2025-11-182025-11-18https://repositorio.uandes.cl/handle/uandes/56734<p>OBJECTIVE To evaluate associations of wildfire fine particulate matter ≤2.5 mm in diameter (PM_2.5) with diabetes across multiple countries and territories. RESEARCH DESIGN AND METHODS We collected data on 3,612,135 diabetes hospitalizations from 1,008 locations in Australia, Brazil, Canada, Chile, New Zealand, Thailand, and Taiwan during 2000–2019. Daily wildfire-specific PM_2.5 levels were estimated through chemical transport models and machine-learning calibration. Quasi-Poisson regression with distributed lag non-linear models and random-effects meta-analysis were applied to estimate associations between wildfire-specific PM_2.5 and diabetes hospitalization. Subgroup analyses were by age, sex, location income level, and country or territory. Diabetes hospitalizations attributable to wildfire-specific PM_2.5 and nonwildfire PM_2.5 were compared. RESULTS Each 10 mg/m³ increase in wildfire-specific PM_2.5 levels over the current day and previous 3 days was associated with relative risks (95% CI) of 1.017 (1.011–1.022), 1.023 (1.011–1.035), 1.023 (1.015–1.032), 0.962 (0.823–1.032), 1.033 (1.001–1.066), and 1.013 (1.004–1.022) for all-cause, type 1, type 2, malnutrition-related, other specified, and unspecified diabetes hospitalization, respectively. Stronger associations were observed for all-cause, type 1, and type 2 diabetes in Thailand, Australia, and Brazil; unspecified diabetes in New Zealand; and type 2 diabetes in high-income locations. An estimate of 0.67% (0.16–1.18%) and 1.02% (0.20–1.81%) for all-cause and type 2 diabetes hospitalizations were attributable to wildfire-specific PM_2.5. Compared with nonwildfire PM_2.5, wildfire-specific PM_2.5 posed greater risks of all-cause, type 1, and type 2 diabetes and were responsible for 38.7% of PM_2.5-related diabetes hospitalizations. CONCLUSIONS We show the relatively underappreciated links between diabetes and wildfire air pollution, which can lead to a nonnegligible proportion of PM_2.5-related diabetes hospitalizations. Precision prevention and mitigation should be developed for those in advantaged communities and in Thailand, Australia, and Brazil.</p>info:eu-repo/semantics/restrictedAccessSDG 2 - Zero HungerSDG 3 - Good Health and Well-beingArticle