Are diabetics more susceptible to the health effects of airborne particles?

Convincing evidence now exists that particulate air pollution exacerbates h eart and lung disease, leading to increased morbidity and mortality. The po pulations particularly susceptible to these exposures are still unclear. Re cent work on potential mechanisms of action of particulate air pollution po int to pathways also influenced by diabetes. We examined whether diabetes m odified the effect of airborne particles by looking at the association of P M10 with hospital admissions for heart and lung disease in persons with or without diabetes as a comorbidity. In addition we stratified by age within persons with and without diabetes. We used Medicare data for Cook County, I llinois for the years 1988-1994, and found that a 10 mug/m(3) increase in P M10 was associated with a 2.01% (95% CI 1.40-2.62%) increase in admissions for heart disease with diabetes, but only a 0.94% (95% CI 0.61-1.28%) incre ase In persons without diabetes. Similar effect modification was not seen f or lung diseases. When analyzing by age we found twice the PM10-associated risk for heart disease in diabetics than nondiabetics in both age groups. W e found for pneumonia admissions that diabetes is an effect modifier in the younger age group, and for COPD in the older age group. We conclude that p ersons with diabetes are a susceptible population.