Association of solid fuel use with risk of stunting in children living in China.
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ABSTRACT:
SUBMITTER: Liang W
PROVIDER: S-EPMC7047593 | biostudies-literature | 2020 Mar
REPOSITORIES: biostudies-literature
Publications
Association of solid fuel use with risk of stunting in children living in China.
Liang Weigang W Wang Beibei B Shen Guofeng G Cao Suzhen S Mcswain Bertrand B Qin Ning N Zhao Liyun L Yu Dongmei D Gong Jicheng J Zhao Shanshan S Zhang Yawei Y Duan Xiaoli X
Indoor air 20191206 2
Stunting adversely affects physical and mental outcomes of children. It has not been examined whether household air pollution from solid fuel combustion is a risk factor for stunting in children. In a total of 41,439 children aged 6-17 across China, height was measured using a unified protocol. Multivariable linear regression models and logistic regression models were used to assess the associations of solid fuel use for cooking/heating with stunting in children. Adjusted for covariates, cooking ...[more]
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Project description:ImportanceWhen combusted indoors, solid fuels generate a large amount of pollutants such as fine particulate matter.ObjectiveTo assess the associations of solid fuel use for cooking and heating with cardiovascular and all-cause mortality.Design, setting, and participantsThis nationwide prospective cohort study recruited participants from 5 rural areas across China between June 2004 and July 2008; mortality follow-up was until January 1, 2014. A total of 271?217 adults without a self-reported history of physician-diagnosed cardiovascular disease at baseline were included, with a random subset (n?=?10?892) participating in a resurvey after a mean interval of 2.7 years.ExposuresSelf-reported primary cooking and heating fuels (solid: coal, wood, or charcoal; clean: gas, electricity, or central heating), switching of fuel type before baseline, and use of ventilated cookstoves.Main outcomes and measuresDeath from cardiovascular and all causes, collected through established death registries.ResultsAmong the 271?217 participants, the mean (SD) age was 51.0 (10.2) years, and 59% (n?=?158?914) were women. A total of 66% (n?=?179?952) of the participants reported regular cooking (at least weekly) and 60% (n?=?163?882) reported winter heating, of whom 84% (n?=?150?992) and 90% (n?=?147?272) used solid fuels, respectively. There were 15?468 deaths, including 5519 from cardiovascular causes, documented during a mean (SD) of 7.2 (1.4) years of follow-up. Use of solid fuels for cooking was associated with greater risk of cardiovascular mortality (absolute rate difference [ARD] per 100?000 person-years, 135 [95% CI, 77-193]; hazard ratio [HR], 1.20 [95% CI, 1.02-1.41]) and all-cause mortality (ARD, 338 [95% CI, 249-427]; HR, 1.11 [95% CI, 1.03-1.20]). Use of solid fuels for heating was also associated with greater risk of cardiovascular mortality (ARD, 175 [95% CI, 118-231]; HR, 1.29 [95% CI, 1.06-1.55]) and all-cause mortality (ARD, 392 [95% CI, 297-487]; HR, 1.14 [95% CI, 1.03-1.26]). Compared with persistent solid fuel users, participants who reported having previously switched from solid to clean fuels for cooking had a lower risk of cardiovascular mortality (ARD, 138 [95% CI, 71-205]; HR, 0.83 [95% CI, 0.69-0.99]) and all-cause mortality (ARD, 407 [95% CI, 317-497]; HR, 0.87 [95% CI, 0.79-0.95]), while for heating, the ARDs were 193 (95% CI, 128-258) and 492 (95% CI, 383-601), and the HRs were 0.57 (95% CI, 0.42-0.77) and 0.67 (95% CI, 0.57-0.79), respectively. Among solid fuel users, use of ventilated cookstoves was also associated with lower risk of cardiovascular mortality (ARD, 33 [95% CI, -9 to 75]; HR, 0.89 [95% CI, 0.80-0.99]) and all-cause mortality (ARD, 87 [95% CI, 20-153]; HR, 0.91 [95% CI, 0.85-0.96]).Conclusions and relevanceIn rural China, solid fuel use for cooking and heating was associated with higher risks of cardiovascular and all-cause mortality. These risks may be lower among those who had previously switched to clean fuels and those who used ventilation.
