Martin Rune Hassan Hansen1, Bishal Gyawali2,3, Dinesh Neupane4,5, Erik Jørs6, Annelli Sandbæk7,8, Per Kallestrup2, Vivi Schlünssen9,10. 1. Department of Public Health, Section for Environment, Work and Health, Danish Ramazzini Centre, Aarhus University, Building 1260, Bartholins Allé 2, 8000, Aarhus C, Denmark. martinrunehassanhansen@ph.au.dk. 2. Department of Public Health, Center for Global Health (GloHAU), Aarhus University, Bygning 1260, Bartholins Allé 2, 8000, Aarhus C, Denmark. 3. Section of Global Health, Department of Public Health, University of Copenhagen, Bartholinsgade 6, building 9, 1356, Copenhagen K, Denmark. 4. Nepal Development Society, Bharatpur-10, Chitwan, Nepal. 5. Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, 2024 E Monument St, Baltimore, MD, 21205, USA. 6. Department of Occupational Medicine, Odense University Hospital, Kløvervænget 3, Indgang 138, 5000, Odense, Denmark. 7. Section of General Practice, Department of Public Health, Aarhus University, Bygning 1260, Bartholins Allé 2, 8000, Aarhus C, Denmark. 8. Steno Diabetes Center Aarhus, Aarhus University Hospital and Central Denmark Region, Hedeager 3, 8200, Aarhus N, Denmark. 9. Department of Public Health, Section for Environment, Work and Health, Danish Ramazzini Centre, Aarhus University, Building 1260, Bartholins Allé 2, 8000, Aarhus C, Denmark. 10. National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark.
Abstract
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.
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.
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