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Li C, Lao W, Wang S. Risk assessment of unclean cooking energy usage from the perspective of subjective wellbeing: The mediating role of perceived physical and mental health. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 281:116603. [PMID: 38896906 DOI: 10.1016/j.ecoenv.2024.116603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 05/19/2024] [Accepted: 06/14/2024] [Indexed: 06/21/2024]
Abstract
Although outdoor air pollution has been associated with adverse health outcomes and decreased subjective welfare, there has been a lack of research investigating the potential risks associated with indoor unclean cooking energy usage from the perspective of subjective wellbeing. This paper systematically assesses the risks of unclean cooking fuel usage from the novel perspective of subjective welfare and examines the mediating role of perceived physical and mental health applying a large-scale nationally representative dataset. Analytical results demonstrate that the usage of unclean cooking energy has significantly negative impacts on subjective wellbeing, and this finding has been confirmed through various robustness tests. The mechanism behind this impact is that unclean cooking fuel usage reduces people's perceived physical and mental health status, which in turn decreases their subjective wellness. Furthermore, the negative consequences of using unclean cooking energy on subjective wellbeing are particularly pronounced among certain demographic groups, including older, lower educated, married individuals as well as those with lower economic status, uncovered by medical insurance and having less social capital. Findings of this study highlight the risks linked to unclean cooking energy usage, as evidenced in the negative impact on perceived health and subjective wellbeing. In light of the increasing focus on improving indoor environment as well as enhancing people's health and wellbeing, results of this paper emphasize the significance of promoting access to cleaner and healthier energy.
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Affiliation(s)
- Chao Li
- Business School, Shandong University, 180 Wenhuaxi Road, Weihai 264209, China; Centre for Quality of Life and Public Policy Research, Shandong University, 72 Binhai Road, Jimo, Qingdao 266237, China.
| | - Wenyu Lao
- Business School, Shandong University, 180 Wenhuaxi Road, Weihai 264209, China
| | - Shiyue Wang
- Business School, Shandong University, 180 Wenhuaxi Road, Weihai 264209, China
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Zhang B, Mendes de Leon CF, Langa KM, Weuve J, Szpiro A, Faul J, D’Souza J, Kaufman JD, Hirth RA, Lisabeth LD, Gao J, Adar SD. Source-Specific Air Pollution and Loss of Independence in Older Adults Across the US. JAMA Netw Open 2024; 7:e2418460. [PMID: 38941096 PMCID: PMC11214115 DOI: 10.1001/jamanetworkopen.2024.18460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 04/23/2024] [Indexed: 06/29/2024] Open
Abstract
Importance Air pollution is a recognized risk factor associated with chronic diseases, including respiratory and cardiovascular conditions, which can lead to physical and cognitive impairments in later life. Although these losses of function, individually or in combination, reduce individuals' likelihood of living independently, little is known about the association of air pollution with this critical outcome. Objective To investigate associations between air pollution and loss of independence in later life. Design, Setting, and Participants This cohort study was conducted as part of the Environmental Predictors Of Cognitive Health and Aging study and used 1998 to 2016 data from the Health and Retirement Study. Participants included respondents from this nationally representative, population-based cohort who were older than 50 years and had not previously reported a loss of independence. Analyses were performed from August 31 to October 15, 2023. Exposures Mean 10-year pollutant concentrations (particulate matter less than 2.5 μm in diameter [PM2.5] or ranging from 2.5 μm to 10 μm in diameter [PM10-2.5], nitrogen dioxide [NO2], and ozone [O3]) were estimated at respondent addresses using spatiotemporal models along with PM2.5 levels from 9 emission sources. Main Outcomes and Measures Loss of independence was defined as newly receiving care for at least 1 activity of daily living or instrumental activity of daily living due to health and memory problems or moving to a nursing home. Associations were estimated with generalized estimating equation regression adjusting for potential confounders. Results Among 25 314 respondents older than 50 years (mean [SD] baseline age, 61.1 [9.4] years; 11 208 male [44.3%]), 9985 individuals (39.4%) experienced lost independence during a mean (SD) follow-up of 10.2 (5.5) years. Higher exposure levels of mean concentration were associated with increased risks of lost