| S-EPMC5933384 | biostudies-literature
Project description:BACKGROUND:Indoor Air Pollution (IPA) is a serious environmental problem that can have detrimental effects on child health. In China, the major sources of indoor pollution are biomass fuel or solid cooking fuels and familial smoking. Previous studies posit that the effects of IAP on health outcomes may be worse for female children, but the empirical evidence has been mixed. METHODS:In this paper we use the China Health and Nutrition Survey to examine the association of solid fuel use and paternal smoking on acute respiratory infections (ARIs) in children focusing on child gender differences. We used conditional logistic regression to examine gender differences in incidents of ARIs in the 4 weeks prior to the survey collection. We modeled gender difference by including an interaction between child gender and solid fuel use and child gender and paternal smoking. We also conducted stratified analyses by child gender. RESULTS:When examining both genders together, female children exposed to solid fuel had an elevated risk of a ARIs, but the coefficient was not statistically significant. When using a stratified models by gender, female children had a higher risk of having ARIs in the past 4 weeks when exposed to solid fuels (OR=3.28; 95% CI 1.34-8.03) and paternal smoking (OR=2.27; 95% CI 1.08-4.77). Whereas neither exposure to solid fuel nor parental smoking had any significant influence on ARIs for male children. CONCLUSION:While many have hypothesized that female children may be more vulnerable to IAP, the empirical evidence has been limited. In our study we found empirical support for gender difference in the effects of solid cooking fuel use on ARIs. Gender differences in ARIs suggest that realized exposures, as opposed to ambient exposures, are likely higher for female children and are important to consider.
| S-EPMC6182818 | biostudies-other
Project description:BackgroundSolid fuels are widely used in China. Household air pollution from the burning of solid fuels may increase the risk of chronic obstructive pulmonary disease (COPD), but prospective evidence is limited.ObjectivesWe examined the association of solid fuel use for cooking and heating with the risk of COPD in a prospective cohort study.MethodsParticipants were from the China Kadoorie Biobank. Current and previous fuels used for household cooking and heating were self-reported at baseline in 2004–2008. In the present study, "solid fuels" refers to coal and wood, whereas "cleaner fuels" refers to energy sources that presumably produce lower levels of indoor pollution, including electricity, gas, and central heating. A total of 475,827 adults 30–79 y of age without prevalent COPD were followed through the end of 2015. We used adjusted Cox regression models to estimate hazard ratios for COPD.ResultsOver 9.1 y of follow-up, 9,835 incident COPD cases were reported. Compared with the use of cleaner fuels for cooking, using coal and wood for cooking was positively associated with COPD, with fully adjusted HRs of 1.06 (95% CI: 0.98, 1.15) and 1.14 (95% CI: 1.06, 1.23), respectively. Adjusted HRs for heating with coal and wood were 1.16 (95% CI: 1.04, 1.29) and 1.21 (95% CI: 1.09, 1.35), respectively. The positive association between cooking with solid fuel and COPD appeared to be limited to women and never- (vs. ever-) smokers. COPD risk increased with a higher number of years of solid fuel use for heating and wood use for cooking.ConclusionsThe use of solid fuel for cooking and heating was associated with the increased risk of COPD in this prospective cohort study. Studies with more accurate exposure assessment are needed to confirm the association. https://doi.org/10.1289/EHP2856.
