Ambient volatile organic compounds and racial/ethnic disparities in gestational diabetes mellitus: Are Asian/Pacific Islander women at greater risk?

Publication Type
Journal Article
Year of Publication
Williams, Andrew D; Grantz, Katherine L; Zhang, Cuilin; Nobles, Carrie; Sherman, Seth; Mendola, Pauline
Am J Epidemiol
Date Published
Air pollution; Asian/Pacific islanders; Consortium on Safe Labor; diabetes; environmental health; Gestational Diabetes; health disparities; pancreatic dysfunction; pregnant women

U.S. Asian/Pacific Islander communities experience high air pollution levels. Asian/Pacific Islanders may be predisposed to pancreatic β-cell dysfunction and have the highest prevalence of gestational diabetes mellitus (GDM) compared to other racial/ethnic groups. Exposure to high levels of volatile organic compounds (VOCs) impairs pancreatic β-cell function, leading to insulin resistance, but racial/ethnic differences in this association are unexamined. We analyzed singleton deliveries (n=220,065) from the Consortium on Safe Labor (2002-2008). Exposure to 14 VOCs in each hospital referral region was based on modified Community Multiscale Air Quality models. Logistic regression estimated odds ratios for GDM associated with high (≥75th percentile) compared to low (<75th percentile) VOC exposure three-months preconception and first trimester of pregnancy. Preconception and first trimester exposure to high VOC levels were associated with increased odds of GDM among Whites and Asian/Pacific Islanders. GDM risk was significantly higher for Asian/Pacific Islanders compared to Whites for most VOCs. Preconception benzene exposure was associated with 29% (95% confidence interval [CI]: 12-47%) increased odds of GDM among Whites compared to 45% (95% CI: 16-81%) increased odds among Asian/Pacific Islanders. These novel findings highlight environmental health disparities impacting pregnant women. Increased focus on GDM risk in U.S. Asian/Pacific Islander communities is warranted.