independence for total PM2.5 levels (risk ratio [RR] per 1-IQR of 10-year mean, 1.05; 95% CI, 1.01-1.10), PM2.5 levels from road traffic (RR per 1-IQR of 10-year mean, 1.09; 95% CI, 1.03-1.16) and nonroad traffic (RR per 1-IQR of 10-year mean, 1.13; 95% CI, 1.03-1.24), and NO2 levels (RR per 1-IQR of 10-year mean, 1.05; 95% CI, 1.01-1.08). Compared with other sources, traffic-generated pollutants were most consistently and robustly associated with loss of independence; only road traffic-related PM2.5 levels remained associated with increased risk after adjustment for PM2.5 from other sources (RR per 1-IQR increase in 10-year mean concentration, 1.10; 95% CI, 1.00-1.21). Other pollutant-outcome associations were null, except for O3 levels, which were associated with lower risks of lost independence (RR per 1-IQR increase in 10-year mean concentration, 0.94; 95% CI, 0.92-0.97). Conclusions and Relevance This study found that long-term exposure to air pollution was associated with the need for help for lost independence in later life, with especially large and consistent increases in risk for pollution generated by traffic-related sources. These findings suggest that controlling air pollution could be associated with diversion or delay of the need for care and prolonged ability to live independently.
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Affiliation(s)
- Boya Zhang
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
| | | | - Kenneth M. Langa
- Institute for Social Research, University of Michigan, Ann Arbor
- University of Michigan Medical School, Ann Arbor
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
- Veterans Affairs Center for Clinical Management Research, Ann Arbor, Michigan
| | - Jennifer Weuve
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Adam Szpiro
- Department of Biostatistics, University of Washington, Seattle
| | - Jessica Faul
- Institute for Social Research, University of Michigan, Ann Arbor
| | - Jennifer D’Souza
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
| | - Joel D. Kaufman
- Department of Epidemiology, University of Washington, Seattle
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle
- Department of Medicine, University of Washington, Seattle
| | - Richard A. Hirth
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor
- Department of Internal Medicine, University of Michigan, Ann Arbor
| | - Lynda D. Lisabeth
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
| | - Jiaqi Gao
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
| | - Sara D. Adar
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor
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Wang H, Mou P, Yao Y, Su J, Guan J, Zhao Z, Dong J, Wei Y. Effects of different sizes of ambient particulate matter and household fuel use on physical function: National cohort study in China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 276:116308. [PMID: 38593496 DOI: 10.1016/j.ecoenv.2024.116308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 04/02/2024] [Accepted: 04/06/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND Impact of outdoor and household air pollution on physical function remains unelucidated. This study examined the influence of various ambient particulate sizes (PM1, PM2.5, and PM10) and household fuel usage on physical function. METHODS Data from the China Health and Retirement Longitudinal Study (CHARLS) spanning 2011 and 2015 were utilized. The physical functional score was computed by summing scores from four tests: grip strength, gait speed, chair stand test, and balance. Multivariate linear and linear mixed-effects models were used to explore the separate and combined effects of PM1, PM2.5, PM10 and household fuel use on physical function in the cross-sectional and longitudinal analyses, respectively, and to further observe the effects of fuel cleanup on physical function in the context of air pollution exposure. RESULTS Both cross-sectional and longitudinal analyses revealed negative correlations between PM1 (β = -0.044; 95% CI: -0.084, -0.004), PM2.5 (β = -0.024; 95% CI: -0.046, -0.001), PM10 (β = -0.041; 95% CI: -0.054, -0.029), and physical function, with a more pronounced impact observed for fine particulate matter (PM1). Cleaner fuel use was associated with enhanced physical function compared to solid fuels (β = 0.143; 95% CI: 0.070, 0.216). The presence of air pollutants and use of solid fuels had a negative impact on physical function, while cleaner fuel usage mitigated the adverse effects of air pollutants, particularly in areas with high exposure. CONCLUSION This study underscores the singular and combined detrimental effects of air pollutants and solid fuel usage on physical function. Addressing fine particulate matter, specifically PM1, and prioritizing efforts to improve household fuel cleanliness in regions with elevated air pollution levels are crucial for preventing physical disability.