| S-EPMC6790542 | biostudies-literature
Project description:BackgroundChronic obstructive pulmonary disease (COPD), lung cancer, and tuberculosis are three leading causes of death in China, where prevalences of smoking and solid-fuel use are also high. We aimed to predict the effects of risk-factor trends on COPD, lung cancer, and tuberculosis.MethodsWe used representative data sources to estimate past trends in smoking and household solid-fuel use and to construct a range of future scenarios. We obtained the aetiological effects of risk factors on diseases from meta-analyses of epidemiological studies and from large studies in China. We modelled future COPD and lung cancer mortality and tuberculosis incidence, taking into account the accumulation of hazardous effects of risk factors on COPD and lung cancer over time, and dependency of the risk of tuberculosis infection on the prevalence of disease. We quantified the sensitivity of our results to methods and data choices.FindingsIf smoking and solid-fuel use remain at current levels between 2003 and 2033, 65 million deaths from COPD and 18 million deaths from lung cancer are predicted in China; 82% of COPD deaths and 75% of lung cancer deaths will be attributable to the combined effects of smoking and solid-fuel use. Complete gradual cessation of smoking and solid-fuel use by 2033 could avoid 26 million deaths from COPD and 6.3 million deaths from lung cancer; interventions of intermediate magnitude would reduce deaths by 6-31% (COPD) and 8-26% (lung cancer). Complete cessation of smoking and solid-fuel use by 2033 would reduce the projected annual tuberculosis incidence in 2033 by 14-52% if 80% DOTS coverage is sustained, 27-62% if 50% coverage is sustained, or 33-71% if 20% coverage is sustained.InterpretationReducing smoking and solid-fuel use can substantially lower predictions of COPD and lung cancer burden and would contribute to effective tuberculosis control in China.
| S-EPMC2652750 | biostudies-literature
Project description:BackgroundCohort studies on the impact of biomass fuel use for cooking on cognitive impairment among older population are still lacking in China and elsewhere. The aim of this study was to examine whether biomass fuel use for cooking is associated with cognitive impairment in Chinese adults aged 65 years or older.MethodsThe prospective population-based cohort study of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) included participants aged 65 years or older in 2014 who were followed-up until 2018 in 23 provinces in China. The Mini-Mental State Examination (MMSE) was used to assess cognitive function, and cognitive impairment was defined as total MMSE scores less than 18. The association between biomass fuel use and cognitive impairment was evaluated using the Cox proportional hazards model.ResultsOf the 4145 participants included at baseline, participants who reported that they used biomass fuel for cooking (40.43%; IR: 3.11 versus 2.77 per 100 person-years; aHR: 1.27, 95% CI: 1.02-1.58) had a higher risk of cognitive impairment compared with participants who used clean fuels (53.75%). A stratified analyses showed greater effect estimates of cognitive impairment in the older people that lived in the rural areas (aHR: 1.444, 95% CI: 1.08-3.90) and never smoked (aHR: 1.33, 95% CI: 1.04-1.71).ConclusionsThese findings demonstrated that biomass fuel used for cooking was associated with cognitive impairment, as defined by MMSE, in a population-based study of elderly in China. To prevent cognitive impairment, the structure of cooking fuels requires improvements.
| S-EPMC7905553 | biostudies-literature
Project description:Introduction: India has a higher number of deaths due to acute lower respiratory infections (ALRIs) in children <5 years than any other country. The underlying cause of half of ALRI deaths is household air pollution from burning of solid fuels, according to the World Health Organization. If there is a direct association between duration of exposure and increased ALRI risk, a potential strategy might be to limit the child's exposure to burning solid fuel.Methods and materials: Children born to pregnant women participating in the Global Network for Women and Children's Health Maternal and Newborn Health Registry near Nagpur, India were followed every two weeks from birth to six months to diagnose ALRI. The number of hours per day that the child's mother spent in front of a burning solid fuel cookstove was recorded. Children of mothers using only clean cookstoves were classified as having zero hours of exposure. Odds Ratios with 95% confidence intervals were obtained from Generalized Estimating Equations logistic models that assessed the relationship of exposure to solid fuels with risk of ?1 ALRI, adjusted for sex of the child, household smoking, wealth, maternal age, birth weight and parity.Results: Between August 2013 and March 2014, 302 of 1,586 children (19%) had ?1 episode of ALRI. Results from the multivariable analysis indicate that the odds of ALRI significantly increased from 1.2 (95% CI: 0.7-2.2) for <1 hour of exposure to 2.1 (95% CI: 1.4-3.3) for >3 hours of exposure to solid fuel cookstoves compared with no exposure (p<0.01). Additionally, decreasing wealth [middle: 1.2 (0.9, 1.6); poor: 1.4 (1.2-1.7); p<0.001] was associated with ALRIs.Conclusions: Our study findings indicate that increasing the time mothers spend cooking near solid fuel cookstoves while children are in the house may be associated with development of ?1 ALRI in children <6 months.
