Cities
Dongwook SOHN, Hyunjin OH


Background: Air pollution has been a serious public health threat worldwide. It has been linked to pulmonary and cardiovascular diseases but is also believed to contribute to air-pollution-mediated cardiometabolic disease such as diabetes. We investigated the relationship between type 2 diabetes mellitus (DM2) and air pollution in densely developed urban settings in South Korea, using national epidemiologic data.

Methods: The analysis focused on examining gender-related differences in the relationship between DM 2 and air pollutants, specifically particulate matter ≤ 10μm (PM10) and sulfur dioxide (SO2). To assess the relationship between DM and exposure to PM10 and SO2, multivariate logistic regression models were developed using the 2012 Korea Community Health Survey data and the ambient air pollution data in South Korean cities at both Gu- and Si levels.

Results: The commonly encountered levels of PM10 and SO2 may be associated with DM 2 prevalence in South Korea but it appears there may be gender differences. In particular, exposure to either PM10 or SO2 was significantly related to the prevalence of DM 2 among women but not among men.

Conclusion: These findings provide new evidence of an association between air pollution and the risk of diabetes in urbanized areas of South Korea.




Air pollution; Diabetes; Gender specificity; PM10; SO2

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Shaw JE, Sicree RA, Zimmet PZ (2010). Global esti-mates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract, 87 (1): 4-14.

Kong S, Bae H, Yoon D, et al. (2012). A Study on the Health and Management Policy of PM2.5 in Korea I. Seoul: Korea Environment Institute.

Peters A, Dockery D, Muller J, Mittleman M (2001). Increased particulate air pollution and the trigger-ing of myocaridal infarction. Circulation, 103: 2810-2815.

Peters A, Liu E, Verrier R, et al. (2000). Air Pollution and Incidence of Cardiac Arrhythmia. Epidemiology, 11 (1): 11-17.

Brook R, Brook J, Urch B, et al. (2002). Inhalation of fine particulate air pollution and ozone causes acule arterial vaso-constriction in healthy adults. Circula-tion, 105: 1534-1536.

Andersen Z, Loft S, Raaschou-Nielsen O, et al. (2012). Diabetes Incidence and Long-Term Ex-posure to Air Pollution. Diabetes Care, 35: 92-98.

Rajagopalan S, Brook R (2012). Air Pollution and Type 2 Diabetes Mechanistic Insights. Diabetes, 61: 3037-3045.

Janghorbani M, Momeni F, Mansourian M (2014). Systematic review and metaanalysis of air pollution exposure and risk of diabetes. Eur J Epidemiol, 29: 231-242.

Wang B, Xu D, Jing Z, et al. (2014). Effect of long-term exposure to air pollution on type 2 diabetes mellitus risk: a systemic review and meta-analysis of cohort studies. Eur J Endocrinol, 171 (5): R173-82.

Balti EV, Echouffo-Tcheugui JB, Yako YY, Kengne AP (2014). Air pollution and risk of type 2 diabe-tes mellitus: A systematic review and meta-analysis. Diabetes Res Clin Pract, 106 (2): 161-172.

Kim JH, Hong YC (2012). GSTM 1, GSTT 1, and GSTP 1 Polymorphisms and Associations be-tween Air Pollutants and Markers of Insulin Re-sistance in Elderly Koreans. Environ Health Perspect, 120 (10): 1378-1384.

Coogan P, White LF, Jerrett M, et al. (2012). Air Pollu-tion and Incidence of Hypertension and Diabetes Mellitus in Black Women Living in Los Angeles. Circulation, 125: 767-772.

Brook R, Jerrett M, Brook J, et al. (2008). The relation-ship between diabetes mellitus and traffic-related air pollution. J Occup Environ Med, 50: 32-38.

Choi Y, Kim J, Hong Y (2015). Sex-dependent and body weight-dependent associations between en-vironmental PAHs exposure and insulin re-sistance: Korean urban elderly panel. J Epidemiol Community Health, 69(7): 625-631.

Dijikema M, Mallant S, Gehring U, et al. (2011). Long-term Exposure to Traffic-related Air Pollu-tion and Type 2 Diabetes Prevalance in a Cross-sectional Screening-study in the Netherlands. Envi-ron Health, 10:76.

Puett R, Hart J, Schwartz J, et al. (2011). Are particulate matter exposures associated with risk of type 2 di-abetes? Environ Health Perspect, 119 (3): 384-389.

Kan H, Jia J, Chen B (2004). The association of daily diabetes mortality and outdoor air pollution in Shanghai, China. J Environ Health, 67 (3): 21-26.

Tahmasebi A, Amin MM, Poursafa P, et al. (2015). Association of geographical distribution of air quality index and type 2 diabetes mellitus in Isfa-han. Pak J Med Sci, 31 (2): 369-373.

Korea Centers for Disease Control and Prevention (2012). Community Health Survey. Osong: Korea Centers for Disease Control and Prevention.

Zhang J, Smith K (2007). Household Air Pollution from Coal and Biomass Fuels in China: Meas-urements, Health Impacts, and Interventions. En-viron Health Perspect, 115 (6): 848-855.

Hong S, Lee J, Moon K, et al. (2012). Analysis of Sea-sonal Characteristics about Long-Range Transport and Deposition of Sulfur. J Korean Soc Atmos Environ, 26 (1): 34-47.

Zeger SL, Thomas D, Dominici F, et al. (2000). Ex-posure measurement error in time-series studies of air pollution: concepts and consequences. Envi-ron Health Perspect, 108 (5): 419-426.

Matte T, Ross Z, Kheirbek I, et al. (2013). Monitoring intraurban spatial patterns of multiple combustion air pollutants in New York City: design and im-plementation. J Expo Sci Environ Epidemiol, 23 (3): 223-231.

Lee Y, Sohn D (2015). An Analysis of the Relation-ships between the Characteristics of Urban Physi-cal Environment and Air Pollution in Seoul. Journal of The Urban Design Institute of Korea (In press).

World Health Organization. (2014). Ambient (out-door) air quality and health.

Chen H, Burnett R, Kwong J, et al. (2013). Risk of In-cident Diabetes in Relation to Long-term Expo-sure to Fine Particulate Matter in Ontario, Canada. Environ Health Perspect, 121 (7): 804-810.

Eze I, Schaffner E, Fischer E, et al. (2014). Long-term air pollution exposure and diabetes in a popula-tion-based Swiss cohort. Environ Int, 70: 95-105.

Whitsel E, Quibrera P, Christ S, et al. (2009). Heart Rate Variability, Ambient Particulate Matter Air Pollution, and Glucose Homeostasis: The Envi-ronmental Epidemiology of Arrhythmogenesis in the Women's Health Initiative. Am J Epidemiol, 169 (6): 693-703.

Butter M. (2006). Are Women More Vulnerable to Environmental Pollution? J Hum Ecol, 20 (3): 221-226.

Yoon I, Kim H. (2003). A Study on Commuting Pat-terns in Seoul Metropolitan Area, 1990-1996. Jour-nal of Korea Planners Association, 38 (6): 87-97.

Ji W, Oh E. (2004). A Study on the Travel Behaviors and Housing Location Choice of Two Worker Households. Suwon: Gyeonggi Research Institute.

Wakefield J, Shaddick G. (2006). Health-exposure modeling and the ecological fallacy. Biostatistics, 7 (3): 438-455.


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