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Affiliation(s)
- Haochen Wang
- Department of Orthopaedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Pengsen Mou
- Department of Occupational and Environmental Health, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang 110122, China
| | - Yuxin Yao
- Department of Occupational and Environmental Health, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang 110122, China
| | - Jianbang Su
- Department of Orthopaedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jiaxin Guan
- Department of Occupational and Environmental Health, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang 110122, China
| | - Ze Zhao
- Department of Orthopaedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jing Dong
- Department of Occupational and Environmental Health, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang 110122, China; Key Laboratory of Environmental Stress and Chronic Disease Control and Prevention, Ministry of Education, China Medical University, No.77 Puhe Road, Shenyang 110122, China.
| | - Yingliang Wei
- Department of Orthopaedics, Shengjing Hospital of China Medical University, Shenyang, China.
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Zhao D, Luo Y, Kemper KA, Zhang L, Pan X. Household Environments and Functional Decline Among Middle-Aged and Older Adults in China: Variations by Gender, Age, and Residence. Res Aging 2024:1640275241246051. [PMID: 38605601 DOI: 10.1177/01640275241246051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
This study examined the associations between household social, economic, and physical environments and the trajectory of functional limitations over time among middle-aged and older adults in China, and how this relationship differs by gender, age, and residence. Linear growth curve models were applied to a sample of 13,564 respondents aged 45 years and older from four waves of the China Health and Retirement Longitudinal Study (CHARLS 2011-2018). Living alone, particularly for rural, female, and older respondents, was associated with a faster functional decline when compared to living with a spouse and without children. Improved housing quality was associated with a slower functional decline. Living with young descendants and without adult children for urban residents and a lower expenditure per capita for younger respondents were associated with a faster functional decline. These findings suggest that policies aimed at enhancing living conditions have the potential to improve physical functioning of older adults.
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Affiliation(s)
- Dandan Zhao
- Department of Sociology, Anthropology and Criminal Justice, Clemson University, Clemson, SC, USA
| | - Ye Luo
- Department of Sociology, Anthropology and Criminal Justice, Clemson University, Clemson, SC, USA
| | - Karen A Kemper
- Department of Public Health Sciences, Clemson University, Clemson, SC, USA
| | - Lingling Zhang
- Department of Nursing, University of Massachusetts Boston, Boston, MA, USA
| | - Xi Pan
- Department of Sociology, Texas State University, San Marcos, TX, USA
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Agyekum MW, Afrifa-Anane GF, Kyei-Arthur F. Prevalence and correlates of disability in older adults, Ghana: evidence from the Ghana 2021 Population and Housing Census. BMC Geriatr 2024; 24:52. [PMID: 38212686 PMCID: PMC10785330 DOI: 10.1186/s12877-023-04587-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 12/11/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Although there are studies on disabilities in older persons, most of these studies have been carried out in developed countries. Hence, there are limited studies on disability in older adults in sub-Saharan Africa, including Ghana. The few studies that have examined the prevalence and correlates of disability in older adults used survey data for their analyses. To contribute to addressing this knowledge gap that has arisen, this study used a national census, the 2021 Ghana Population and Housing Census, to examine the prevalence and correlates of disability in older adults in Ghana. METHODS The 2021 Ghana Population and Housing Census data was used for this study. A sample size of 197,057 Ghanaians aged 60 years and above was used for this study. The Washington Group questions on disability were used to measure disability by asking older adults about their difficulties in performing the six domains of disability (physical, sight, intellectual, hearing, self-care, and speech). A multinomial logistic regression housed in STATA was used to analyse the correlates of disability in older adults in Ghana. A p-value less than 0.05 was used for statistical significance. RESULTS The results show that slightly more than one-third (38.4%) of the older adults were disabled. In terms of the number of disabilities in older adults, 16.9% had one disability condition, while 2.4% had six disability conditions. Also, 9.4% had two disability conditions. Older adults who were females, aged 70-79 years and 80 years and above, resided in rural areas, with primary, JHS/Middle, SHS, unaffiliated with religion, ever married and never married, unemployed, and belonged to the middle and rich households were more likely to have a disability condition. Also, older adults residing in the Middle and Northern zones, having no health insurance, and using clean cooking fuel were less likely to have a disability condition. CONCLUSIONS The results show that socio-demographic and household factors were associated with disability in older adults in Ghana. Hence, policymakers and researchers should target these factors when designing appropriate policies, programmes, and interventions to improve the wellbeing of older adults.
