Observational Study
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World J Diabetes. May 15, 2021; 12(5): 673-684
Published online May 15, 2021. doi: 10.4239/wjd.v12.i5.673
Relationships between emissions of toxic airborne molecules and type 1 diabetes incidence in children: An ecologic study
Agostino Di Ciaula, Piero Portincasa
Agostino Di Ciaula, Piero Portincasa, Clinica Medica "A. Murri", Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, Bari 70124, Italy
Agostino Di Ciaula, International Society of Doctors for Environment (ISDE), Via XXV Aprile n.34 – 52100 Arezzo, Italy
Author contributions: Di Ciaula A designed the research study and performed the research; Di Ciaula A and Portincasa P wrote and revised the manuscript; All authors have read and approved the final manuscript.
Institutional review board statement: No institutional review board authorization is required, since the study uses an ecologic approach exploring previously published data on type 1 diabetes incidence and pollutant emissions at country level.
Informed consent statement: No informed consent is required for this study, since no individual patients were enrolled.
Conflict-of-interest statement: The Authors have no conflict of interest.
Data sharing statement: Data sharing is available on request to the corresponding authors.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Agostino Di Ciaula, MD, Academic Fellow, Academic Research, Doctor, Medical Assistant, Clinica Medica "A. Murri", Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, P.zza Giulio Cesare 11, Bari 70124, Italy. agostinodiciaula@tiscali.it
Received: December 18, 2020
Peer-review started: December 18, 2020
First decision: March 16, 2021
Revised: March 17, 2021
Accepted: April 12, 2021
Article in press: April 12, 2021
Published online: May 15, 2021
Processing time: 138 Days and 16.1 Hours
Core Tip

Core Tip: The environment has a role in the onset of type 1 diabetes. Possible associations include pollutants that are, however, scarcely explored. We evaluated with an ecologic approach associations between the incidence of type 1 diabetes in children and the global emissions of specific air pollutants in 19 European countries, during three decades. We showed that the incidence of type 1 diabetes is associated with the emissions of particulate matter < 10 μm, non-methane volatile organic compounds, and nitrogen oxides. Results allow us to speculate that type 1 diabetes is, at least in part, a preventable condition, with implications in terms of primary prevention.