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Long-term Exposure to Traffic-related Air Pollution and Type 2 Diabetes Prevalence in a Cross-sectional Screening-study in the Netherlands

Marieke BA Dijkema12*, Sanne F Mallant13, Ulrike Gehring2, Katja van den Hurk3, Marjan Alssema3, Rob T van Strien1, Paul H Fischer4, Giel Nijpels3, Coen DA Stehouwer5, Gerard Hoek2, Jacqueline M Dekker36 and Bert Brunekreef27

Author Affiliations

1 Department of Environmental Health, Public Health Service Amsterdam, Amsterdam, the Netherlands

2 Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands

3 EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands

4 Centre for Environmental Health Research, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands

5 Department of Internal Medicine and Cardiovascular Research Institute Maastricht, Maastricht University Medical Centre, Maastricht, the Netherlands

6 Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands

7 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands

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Environmental Health 2011, 10:76  doi:10.1186/1476-069X-10-76

Published: 5 September 2011



Air pollution may promote type 2 diabetes by increasing adipose inflammation and insulin resistance. This study examined the relation between long-term exposure to traffic-related air pollution and type 2 diabetes prevalence among 50- to 75-year-old subjects living in Westfriesland, the Netherlands.


Participants were recruited in a cross-sectional diabetes screening-study conducted between 1998 and 2000. Exposure to traffic-related air pollution was characterized at the participants' home-address. Indicators of exposure were land use regression modeled nitrogen dioxide (NO2) concentration, distance to the nearest main road, traffic flow at the nearest main road and traffic in a 250 m circular buffer. Crude and age-, gender- and neighborhood income adjusted associations were examined by logistic regression.


8,018 participants were included, of whom 619 (8%) subjects had type 2 diabetes. Smoothed plots of exposure versus type 2 diabetes supported some association with traffic in a 250 m buffer (the highest three quartiles compared to the lowest also showed increased prevalence, though non-significant and not increasing with increasing quartile), but not with the other exposure metrics. Modeled NO2-concentration, distance to the nearest main road and traffic flow at the nearest main road were not associated with diabetes. Exposure-response relations seemed somewhat more pronounced for women than for men (non-significant).


We did not find consistent associations between type 2 diabetes prevalence and exposure to traffic-related air pollution, though there were some indications for a relation with traffic in a 250 m buffer.

50-75 yrs; general population; long term; the Netherlands; traffic related air pollution; type 2 diabetes