Potential effects of microbial air quality on the number of new cases of diabetes type 1 in children in two regions of Poland: a pilot study

Air Pollution, Oxidative Stress, and the Risk of Development of Type 1 Diabetes

Despite multiple studies focusing on environmental factors conducive to the development of type 1 diabetes mellitus (T1DM), knowledge about the involvement of long-term exposure to air pollution seems insufficient. The main focus of epidemiological studies is placed on the relationship between exposure to various concentrations of particulate matter (PM): PM1, PM2.5, PM10, and sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (O3), versus the risk of T1DM development. Although the specific molecular mechanism(s) behind the link between increased air pollution exposure and a higher risk of diabetes and metabolic dysfunction is yet unknown, available data indicate air pollution-induced inflammation and oxidative stress as a significant pathway. The purpose of this paper is to assess recent research examining the association between inhalation exposure to PM and associated metals and the increasing rates of T1DM worldwide. The development of modern and more adequate methods for air quality monitoring is also introduced. A particular emphasis on microsensors, mobile and autonomous measuring platforms, satellites, and innovative approaches of IoT, 5G connections, and Block chain technologies are also presented. Reputable databases, including PubMed, Scopus, and Web of Science, were used to search for relevant literature. Eligibility criteria involved recent publication years, particularly publications within the last five years (except for papers presenting a certain novelty or mechanism for the first time). Population, toxicological and epidemiological studies that focused particularly on fine and ultra-fine PM and associated ambient metals, were preferred, as well as full-text publications.

Environmental Factors and the Risk of Developing Type 1 Diabetes-Old Disease and New Data

Simple Summary

Despite many studies, the risk factors of type 1 diabetes (T1DM) in children and adolescents are still not fully understood and remain a big challenge. Therefore, an extensive online search for scientific research on factors related to diabetes has been performed for the identification of new factors of unexplained etiology. A better understanding of the role of viral, bacterial, and yeast-like fungi infections related to the risk of T1DM in children and adolescents and the identification of new risk factors, especially those spread by the droplet route, is of great importance for people and families with diabetes.

Abstract

The incidence of type 1 diabetes (T1D) is increasing worldwide. The onset of T1D usually occurs in childhood and is caused by the selective destruction of insulin-producing pancreatic islet cells (β-cells) by autoreactive T cells, leading to insulin deficiency. Despite advanced research and enormous progress in medicine, the causes of T1D are still not fully understood. Therefore, an extensive online search for scientific research on environmental factors associated with diabetes and the identification of new factors of unexplained etiology has been carried out using the PubMed, Cochrane, and Embase databases. The search results were limited to the past 11 years of research and discovered 143 manuscripts published between 2011 and 2022. Additionally, 21 manuscripts from between 2000 and 2010 and 3 manuscripts from 1974 to 2000 were referenced for historical reference as the first studies showcasing a certain phenomenon or mechanism. More and more scientists are inclined to believe that environmental factors are responsible for the increased incidence of diabetes. Research results show that higher T1D incidence is associated with vitamin D deficiency, a colder climate, and pollution of the environment, as well as the influence of viral, bacterial, and yeast-like fungi infections. The key viral infections affecting the risk of developing T1DM are rubella virus, mumps virus, Coxsackie virus, cytomegalovirus, and enterovirus. Since 2020, i.e., from the beginning of the COVID-19 pandemic, more and more studies have been looking for a link between Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and diabetes development. A better understanding of the role of viral, bacterial, and yeast-like fungi infections related to the risk of T1DM in children and adolescents and the identification of new risk factors, especially those spread by the droplet route, is of great importance for people and families with diabetes.

Potential Therapeutic Application of Regulatory T Cells in Diabetes Mellitus Type 1

The autoimmune reaction against the beta cells of the pancreatic islets in type 1 diabetes mellitus (T1DM) patients is active in prediabetes and during the development of the clinical manifestation of T1DM, but it decreases within a few years of the clinical manifestation of this disease. A key role in the pathogenesis of T1DM is played by regulatory T cell (Treg) deficiency or dysfunction. Immune interventions, such as potential therapeutic applications or the induction of the Treg-cell population in T1DM, will be important in the development of new types of treatment. The aim of this study was to evaluate innovative immune interventions as treatments for T1DM. After an evaluation of full-length papers from the PubMed database from 2010 to 2021, 20 trials were included for the final analysis. The analysis led to the following conclusions: Treg cells play an important role in the limitation of the development of T1DM, the activation or application of Tregs may be more effective in the early stages of T1DM development, and the therapeutic use of Treg cells in T1DM is promising but requires long-term observation in a large group of patients.

The emergency discharge of sewage to the Bay of Gdańsk as a source of bacterial enrichment in coastal air

The purpose of this research was to study the presence of potential pathogenic bacteria in the seawater and air in five coastal towns (Hel, Puck, Gdynia, Sopot, Gdańsk-Brzeźno) as well as the enrichment of bacteria from the seawater into the coastal air after an emergency discharge of sewage into the Bay of Gdańsk. A total of 594 samples of air and seawater were collected in the coastal zone between spring and summer (between 2014 and 2018). Air samples were collected using the impact method with a SAS Super ISO 100. The multivariate analysis, conducted using contingency tables, showed a statistically significant variation between the concentration of coliforms, psychrophilic and mesophilic bacteria in the seawater microlayer and air in 2018, after an emergency discharge of sewage into the Bay of Gdańsk, compared to 2014-2017. Moreover, we detected a marine aerosol enrichment in psychrophilic, mesophilic bacteria, coliforms and Escherichia coli. We also showed a statistically significant relationship between the total concentration of bacteria and humidity, air temperature, speed and wind direction. This increased concentration of bacteria in the seawater and coastal air, and the high factor of air enrichment with bacteria maybe associated with the emergency discharge of wastewater into the Bay of Gdańsk. Therefore, it is suggested that in the event of a malfunction of a sewage treatment plant, as well as after floods or sudden rainfall, the public should be informed about the sanitary and epidemiological status of the coastal waters and be recommended to limit their use of coastal leisure areas.