| S-EPMC6812868 | biostudies-literature
Project description:Household air pollution (HAP) from solid cooking fuels continues to affect 600 million people in China and has been associated with high blood pressure. The role of diet in HAP-associated high blood pressure has yet to be evaluated in China. The aim of this study was to estimate the impact of cooking fuel on change in blood pressure and evaluate whether intake of antioxidant- and omega-3 fatty acid-rich foods (fruits, vegetables, and seafood) attenuates any adverse effects of solid fuel use on blood pressure. We analyzed longitudinal data collected between 1991 and 2011 from nonpregnant women aged 18 to 80 years living in rural areas of China. We used linear mixed effects models to estimate the association between cooking fuel (coal or wood versus clean [electric or liquid petroleum gas]) and blood pressure. Possible mediation of the fuel effect by diet was assessed by the difference method. A total of 6671 women were included in this study. Women less than 40 years of age cooking with cleaner fuels over time had lower rates of change in systolic blood pressure compared to women cooking with coal (p = 0.004), and this effect was not mediated by dietary intake. Associations between fuel use and change in diastolic blood pressure were not significant. These findings lend further support for there being a direct effect of reducing HAP on improvements in blood pressure, independent of concurrent dietary intake.
| S-EPMC7432946 | biostudies-literature
Project description:Background: The adverse health effects of air pollutants are widely reported, and the elderly are susceptible to toxic environments. This study aimed to evaluate the association between use of solid fuels for cooking and mortality among the elderly. Methods: A total of 5,732 and 3,869 participants from the Chinese Longitudinal Healthy Longevity Survey were enrolled in two (2014 and 2018) and three surveys (2011, 2014, and 2018) of survey. Cooking fuel was divided into clean and solid fuel. Cox proportional hazards models were used to estimate the mortality hazard ratio (HR). Subgroup analyses were performed to assess the potential interaction effect. Results: Among the participants in the 2011-2018 survey, 53% reported using solid fuel. Such group was associated with a 9% increase in mortality risk relative to clean fuel users (HR = 1.09, 95% CI = 1.01-1.18). Among participants in the 2014-2018 survey, 339 reported a switch from solid to clean fuels and they were not at increased mortality risk relative to the 488 people that reported a stable use of clean fuels (HR = 1.14, 95% CI = 0.99-1.31) although the estimated HR was similar to the one for stable solid fuel users (HR = 1.19, 95%CI = 1.04-1.36 n = 509). Interaction and stratified analyses showed that solid fuel use had an impact on mortality in participants who were non-current smokers, had low dietary diversity scores, and were living in areas with high PM2.5 concentrations (>50 μg/m3) and city population below 8 million (P for interaction < 0.05). The association was robust in the three sensitivity analyses. Conclusion: The finding showed a clear association between solid fuel use and mortality among older Chinese, and an even stronger association between risk of mortality and solid fuel use among individuals exposed to high levels of PM2.5.
