Air pollution and type 1 diabetes in children

Pediatr Diabetes. 2006 Apr;7(2):81-7. doi: 10.1111/j.1399-543X.2006.00150.x.


Background: Over the past decade, there has been a worldwide largely unexplained increase in the incidence of type 1 diabetes in young children. This study explores the quantitative role of exposure to specific air pollutants in the development of type 1 diabetes in children.

Methods: A total of 402 children were retrospectively studied. Zip code-related, time-specific birth-to-diagnosis exposure to five ambient air pollutants was obtained for 102 children with type 1 diabetes and 300 healthy children receiving care at a single hospital. Pollution exposure levels were created by summing up zip code-specific pollution data and dividing by months of exposure from birth to diagnosis. Analysis employed chi2, two-tailed independent sample t-test and unconditional logistic regression.

Results: Odds ratio (OR) was significantly high for cumulative exposure to ambient ozone (O3) and sulfate (SO4) in cases compared with controls, OR = 2.89 [95% confidence interval (CI) = 1.80-4.62] and OR = 1.65 (CI = 1.20-2.28), respectively, even after adjustment for several potential confounders. Passive smoking was more frequent in children with diabetes (30 vs. 10%, p = 0.001). Attending day care and breast feeding in infancy were less frequent in children with diabetes (14 vs. 23%, p = 0.025; 59 vs. 78%, p = 0.001). Family history of diabetes, autoimmune disease and drug abuse was more frequent in cases (p < 0.01).

Conclusion: Cumulative exposure to ozone and sulfate in ambient air may predispose to the development of type 1 diabetes in children. Early infant formula feeding and passive smoking in the household may precipitate or accelerate the onset of type 1 diabetes.

MeSH terms

  • Adolescent
  • Air Pollution / adverse effects*
  • Birth Weight
  • California / epidemiology
  • Child
  • Diabetes Mellitus, Type 1 / epidemiology*
  • Diabetes Mellitus, Type 1 / etiology
  • Educational Status
  • Environmental Exposure / adverse effects*
  • Ethnicity
  • Family
  • Female
  • Humans
  • Incidence
  • Male
  • Ozone / analysis
  • Reference Values
  • Substance-Related Disorders / epidemiology
  • Sulfates / analysis
  • Tobacco Smoke Pollution


  • Sulfates
  • Tobacco Smoke Pollution
  • Ozone