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Liang W, Wang B, Shen G, Cao S, Mcswain B, Qin N, Zhao L, Yu D, Gong J, Zhao S, Zhang Y, Duan X. Association of solid fuel use with risk of stunting in children living in China. INDOOR AIR 2020; 30:264-274. [PMID: 31755597 PMCID: PMC7047593 DOI: 10.1111/ina.12627] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 11/16/2019] [Accepted: 11/19/2019] [Indexed: 05/02/2023]
Abstract
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/heating with solid fuel was significantly associated with a lower z-score for height for age and sex (β = -0.21 [-0.32 to -0.09] and -0.17 [-0.31 to -0.03], respectively) and an increased risk of stunting with an estimated ORs of 1.34 [1.07~1.68] and 1.37 [1.02~1.83], respectively. The risk of stunting associated with solid fuel use was statistically significant in high-age children. And the effect was greater on girls than on boys, though the difference was not statistically significant. Our study suggested that Chinese children living in households using solid fuel had a significantly higher risk of stunting than those living in households using cleaner fuel.
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Affiliation(s)
- Weigang Liang
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing 100083, China
| | - Beibei Wang
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing 100083, China
| | - Guofeng Shen
- College of Urban and Environmental Sciences, Peking university, Beijing 100871, China
| | - Suzhen Cao
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing 100083, China
| | - Bertrand Mcswain
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing 100083, China
| | - Ning Qin
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing 100083, China
| | - Liyun Zhao
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Dongmei Yu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Jicheng Gong
- BIC-ESAT and SKL-ESPC, College of Environmental Science and Engineering, Peking university, Beijing 100871, China
| | - Shanshan Zhao
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, NC 27709, USA
| | - Yawei Zhang
- Department of Environmental Health Sciences, Yale School of Public Health, Yale University, New Haven, CT 06520, USA
| | - Xiaoli Duan
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing 100083, China
- Corresponding authors: Dr. Xiaoli Duan, School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing 100083, China, Tel: +86 010 62334308, Fax: +86 010 8493 4276,
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Yu K, Lv J, Qiu G, Yu C, Guo Y, Bian Z, Yang L, Chen Y, Wang C, Pan A, Liang L, Hu FB, Chen Z, Li L, Wu T. Cooking fuels and risk of all-cause and cardiopulmonary mortality in urban China: a prospective cohort study. Lancet Glob Health 2020; 8:e430-e439. [PMID: 31972151 PMCID: PMC7031698 DOI: 10.1016/s2214-109x(19)30525-x] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 11/08/2019] [Accepted: 11/26/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Cooking practice has transitioned from use of solid fuels to use of clean fuels, with addition of better ventilation facilities. However, the change in mortality risk associated with such a transition remains unclear. METHODS The China Kadoorie Biobank (CKB) Study enrolled participants (aged 30-79 years) from ten areas across China; we chose to study participants from five urban areas where transition from use of solid fuels to clean fuels for cooking was prevalent. Participants who reported regular cooking (weekly or more frequently) at baseline were categorised as persistent clean fuel users, previous solid fuel users, or persistent solid fuel users, according to self-reported fuel use histories. All-cause and cardiopulmonary mortality were identified through linkage to China's Disease Surveillance Point system and local mortality records. FINDINGS Between June 24, 2004, and July 15, 2008, 226 186 participants living in five urban areas of China were enrolled in the CKB Study. Among 171 677 participants who reported cooking regularly (weekly or more frequently), 75 785 (44%) were persistent clean fuel users, 80 511 (47%) were previous solid fuel users, and 15 381 (9%) were persistent solid fuel users. During a mean of 9·8 (SD 1·7) years of follow-up, 10 831 deaths were documented, including 3819 cardiovascular deaths and 761 respiratory deaths. Compared with persistent clean fuel users, persistent solid fuel users had significantly higher risks of all-cause mortality (hazard ratio [HR] 1·19, 95% CI 1·10-1·28), cardiovascular mortality (1·24, 1·10-1·39), and respiratory mortality (1·43, 1·10-1·85). The excess risk of all-cause and cardiopulmonary mortality fell by more than 60% in 5 years after cessation of solid fuel use and continued to decrease afterwards. Use of ventilation was associated with lower all-cause mortality risk, even among persistent clean fuel users (HR 0·78, 0·69-0·89). INTERPRETATION Solid fuel use for cooking is associated with a higher risk of mortality, and cessation of solid fuel use cuts excess mortality risks swiftly and substantially within 5 years. Ventilation use also lowers the risk of mortality, even among people who persistently use clean fuels. It is of prime importance for both policy makers and the public to accelerate the transition from solid fuels to clean fuels and promote efficient ventilation to minimise further adverse health effects. FUNDING National Natural Science Foundation of China, Wellcome Trust, and Kadoorie Charitable Foundation.
