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Short term effects of urban air-pollution on physicians' visits for persons with diabetes in Israel

David Broday, Chava Peretz, Yehudith Tzamir

Many epidemiological studies found short term effects of air pollution on cardiovascular morbidity in the elderly population, yet the effect in diabetes patients was less investigated. Recent studies suggest that persons with diabetes and cardiovascular disease that suffer repeated short term exposures to air pollution may be at a higher risk for cardiovascular hospitalization. Furthermore, it has been suggested that air pollution affects light cardiovascular morbidity among diabetes patients beyond their individual life style and daily activities. The effect of air pollution on physicians' visits of patients with diabetes mellitus (DM) has not yet been investigated. The findings of this study are expected to be helpful for decision-makers in their actions towards reducing morbidity related costs.

This project is designed as a cohort, time series study. Inclusion criteria includes all Type 2 diabetes patients ages >21 years of Maccabi HMO who lived in the cities of Tel Aviv and Haifa during 1.1.2004 - 31.12.2010. The relationship between air pollutants and daily physicians' visits for cardio-vascular symptoms, controlled for time related variables (day of week, month, season, holydays), climate variables and personal covariates (age, gender, etc.) will be estimated using GEE models for both diabetic patients and for non-diabetic controls.