Type 2 Diabetes (T2D) is a persistent health problem in the United States and is caused by a multitude of
lifestyle and environmental factors. While the increased incidence of T2D has been attributed to lifestyle
factors, very little is known about the effect of environmental pollutants on the incidence of chronic
metabolic diseases such as T2D. Occupational lead exposure is of particular interest in this regard. Even
though there has been a consistent decline in overall environmental lead exposure levels, occupational
lead exposure has been identified as the most common source of lead poisoning in non-pregnant adults.
Lead, being a xenobiotic heavy metal, has severe ramifications on overall metabolic health. Firstly, an
ecological study was conducted to understand the extent to which occupational blood lead (Pb)
exposure ≥25 μg/dL affects the risk of Type 2 Diabetes in Adults >18 years old in all states in the United
States 2000 to 2012. Diabetes Data was obtained from the CDC United States Diabetes Surveillance
System and Lead Exposure Data was obtained from the CDC report “Elevated Blood Lead Levels Among
Employed Adults — the United States, 1994–2012” by State Adult Blood Lead Epidemiology and
Surveillance (ABLES). It was found that there is a strong negative correlation between Total Diagnosed
Type 2 Diabetes in Adults and the Number of cases of employed adults with blood lead levels ≥25 μg/dL
nationally from the years 2000 to 2012. Limitations of the study were also considered: there were not
very optimized datasets, the incidence of lead exposure were deeply underestimated as only lead
exposure ≥25 μg/dL was surveyed and synergistic effects of occupational exposure to many other
environmental compounds were not considered. Considering the limitations and the fact that our
understanding of the metabolic health effects of lead exposure is incomplete, a literature review of
proposed epidemiological evidence and biological mechanisms linking environmental lead exposure to
T2D risk was conducted. It is well known that even very low doses of lead exposure have harmful effects,
so it is worthwhile to understand the mechanisms by which lead affects biological systems and to
determine the exact role it plays in T2D risk. This paper supports the existence of a link between lead
and T2D risk, but more research needs to be conducted to provide a clear mechanistic pathway for how
a limited exposure to lead might lead to diseases like T2D.