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Affiliation(s)
- Martin Wiredu Agyekum
- Institute for Educational Research and Innovation Studies, University of Education Winneba, Winneba, Ghana.
| | - Grace Frempong Afrifa-Anane
- Department of Environment and Public Health, University of Environment and Sustainable Development, Somanya, Ghana
| | - Frank Kyei-Arthur
- Department of Environment and Public Health, University of Environment and Sustainable Development, Somanya, Ghana
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Zhang Y, Chen YC, Wang JSH. Long-term Care Insurance and Health and Perceived Satisfaction of Older Chinese: Comparisons Between Urban/Rural Areas, Chronic Conditions, and Their Intersectionality. Int J Health Policy Manag 2023; 12:7938. [PMID: 38618772 PMCID: PMC10843175 DOI: 10.34172/ijhpm.2023.7938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 11/21/2023] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Evidence of the impact of long-term care insurance (LTCI) on health and well-being has predominantly come from developed countries. China officially launched its city-level LTCI policy in 2016. Recent evidence in China has shown that having an LTCI program contributes to positive health. However, it is unclear whether such positive policy effects were attributed to policy announcement or implementation effects, and whether the policy effects vary by locality, chronic conditions, and their intersectionality. This study examines whether there are longitudinal health benefits for older Chinese who are participating in LTCI, particularly considering their city location (urban/rural), whether they have chronic conditions, and the intersectionality. METHODS Following the Andersen Behavioral Model, health and satisfaction outcomes of 9253 adults aged 60+ years were extracted from the 2015 and 2018 waves of the China Health and Retirement Longitudinal Study (CHARLS). Individual data were linked to census socioeconomic data with city-level characteristics and LTCI policy variable. Multilevel lagged regression models investigated the impact of LTCI policy on health and satisfaction with health services, after controlling for baseline individual- and city-level covariates. RESULTS Of 125 cities in the dataset, 21 (16.8%) had adopted LTCI. These city inhabitants had significantly better self-rated health and higher satisfaction relative to cities without LTCI policies when environmental- and personal-level characteristics were modeled. Health benefits of LTCI were stronger after policy announcement and were particularly observed among rural older adults and those with chronic conditions. Results also suggest that LTCI's positive effects on satisfaction spill over to middle-aged adults. CONCLUSION Expanding coverage and eligibility to LTCI for all older Chinese could improve health and well-being.
