Question

The association of type 1 diabetes mellitus and concentrations of drinking water components in Newfoundland and Labrador, Canada

Answer 1

• We verified that type 1 diabetes is very common in NL.
• A substantial association between any component and type 1 diabetes was not identified across the three levels of study, however we did find that various component concentrations in drinking water were linked to increased incidences of the disease.

Methods and design of the study:

• A case-control, community-based study design was employed.
• The incidence rates of type 1 diabetes were first determined at the provincial, regional, and local levels.
• The relationship between incidence rates and elements in public water supplies was then examined in three different ways.
• First, it was determined whether communities with and without incident cases of type 1 diabetes had different water quality.
• Second, it was determined whether there was a connection between water quality and incidence rates at both the community and regional levels.

Results:

• During the study period, the provincial incidence of type 1 diabetes was 51.7/100 000 in children aged 0 to 14.
• Significant correlations between greater levels of arsenic ($\beta$=0.268, P=0.013) and fluoride ($\beta$=0.202, P=0.005) in drinking water and a higher incidence of type 1 diabetes were discovered in the community-based investigation. In the regional analysis, the amounts of nickel ($\beta$=0.354, P=0.050) and barium ($\beta$=0.478, P=0.009) were adversely correlated with the prevalence of type 1 diabetes.

Conclusions:

• We verified that type 1 diabetes is very common in NL.
• A substantial association between any component and type 1 diabetes was not identified across the three levels of study, however we did find that various component concentrations in drinking water were linked to increased incidences of the disease.

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