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The exposure-response function (quantitative variation of a health outcome per unit of pollutant load) was derived by a meta-analytical assessment of various (international) studies selected from the peer-reviewed epidemiological literature. The effect estimate (gradient) was calculated as the variance weighted average across the results of all studies included in the meta-analysis. In this project, the impact of air pollution on mortality is based on the long-term effect. This approach is chosen because the impact of air pollution is a combination of acute short-term as well as cumulative long-term effects. For example, lifetime air pollution exposure may lead to recurrent injury and, in the long term, cause. | Dijkema et al. Environmental Health 2011 10 76 http www.ehjournal.net content 10 1 76 ENVIRONMENTAL HEALTH RESEARCH Open Access Long-term Exposure to Traffic-related Air Pollution and Type 2 Diabetes Prevalence in a Cross-sectional Screening-study in the Netherlands 1.2 t 1.3 t 2 3 3 Marieke BA Dijkema 1 Sanne F Mallant1 11 Ulrike Gehring Katja van den Hurk Marjan Alssema Dr iH T n Qirion1 Dtii il I I Picr hor4 iol Miir iolc3 QfoHmi i A or5 I Imolz2 I I lolino l i rìoH or3 6 nrl nuu I van Stiien 1 Paul H Fiscnei 1 Giel Nijpels 1 cuen DA Steiiouwei 1 Geiaid Hoek 1 Jacqueline M Dekkei and Bert Brunekreef27 Abstract Background Air pollution may promote type 2 diabetes by increasing adipose inflammation and insulin resistance. This study examined the relation between long-term exposure to traffic-related air pollution and type 2 diabetes prevalence among 50- to 75-year-old subjects living in Westfriesland1 the Netherlands. Methods Participants were recruited in a cross-sectional diabetes screening-study conducted between 1998 and 2000. Exposure to traffic-related air pollution was characterized at the participants home-address. Indicators of exposure were land use regression modeled nitrogen dioxide NO2 concentration distance to the nearest main road1 traffic flow at the nearest main road and traffic in a 250 m circular buffer. Crude and age-1 gender- and neighborhood income adjusted associations were examined by logistic regression. Results 81018 participants were included1 of whom 619 8 subjects had type 2 diabetes. Smoothed plots of exposure versus type 2 diabetes supported some association with traffic in a 250 m buffer the highest three quartiles compared to the lowest also showed increased prevalence1 though non-significant and not increasing with increasing quartile but not with the other exposure metrics. Modeled NO2-concentration1 distance to the nearest main road and traffic flow at the nearest main road were not associated with diabetes. Exposure-response .