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Affiliation(s)
- Yinkai Zhang
- Department of Social Work & Social Administration, The University of Hong Kong, Hong Kong SAR, China
| | - Yu-Chih Chen
- Department of Social Work & Social Administration, The University of Hong Kong, Hong Kong SAR, China
- Social Policy Institute, Washington University in St. Louis, St. Louis, MO, USA
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Hu Z, Tian Y, Song X, Zeng F, Yang A. Associations between indoor air pollution for cooking and heating with muscle and sarcopenia in Chinese older population. J Cachexia Sarcopenia Muscle 2023; 14:2029-2043. [PMID: 37448255 PMCID: PMC10570078 DOI: 10.1002/jcsm.13281] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 03/21/2023] [Accepted: 06/11/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Exposure to air pollution brings the advent effect for various diseases, but study about the relationship between air pollution and ageing is scant. We aimed to determine the associations between household air pollution for cooking and heating with muscle and sarcopenia in Chinese older population by a nationally representative study. METHODS This cross-sectional study included individuals aged 60 and above from the China Health and Retirement Longitudinal Study between 2011 and 2015. The diagnosis of sarcopenia was defined by low muscle mass with low muscle strength and/or reduced physical performance. Generalized additive analyses and dose-dependent analyses with three models were used to assess the effects of different pattern of cooking and heating on muscle and sarcopenia. RESULTS A total of 8126 Chinese older individuals with predominant male (53.7%) and mean age of 67.3 ± 6.0 years were included in our study. Solid fuel use in cooking showed significant declines in muscle strength (β = -0.424, 95% CI: -0.767, -0.082, P = 0.01 in model 3) and mass (β = -0.034, 95% CI: -0.051, -0.017, P < 0.01 in model 3), when compared with clean fuel use in cooking, respectively. Solid fuel for heating was correlated with lower muscle strength (β = -0.637, 95% CI: -1.033, -0.241, P < 0.01 in model 3) than clean fuel for heating. The joint use of solid fuel for cooking and heating was associated with reduced muscle strength (β = -0.835, 95% CI: -1.306, -0.365, P < 0.01 in model 3) and mass (β = -0.038, 95% CI: -0.061, -0.015, P < 0.01 in model 3) than clean fuel for cooking and heating. Solid fuel for cooking was associated with significantly increased risk of low muscle strength (adjusted OR = 1.29, 95% CI: 1.11, 1.50, P < 0.01 in model 3) and mass (adjusted OR = 1.35, 95% CI: 1.11, 1.61, P < 0.01 in model 3), possible sarcopenia (adjusted OR = 1.33, 95% CI: 1.19, 1.48, P < 0.01 in model 3) and sarcopenia (adjusted OR = 1.44, 95% CI: 1.21, 1.72, P < 0.01 in model 3) compared with clean fuel for cooking. Solid fuel for heating had a significant correlation with low muscle strength (adjusted OR = 1.30, 95% CI: 1.09, 1.56, P < 0.01 in model 3) and possible sarcopenia (adjusted OR = 1.49, 95% CI: 1.31, 1.70, P < 0.01 in model 3). Dose-dependent manner was shown in the associations between the number of solid fuel with low muscle strength and possible sarcopenia. Clean fuel for cooking and solid fuel for heating was positively associated with the prevalence of possible sarcopenia than clean fuel for cooking and heating (adjusted OR = 1.34, 95% CI: 1.14, 1.57, P < 0.01 in model 3). CONCLUSIONS Our findings suggested that solid fuel for cooking and the number of solid fuel use potentially facilitates the onset and progression of muscle loss and sarcopenia.
