By Tom Frantz
This article is about diabetes. Diabetes is related to air quality because fine particulate matter pollution (PM2.5) has been recently proven, without a doubt, to be a significant cause of the disease. As it turns out, you don’t have to be obese or have it in your family to be susceptible. All you need to do to get diabetes is breathe our lousy air for a few years.
Residents of the San Joaquin Valley should be concerned because we have the highest levels in the nation of fine particle pollution and local diabetes rates are also among the highest in the nation. It is not a coincidence. Unfortunately, this cause-and-effect between particulate pollution and diabetes was not well known 10 years ago when the headline above appeared in the Fresno Bee or else we might be more serious about our air pollution today.
Diabetes is a disease where the body has levels of blood sugar or glucose that are too high. It is caused directly by either defective insulin production in the pancreas or inadequate cell response to insulin. Once developed, it never goes away but it can be controlled.
Diabetes symptoms include the following:
- Increased urine output
- Excessive thirst, dry mouth
- Weight loss or gain
- Skin problems, infections, itchiness
- Slow healing wounds
- Yeast infections
- Tingling or numbness in the feet or toes
- Blurred vision
Besides putting lives in danger, or causing blindness, or instigating kidney failure, diabetes costs individuals thousands of dollars per year to control. Sugar levels in the blood have to be checked several times per day and insulin shots are given as needed. The testing equipment and shots are not cheap.
Diabetes rates in the San Joaquin Valley are definitely higher than in better air quality parts of the state such as the San Francisco, Ventura and San Diego areas. The official local rates are around 10%–12%. Valley demographics of poverty and race also would indicate this percentage is too low due to undiagnosed cases. In Kern County, it is estimated that 33% of the Medicare population has diabetes. This matches the predicted result of long-term exposure to high levels of PM2.5 recently discovered by the researchers.
It is also a fact that people of color in the Valley are more likely to get diabetes than Whites. This probably explains why our current slate of local politicians do not seem overly concerned about the problem.
Prediabetes is a wake-up call saying it is time to make changes in lifestyle to prevent actual diabetes from taking over the body. It is indicated by high blood sugar determined through a series of tests. It is estimated that 45%–50% of Valley residents have prediabetes. The changes needed for them to prevent diabetes are usually weight control, exercise and better nutrition. What we also know now, but didn’t realize before, is they need cleaner air to breathe.
The results of recent studies on the relationship between PM2.5 and higher rates of diabetes are profound. Studies have indicated a link for years but now scientists have stronger, irrefutable, evidence. The conclusive study was of 1.7 million veterans over a period averaging 8.5 years.
A good description of the study can be found at www.theatlantic.com/health/archive/2018/07/a-frightening-new-reason-to-worry-about-air-pollution/564428/.
So, how does PM2.5 cause diabetes? Basically, the small particles of PM2.5 enter the bloodstream through the lungs and invade the major organs of the body. They subsequently cause inflammation, which leads to insulin resistance, one of the key effects of diabetes. The data in the study were adjusted for obesity and genetics. The results apply to everyone. The key result is that 14% of all diabetes cases worldwide have been caused by air pollution.
Another statistic from the study says that if the average PM2.5 level for the year is higher than 2.4 micrograms per cubic meter then there is a higher associated risk of diabetes. Our Valley annual levels are 15–17 micrograms. We need a plan to take our levels down to near zero. Sadly, our air district does not have a plan to even meet the current health standard of 15 micrograms or the latest standard, which is 12 micrograms. In other words, there is no timeline for us to get healthy air to breathe in the Valley. This lack of action is akin to genocide.
At the high levels of PM2.5, we have currently, the study shows that around 30% of the population should develop diabetes after a few years of exposure. That number seems to match well with actual numbers of cases among the elderly living here in the Valley.
It is a fact that residents of the San Joaquin Valley are at a high risk for developing diabetes because of our air pollution. Because of poverty and deficiencies in local healthcare, there are a lot of undiagnosed cases as well. Once diagnosed, poor treatment in the Valley is also common, demonstrated by high rates of emergency room visits for complications from diabetes. Untreated diabetes is definitely a cause of premature death in the Valley.
The bottom line is that we are failing to meet any kind of health standard for PM2.5 and suffering the consequences with high rates of disease such as diabetes and premature death. And there is currently not much hope that anything will change for at least the next 30 years.
Longtime clean air advocate Tom Frantz is a retired math teacher and Kern County almond farmer. A founding member of the Central Valley Air Quality Coalition (CVAQ), he serves on its steering committee and as president of the Association of Irritated Residents. The CVAQ is a partnership of more than 70 community, medical, public health and environmental justice organizations representing thousands of residents in the San Joaquin Valley unified in their commitment to improving the health of Californians. For more information, visit www.calcleanair.org.