Higher Number of Yeast-like Fungi in the Air in 2018 after an Emergency Discharge of Raw Sewage to the Gulf of Gdańsk—Use of Contingency Tables

This study aimed to investigate the differences between the number of yeast-like fungi and molds in the coastal air of five coastal towns of the Gulf of Gdańsk in 2014–2017 vs. 2018, which saw an emergency discharge of sewage. In 2014–2017, a total of 62 duplicate samples were collected in the coastal towns of Hel, Puck, Gdynia, Sopot, and Gdańsk-Brzeźno. In 2018, after the emergency disposal of raw sewage, 26 air samples were collected. A Pearson chi-squared test of independence showed that during 2018 in Hel and Sopot, the mean number of molds and yeast-like fungi was higher than in 2014–2017. The result was significantly positive, p ≤ 2.22 × 10−16. The analysis of the General Asymptotic Symmetry Test showed that in Puck and Gdańsk-Brzeźno, the average number of Aspergillus sp. mold fungi was higher in 2018 after an emergency discharge of sewage into the Gulf of Gdańsk compared to the period 2014–2017. The result was not statistically significant. In addition, the average number of Penicillium sp. molds in 2018 in Gdańsk-Brzeźno was higher than in 2014–2017, but statistically insignificant (p = 0.9593). In 2018, the average number of Cladosporium sp. molds in Sopot was higher, but also statistically insignificant (p = 0.2114) compared to 2014–2017. Our results indicate that the study of the number of yeast-like fungi in the air may indicate coastal areas that may be particularly at risk of bacterial or mycological pathogens, e.g., after an emergency discharge of raw sewage.

Mold and Yeast-Like Fungi in the Seaside Air of the Gulf of Gdańsk (Southern Baltic) after an Emergency Disposal of Raw Sewage

The aim of this study was to determine the correlation between the meteorological factors and the number of molds and yeast-like fungi in the air in the five coastal towns in the years 2014-2017, and in 2018, after emergency disposal of raw sewage to the Gdańsk Gulf. In the years 2014-2018, a total number of 88 air samples were collected in duplicate in the five coastal towns of Hel, Puck, Gdynia, Sopot, and Gdańsk-Brzeźno. After the application of the (PCA) analysis, this demonstrated that the first principal component (PC1) had a positive correlation with the water temperature, wind speed, air temperature, and relative humidity. The second principal component (PC2) had a positive correlation with the relative humidity, wind speed, wind direction, and air temperature. In 2018, potentially pathogenic mold and yeast-like fungi (Candida albicans, Stachybotrys chartarum complex, Aspergillus section Fumigati) were detected in the seaside air. While the detected species were not observed in the years 2014-2017. We suggest that it is advisable to inform residents about the potential health risk in the event of raw sewage disposal into the water. Moreover, in wastewater treatment plants, tighter measures, including wastewater disinfection, should be introduced.

Gaseous Pollutants and Particulate Matter (PM) in Ambient Air and the Number of New Cases of Type 1 Diabetes in Children and Adolescents in the Pomeranian Voivodeship, Poland

The increase in type 1 diabetes mellitus (T1DM) incidence in children is worrying and not yet fully explored. It is suggested that probably air pollution exposure could contribute to the development of T1DM. The aim of the study was to investigate the relationship between the concentration of gaseous pollutants including, nitrogen dioxide (NO₂), nitric oxides (NOx), sulphur dioxide (SO₂), carbon monoxide (CO), and particulate matter (PM) in the air, and the number of new cases of T1DM in children. The number of new cases of T1DM was obtained from the Clinic of Paediatrics, Diabetology, and Endocrinology, Medical University of Gdańsk. The number of children of 0-18 years old in Pomeranian Voivodeship was acquired from the Statistical Yearbook. The concentrations of PM₁₀ absorbance, NO₂, NOx, SO₂, and CO were measured at 41 measuring posts, between 1 January 2015 and 31 December 2016. It was detected that the average annual concentration of PM₁₀ was higher than the value acceptable to the WHO. Furthermore, the average 24-hour concentration of PM₁₀ was 92 μg/m³ and was higher compared to the acceptable value of 50 μg/m³ (acc. to EU and WHO). Moreover, the number of new cases of T1DM showed a correlation with the annual average concentration of PM₁₀ (β = 2.396, p < 0.001), SO₂ (β = 2.294, p < 0.001), and CO (β = 2.452, p < 0.001). High exposure to gaseous pollutants and particulate matter in ambient air may be one of the factors contributing to the risk of developing T1DM in children. Therefore, it is important to take action to decrease air pollutant emissions in Poland. It is crucial to gradually but consistently eliminate the use of solid fuels, such as coal and wood in households, in favour of natural gas and electricity. The development of new technologies to improve air quality, such as "best available techniques" (BAT) or renewable energy sources (water, wind, and solar generation) is of critical importance as well.