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Affiliation(s)
- Kuai Yu
- Department of Occupational and Environmental Health and Department of Epidemiology and Biostatistics, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Gaokun Qiu
- Department of Occupational and Environmental Health and Department of Epidemiology and Biostatistics, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yu Guo
- Chinese Academy of Medical Sciences, Beijing, China
| | - Zheng Bian
- Chinese Academy of Medical Sciences, Beijing, China
| | - Ling Yang
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Yiping Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Chaolong Wang
- Department of Occupational and Environmental Health and Department of Epidemiology and Biostatistics, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - An Pan
- Department of Occupational and Environmental Health and Department of Epidemiology and Biostatistics, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liming Liang
- Department of Epidemiology and Department of Biostatistics, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Frank B Hu
- Department of Nutrition and Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Zhengming Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China.
| | - Tangchun Wu
- Department of Occupational and Environmental Health and Department of Epidemiology and Biostatistics, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Liu Y, Chen X, Yan Z. Depression in the house: The effects of household air pollution from solid fuel use among the middle-aged and older population in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 703:134706. [PMID: 31731156 PMCID: PMC9420076 DOI: 10.1016/j.scitotenv.2019.134706] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 08/22/2019] [Accepted: 09/27/2019] [Indexed: 05/23/2023]
Abstract
BACKGROUND Although the adverse health effects of ambient air pollution are well documented, evidence on the depression effects of household air pollution (HAP) are scarce. OBJECTIVES We investigated the effects of HAP exposure from the use of solid fuel on depression using a nationally representative dataset of middle-aged and older population in China. METHODS By employing the propensity score matching method, we first matched the type of household fuel based on background information, including demographic characteristics, lifestyles, health status, and household economic levels. Based on the matched data, we conducted OLS and logistic regressions with cluster standard error at community level to examine the effects of household solid fuel use on depression and adjusted for potential confounders. Heterogeneous effects for vulnerable population were also considered. RESULTS We found a significantly higher Center for Epidemiologic Studies Depression Scale (CES-D) score and depression risk among current household solid fuel users. After matching and adjusting for potential confounders, current solid fuel users had a higher CES-D score of 0.59 (95% confidence interval [CI]: 0.31, 0.89) than clean fuel users. The OR of depression risk were 1.26 (95% CI: 1.14, 1.41). Solid fuel users had the highest CES-D scores (β = 0.99, 95% CI: 0.62, 1.36) and depression risk (OR = 1.49, 95% CI: 1.30, 1.73) for over five years. These associations were generally higher in females, participants aged 65 years and older, with a BMI ≥ 25, with low education, with low household economic levels, and those suffer from chronic diseases, including diabetes, chronic lung diseases, and cardiovascular diseases. CONCLUSIONS Exposure to HAP from solid fuel combustion was linked with strong depression outcomes. Findings suggested a need to strengthen public health efforts, such as controlling the social, health, and economic costs of depression by taking the physical environment, including HAP exposure, into account.
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Affiliation(s)
- Yan Liu
- School of Management and Economics, Beijing Institute of Technology, Beijing, China; Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, United States
| | - Xi Chen
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, United States; Department of Economics, Yale University, New Haven, CT, United States
| | - Zhijun Yan
- School of Management and Economics, Beijing Institute of Technology, Beijing, China; Sustainable Development Research Institute for Economy and Society of Beijing, Beijing, China.
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