The effects of long-term exposure to air pollution on incident mental disorders among patients with prediabetes and diabetes: Findings from a large prospective cohort

Background: The association between air pollution and mental disorders has been widely documented in the general population. However, the evidence among susceptible populations, such as individuals with prediabetes or diabetes, is still insufficient. Methods: We analyzed data from 48,515 participants with prediabetes and 24,393 participants with diabetes from the UK Biobank. Annual pollution data were collected for fine particulate matter (PM2.5), inhalable particulate matter (PM10), nitrogen dioxide (NO2), and nitrogen dioxides (NOx) during 2006-2021. The exposure to air pollution and temperature for each participant were estimated by the bilinear interpolation approach and time-weighted method based on their geocoded home addresses and time spent at each address. We employed the generalized propensity score model based on the generalized estimating equation and the time-varying covariates Cox model to assess the effects of air pollution.