High Airborne PM2.5 Chlorine Concentrations Link to Diabetes Surge in Portugal

Sci Total Environ. 2009 Oct 15;407(21):5726-34. doi: 10.1016/j.scitotenv.2009.07.029. Epub 2009 Aug 15.


Since 1995 airborne particles have been sampled near Lisbon and analysed by PIXE at ITN. On the Summer of 2004 extremely high concentrations of 14 microg/m(3) of chlorine in PM2.5 were determined in a week average sample. Later in 2004 and in 2005 similar events occurred. A 12 year database of PIXE data on airborne elemental concentrations (1995 to 2006) compiled on 2007 was then analysed for PM2.5 chlorine concentrations above 1 microg/m(3), and showed that the number of this type of events per year is increasing since 1995 up until the present. A quest for time coincident abnormal health data reports was carried out and revealed a 30% raise in diabetes mellitus incidence from 2003 to 2004 followed by a 20% raise from 2004 to 2005. After a first short publication at the XIth Int. PIXE Conference in 2007 (Reis et al., 2007a) the problem remained live. Taking into account new insights into the problem, recently published data, and biomonitoring data that were previously not considered, it was possible to establish a highly probable link between the abnormally high values of PM2.5 chlorine measured in the Lisbon area and the surge in diabetes mellitus incidence in Portugal in 2004 and 2005. Data, reasoning, possible mechanisms and conclusions regarding this link are reported in the present paper.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Chlorine / analysis*
  • Chlorine / chemistry
  • Chlorine / toxicity
  • Diabetes Mellitus / epidemiology
  • Diabetes Mellitus / etiology*
  • Environmental Exposure / adverse effects*
  • Environmental Monitoring
  • Epidemiological Monitoring
  • Humans
  • Particle Size
  • Particulate Matter / analysis*
  • Particulate Matter / chemistry
  • Particulate Matter / toxicity
  • Portugal / epidemiology


  • Particulate Matter
  • Chlorine