TY - JOUR
T1 - Pesticide exposure and diabetes mellitus in a semi-urban Nepali population
T2 - a cross-sectional study
AU - Hansen, Martin Rune Hassan
AU - Gyawali, Bishal
AU - Neupane, Dinesh
AU - Jørs, Erik
AU - Sandbæk, Annelli
AU - Kallestrup, Per
AU - Schlünssen, Vivi
N1 - Funding Information:
MRHH is a Ph.D. student at Aarhus University, supported by grants from the National Research Center for the Working Environment (project number 10322) and Aarhus University Research Foundation (project number 81231). At the time of the project, BG was also a Ph.D. student at Aarhus University, supported by grants from Aarhus University Research Foundation (project number 19439) and the Aarhus University Graduate School of Health (project number 12561). Data collection was supported by the International Centre for Occupational and Environmental Medicine and Public Health, Odense University Hospital (project number N/A). The funding bodies played no role in the design of the study, the collection, analysis and interpretation of the data, or in the writing of the manuscript.
Publisher Copyright:
© 2019, Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2020/5/1
Y1 - 2020/5/1
N2 - Objective: Epidemiological studies suggest exposure to pesticides to be related to risk of diabetes mellitus. The objective of the present study was to assess the association between pesticide use and diabetes mellitus in a semi-urban population in Nepal. Methods: We conducted a nested cross-sectional study on pesticides and diabetes mellitus in a population-based cohort from the former Lekhnath Municipality, Nepal. 2643 persons were invited, and 2310 persons participated (response rate 87.4%). All participants were tested for fasting plasma glucose. Diabetes mellitus was defined as either fasting plasma glucose (FPG) ≥ 7.0 mmol/L (126 mg/dL) or self-reported diagnosis of diabetes mellitus. Exposure to pesticides was determined by questionnaire. For the exposed persons, three exposure metrics (years of exposure, weeks of exposure per year and hours of exposure per week) were categorized and used to model exposure–response relationships. Results: Although 62% of participants reported to be exposed to pesticides, the frequency and intensity of pesticide usage was low. Contrary to our hypothesis, we found lower odds of diabetes mellitus among persons reporting any pesticide use compared to those reporting no use of pesticides—adjusted odds ratio with 95% CI = 0.68 [0.52; 0.90]. However, we found no clear exposure–response relationships between pesticide exposure and neither diabetes mellitus nor FPG, and few and inconsistent associations were seen between pesticide exposure and symptoms of acute pesticide intoxication. Conclusions: The apparently lower odds of diabetes mellitus among pesticide-exposed persons in this population are probably due to residual confounding. Our results do not seem to support an association between pesticide exposure and diabetes mellitus in this low-exposed population dominated by subsistence farmers, although results should be interpreted with caution in light of the study limitations.
AB - Objective: Epidemiological studies suggest exposure to pesticides to be related to risk of diabetes mellitus. The objective of the present study was to assess the association between pesticide use and diabetes mellitus in a semi-urban population in Nepal. Methods: We conducted a nested cross-sectional study on pesticides and diabetes mellitus in a population-based cohort from the former Lekhnath Municipality, Nepal. 2643 persons were invited, and 2310 persons participated (response rate 87.4%). All participants were tested for fasting plasma glucose. Diabetes mellitus was defined as either fasting plasma glucose (FPG) ≥ 7.0 mmol/L (126 mg/dL) or self-reported diagnosis of diabetes mellitus. Exposure to pesticides was determined by questionnaire. For the exposed persons, three exposure metrics (years of exposure, weeks of exposure per year and hours of exposure per week) were categorized and used to model exposure–response relationships. Results: Although 62% of participants reported to be exposed to pesticides, the frequency and intensity of pesticide usage was low. Contrary to our hypothesis, we found lower odds of diabetes mellitus among persons reporting any pesticide use compared to those reporting no use of pesticides—adjusted odds ratio with 95% CI = 0.68 [0.52; 0.90]. However, we found no clear exposure–response relationships between pesticide exposure and neither diabetes mellitus nor FPG, and few and inconsistent associations were seen between pesticide exposure and symptoms of acute pesticide intoxication. Conclusions: The apparently lower odds of diabetes mellitus among pesticide-exposed persons in this population are probably due to residual confounding. Our results do not seem to support an association between pesticide exposure and diabetes mellitus in this low-exposed population dominated by subsistence farmers, although results should be interpreted with caution in light of the study limitations.
KW - Blood glucose
KW - Diabetes mellitus
KW - Fungicide
KW - Herbicide
KW - Insecticide
KW - Pesticide
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U2 - 10.1007/s00420-019-01508-2
DO - 10.1007/s00420-019-01508-2
M3 - Article
C2 - 31838733
AN - SCOPUS:85077062961
SN - 0340-0131
VL - 93
SP - 513
EP - 524
JO - International Archives of Occupational and Environmental Health
JF - International Archives of Occupational and Environmental Health
IS - 4
ER -