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. 2018 Feb 21;6(1):e000466.
doi: 10.1136/bmjdrc-2017-000466. eCollection 2018.

Association of type 1 diabetes and concentrations of drinking water components in Newfoundland and Labrador, Canada

Roger Chafe  1 , Rana Aslanov  2 , Atanu Sarkar  3 , Peter Gregory  1   2   3 , Alex Comeau  2 , Leigh Anne Newhook  1
Affiliations

Association of type 1 diabetes and concentrations of drinking water components in Newfoundland and Labrador, Canada

Roger Chafe et al. BMJ Open Diabetes Res Care. .

Abstract

Objective: To determine the association between drinking water quality and rates of type 1 diabetes in the Newfoundland and Labrador (NL) population, which has one of the highest incidences of type 1 diabetes reported globally.

Research design and methods: The study used a community-based, case-control design. We first calculated incidence rates of type 1 diabetes at the provincial, regional and community levels. The connection between incidence rates and components in public water supplies were then analyzed in three ways: to evaluate differences in water quality between communities with and without incident cases of type 1 diabetes, and to analyze the relationship between water quality and incidence rates of type 1 diabetes at both the community and regional levels.

Results: The provincial incidence of type 1 diabetes was 51.7/100 000 (0-14 year age group) for the period studied. In the community-based analysis, there were significant associations found between higher concentrations of arsenic (β=0.268, P=0.013) and fluoride (β=0.202, P=0.005) in drinking water and higher incidence of type 1 diabetes. In the regional analysis, barium (β=-0.478, P=0.009) and nickel (β=-0.354, P=0.050) concentrations were negatively associated with incidence of type 1 diabetes.

Conclusions: We confirmed the high incidence of type 1 diabetes in NL. We also found that concentrations of some components in drinking water were associated with higher incidence of type 1 diabetes, but no component was found to have a significant association across the three different levels of analysis performed.

Keywords: Canada; Newfoundland and Labrador; arsenic; barium; drinking water quality; fluoride; incidence; nickel; type 1 diabetes mellitus.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Map of Newfoundland and Labrador.
Figure 2
Figure 2
Included communities at different levels of analysis.
See this image and copyright information in PMC

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