Acute Effects of Air Pollution on Type II Diabetes Mellitus Hospitalization in Shijiazhuang, China

Environ Sci Pollut Res Int. 2018 Oct;25(30):30151-30159. doi: 10.1007/s11356-018-3016-9. Epub 2018 Aug 27.


Air pollution has been considered as an important contributor to diabetes development. However, the evidence is fewer in developing countries where air pollution concentrations were much higher. In this study, we conduct a time-series study to investigate the acute adverse effect of six air pollutants on type II diabetes mellitus (T2DM) hospitalization in Shijiazhuang, China. An over-dispersed passion generalized addictive model adjusted for weather conditions, day of the week, and long-term and seasonal trends was used. Finally, a 10-μg/m3 increase of fine particulate matter (PM2.5), inhalable particulate matter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), and carbon monoxide (CO) corresponded to 0.53% (95% confidence interval = 0.22-0.83), 0.32% (95% CI = 0.10-0.55), 0.55% (95% CI = 0.04-1.07), 1.27% (95% CI = 0.33-2.22), and 0.04% (95% CI = 0.02-0.06) increment of T2DM hospitalization, respectively. The effects of PM2.5, PM10, and CO were robust when adjusted for co-pollutants. The associations appeared to be a little stronger in the cool season than in the warm season. And stronger associations were found in male and elderly (≥ 65 years) than in female and younger people (35-65 years). Our results contribute to the limited data in the scientific literature on acute effects of air pollution on type II diabetes mellitus in developing countries.

Main findings: This is the first adverse effect evidence of air pollution on T2DM in Shijiazhuang, a severely polluted city in China. Males were more vulnerable than females in severe pollution.

Keywords: Air pollution; Hospitalization; Time-series study; Type II diabetes mellitus.

MeSH terms

  • Adult
  • Aged
  • Air Pollutants / adverse effects*
  • Air Pollutants / analysis
  • Air Pollution / adverse effects*
  • Air Pollution / analysis
  • Carbon Monoxide / adverse effects
  • China
  • Cities
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / therapy*
  • Female
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Nitrogen Dioxide / adverse effects
  • Nitrogen Dioxide / analysis
  • Particulate Matter / adverse effects
  • Particulate Matter / analysis
  • Seasons
  • Time Factors
  • Weather


  • Air Pollutants
  • Particulate Matter
  • Carbon Monoxide
  • Nitrogen Dioxide