AUTHOR=Kutlar Joss Meltem , Boogaard Hanna , Samoli Evangelia , Patton Allison P. , Atkinson Richard , Brook Jeff , Chang Howard , Haddad Pascale , Hoek Gerard , Kappeler Ron , Sagiv Sharon , Smargiassi Audrey , Szpiro Adam , Vienneau Danielle , Weuve Jennifer , Lurmann Fred , Forastiere Francesco , Hoffmann Barbara H. 

TITLE=Long-Term Exposure to Traffic-Related Air Pollution and Diabetes: A Systematic Review and Meta-Analysis

JOURNAL=International Journal of Public Health

VOLUME=68

YEAR=2023

URL=https://www.ssph-journal.org/journals/international-journal-of-public-health/articles/10.3389/ijph.2023.1605718

DOI=10.3389/ijph.2023.1605718

ISSN=1661-8564

ABSTRACT=<p><bold>Objectives:</bold> We report results of a systematic review on the health effects of long-term traffic-related air pollution (TRAP) and diabetes in the adult population.</p><p><bold>Methods:</bold> An expert Panel appointed by the Health Effects Institute conducted this systematic review. We searched the PubMed and LUDOK databases for epidemiological studies from 1980 to July 2019. TRAP was defined based on a comprehensive protocol. Random-effects meta-analyses were performed. Confidence assessments were based on a modified Office for Health Assessment and Translation (OHAT) approach, complemented with a broader narrative synthesis. We extended our interpretation to include evidence published up to May 2022.</p><p><bold>Results:</bold> We considered 21 studies on diabetes. All meta-analytic estimates indicated higher diabetes risks with higher exposure. Exposure to NO<sub>2</sub> was associated with higher diabetes prevalence (RR 1.09; 95% CI: 1.02; 1.17 per 10 μg/m<sup>3</sup>), but less pronounced for diabetes incidence (RR 1.04; 95% CI: 0.96; 1.13 per 10 μg/m<sup>3</sup>). The overall confidence in the evidence was rated moderate, strengthened by the addition of 5 recently published studies.</p><p><bold>Conclusion:</bold> There was moderate evidence for an association of long-term TRAP exposure with diabetes.</p>