Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
Department of Epidemiology, UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, DHHS, Research Triangle Park, NC, USA.
Environ Res. 2022 Sep;212(Pt E):113591. doi: 10.1016/j.envres.2022.113591. Epub 2022 Jun 1.
Although evidence suggests relationships between some crude oil components and glycemic dysregulation, no studies have examined oil spill-related chemical exposures in relation to type 2 diabetes mellitus (DM) risk. This study examined the relationship between total hydrocarbon (THC) exposure among workers involved in the 2010 Deepwater Horizon (DWH) oil spill and risk of DM up to 6 years afterward.
Participants comprised 2660 oil-spill cleanup or response workers in the prospective GuLF Study who completed a clinical exam and had no self-reported DM diagnosis prior to the spill. Maximum THC exposure was estimated with a job-exposure matrix based on interview data and personal measurements taken during cleanup operations. We defined incident DM by self-reported physician diagnosis of DM, antidiabetic medication use, or a measured hemoglobin A1c value ≥ 6.5%. We used log binomial regression to estimate risk ratios (RRs) for DM across ordinal categories of THC exposure. The fully adjusted model controlled for age, sex, race/ethnicity, education, employment status, and health insurance status. We also stratified on clinical body mass index categories.
We observed an exposure-response relationship between maximum daily ordinal THC exposure level and incident DM, especially among overweight participants. RRs among overweight participants were 0.99 (95% CI: 0.37, 2.69), 1.46 (95% CI: 0.54, 3.92), and 2.11 (95% CI: 0.78, 5.74) for exposure categories 0.30-0.99 ppm, 1.00-2.99 ppm, and ≥3.00 ppm, respectively (p = 0.03).
We observed suggestively increasing DM risk with increasing THC exposure level among overweight participants, but not among normal weight or obese participants.
尽管有证据表明一些原油成分与血糖调节紊乱有关，但尚无研究调查与石油泄漏相关的化学暴露与 2 型糖尿病（DM）风险之间的关系。本研究调查了 2010 年深水地平线（DWH）石油泄漏事件中涉及的工人的总碳氢化合物（THC）暴露与 DM 风险之间的关系，随访时间长达 6 年。
前瞻性 Gulf 研究包括 2660 名石油泄漏清理或应对工人，他们在泄漏前完成了临床检查，并且没有自我报告的 DM 诊断。最大 THC 暴露量是根据访谈数据和清理作业期间的个人测量值，使用职业暴露矩阵来估计的。我们通过自我报告的医生诊断为 DM、使用抗糖尿病药物或测量的血红蛋白 A1c 值≥6.5%来定义 DM 事件。我们使用对数二项式回归来估计 THC 暴露的有序分类的 DM 风险比（RR）。完全调整后的模型控制了年龄、性别、种族/民族、教育程度、就业状况和医疗保险状况。我们还根据临床体重指数类别进行分层。
我们观察到最大每日 THC 暴露水平与 DM 事件之间存在暴露-反应关系，尤其是在超重参与者中。超重参与者的 RR 分别为 0.99（95%CI：0.37，2.69）、1.46（95%CI：0.54，3.92）和 2.11（95%CI：0.78，5.74），暴露类别分别为 0.30-0.99ppm、1.00-2.99ppm 和≥3.00ppm（p=0.03）。
我们观察到，在超重参与者中，随着 THC 暴露水平的增加，DM 风险呈递增趋势，但在正常体重或肥胖参与者中则没有。