| S-EPMC8551618 | biostudies-literature
Project description:BackgroundOver 3.5 billion individuals worldwide are exposed to household air pollution from solid fuel use. There is limited evidence from cohort studies on associations of solid fuel use with risks of major eye diseases, which cause substantial disease and economic burden globally.Methods and findingsThe China Kadoorie Biobank recruited 512,715 adults aged 30 to 79 years from 10 areas across China during 2004 to 2008. Cooking frequency and primary fuel types in the 3 most recent residences were assessed by a questionnaire. During median (IQR) 10.1 (9.2 to 11.1) years of follow-up, electronic linkages to national health insurance databases identified 4,877 incident conjunctiva disorders, 13,408 cataracts, 1,583 disorders of sclera, cornea, iris, and ciliary body (DSCIC), and 1,534 cases of glaucoma. Logistic regression yielded odds ratios (ORs) for each disease associated with long-term use of solid fuels (i.e., coal or wood) compared to clean fuels (i.e., gas or electricity) for cooking, with adjustment for age at baseline, birth cohort, sex, study area, education, occupation, alcohol intake, smoking, environmental tobacco smoke, cookstove ventilation, heating fuel exposure, body mass index, prevalent diabetes, self-reported general health, and length of recall period. After excluding participants with missing or unreliable exposure data, 486,532 participants (mean baseline age 52.0 [SD 10.7] years; 59.1% women) were analysed. Overall, 71% of participants cooked regularly throughout the recall period, of whom 48% used solid fuels consistently. Compared with clean fuel users, solid fuel users had adjusted ORs of 1.32 (1.07 to 1.37, p < 0.001) for conjunctiva disorders, 1.17 (1.08 to 1.26, p < 0.001) for cataracts, 1.35 (1.10 to 1.66, p = 0.0046) for DSCIC, and 0.95 (0.76 to 1.18, p = 0.62) for glaucoma. Switching from solid to clean fuels was associated with smaller elevated risks (over long-term clean fuel users) than nonswitching, with adjusted ORs of 1.21 (1.07 to 1.37, p < 0.001), 1.05 (0.98 to 1.12, p = 0.17), and 1.21 (0.97 to 1.50, p = 0.088) for conjunctiva disorders, cataracts, and DSCIC, respectively. The adjusted ORs for the eye diseases were broadly similar in solid fuel users regardless of ventilation status. The main limitations of this study include the lack of baseline eye disease assessment, the use of self-reported cooking frequency and fuel types for exposure assessment, the risk of bias from delayed diagnosis (particularly for cataracts), and potential residual confounding from unmeasured factors (e.g., sunlight exposure).ConclusionsAmong Chinese adults, long-term solid fuel use for cooking was associated with higher risks of not only conjunctiva disorders but also cataracts and other more severe eye diseases. Switching to clean fuels appeared to mitigate the risks, underscoring the global health importance of promoting universal access to clean fuels.
| S-EPMC8321372 | biostudies-literature
Project description:BackgroundExposure to household air pollution from cooking with solid fuels in simple stoves is a major health risk. Modeling reliable estimates of solid fuel use is needed for monitoring trends and informing policy.ObjectivesIn order to revise the disease burden attributed to household air pollution for the Global Burden of Disease 2010 project and for international reporting purposes, we estimated annual trends in the world population using solid fuels.MethodsWe developed a multilevel model based on national survey data on primary cooking fuel.ResultsThe proportion of households relying mainly on solid fuels for cooking has decreased from 62% (95% CI: 58, 66%) to 41% (95% CI: 37, 44%) between 1980 and 2010. Yet because of population growth, the actual number of persons exposed has remained stable at around 2.8 billion during three decades. Solid fuel use is most prevalent in Africa and Southeast Asia where > 60% of households cook with solid fuels. In other regions, primary solid fuel use ranges from 46% in the Western Pacific, to 35% in the Eastern Mediterranean and < 20% in the Americas and Europe.ConclusionMultilevel modeling is a suitable technique for deriving reliable solid-fuel use estimates. Worldwide, the proportion of households cooking mainly with solid fuels is decreasing. The absolute number of persons using solid fuels, however, has remained steady globally and is increasing in some regions. Surveys require enhancement to better capture the health implications of new technologies and multiple fuel use.
| S-EPMC3701999 | biostudies-literature