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Affiliation(s)
- Zhigang Hu
- Department of Respiratory and Critical Care Medicine, The First College of Clinical Medicine ScienceChina Three Gorges UniversityYichangPeople's Republic of China
- Department of Respiratory and Critical Care MedicineYichang Central People's Hospital at ZhijiangZhijiangPeople's Republic of China
- Department of Respiratory and Critical Care MedicineYichang Central People's HospitalYichangPeople's Republic of China
| | - Yufeng Tian
- Department of Academic Management, Clinical Research CenterChina Three Gorges UniversityYichangPeople's Republic of China
| | - Xinyu Song
- Department of Respiratory and Critical Care Medicine, The First College of Clinical Medicine ScienceChina Three Gorges UniversityYichangPeople's Republic of China
- Department of Respiratory and Critical Care MedicineYichang Central People's HospitalYichangPeople's Republic of China
| | - Fanjun Zeng
- Department of Respiratory and Critical Care Medicine, The First College of Clinical Medicine ScienceChina Three Gorges UniversityYichangPeople's Republic of China
- Department of Respiratory and Critical Care MedicineYichang Central People's HospitalYichangPeople's Republic of China
| | - Ailan Yang
- Department of Respiratory and Critical Care MedicineYichang Central People's Hospital at ZhijiangZhijiangPeople's Republic of China
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Ming X, Guo R, Liu M, He X, Guo F, Gao S. Associations of Household Solid Fuel Use With Falls and Fall-Related Injuries in Middle-Aged and Older Population in China: A Cohort Study. Int J Public Health 2023; 67:1605425. [PMID: 36686388 PMCID: PMC9852047 DOI: 10.3389/ijph.2022.1605425] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 12/22/2022] [Indexed: 01/09/2023] Open
Abstract
Objective: This study evaluated the associations of solid fuels with incidence of falls and fall-related injuries. Methods: Data were taken from wave 1∼4 of the China Health and Retirement Longitudinal Study, including 15,651 participants aged 45 years and older. Modified Poisson regression was used to examine the associations of solid fuels with falls and fall-related injuries. Results: Modified Poisson regression analysis showed that solid fuels users for cooking had an increasing incidence of falls and fall-related injuries, with RR of 1.211 (95% CI: 1.124, 1.305) and 1.248 (95% CI: 1.107, 1.408); for heating had an incidence, with RR of 1.178 (95% CI: 1.062, 1.306) and 1.134 (95% CI: 0.963, 1.335); combined for cooking and heating, with RR of 1.247 (95% CI: 1.105, 1.408) and 1.185 (95% CI: 0.982, 1.431). Conclusion: Our study suggests that solid fuel use is associated with a higher incidence of falls and fall-related injuries among adults aged 45 years and older in China. It is necessary to restrict solid fuel use to reduce household air pollution and make stronger environmental protection policies to improve household environment.
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Affiliation(s)
- Xing Ming
- Pathophysiology Department, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Ruixiao Guo
- Pathophysiology Department, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Mengli Liu
- Department of Epidemiology and Health Statistics, Public Health College, Qingdao University, Qingdao, China
| | - Xiaoman He
- Pathophysiology Department, School of Basic Medicine, Qingdao University, Qingdao, China
| | - Feifei Guo
- Pathophysiology Department, School of Basic Medicine, Qingdao University, Qingdao, China,*Correspondence: Feifei Guo, ; Shengli Gao,
| | - Shengli Gao
- Biomedical Center, Qingdao medical College, Qingdao University, Qingdao, China,*Correspondence: Feifei Guo, ; Shengli Gao,
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Jia Z, Gao Y, Zhao L, Han S. Effects of pain and depression on the relationship between household solid fuel use and disability among middle-aged and older adults. Sci Rep 2022; 12:21270. [PMID: 36481918 PMCID: PMC9732289 DOI: 10.1038/s41598-022-25825-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022] Open
Abstract
Household air pollution (HAP) is suggested to increases people's risk of disability, but mediating mechanisms between HAP and disability remains under-investigated. The aim of this study was to investigate the underlying mechanisms between household air pollution and disability in middle-aged and older adults (i.e., older than 45 years) using a nationally representative prospective cohort. In total, 3754 middle-aged and older adults were selected from the China Health and Retirement Longitudinal Study. Correlation analysis and logistic regression analysis were employed to estimate the association between HAP, pain, depression and disability. Finally, three significant mediation pathways through which HAP directly impacts disability were found: (1) pain (B = 0.09, 95% CI 0.01, 0.02), accounting for 15.25% of the total effect; (2) depression (B = 0.07, 95% CI 0.004, 0.02), accounting for 11.86% of the total effect; (3) pain and depression (B = 0.04, 95% CI 0.003, 0.01), accounting for 6.78% of the total effect. The total mediating effect was 33.89%. This study clarified that HAP can indirectly affect disability through the respective and serial mediating roles of pain and depression. These findings potentially have important implications for national strategies concerning the widespread use of clean fuels by citizens.
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Affiliation(s)
- Zhihao Jia
- grid.27255.370000 0004 1761 1174School of Physical Education, Shandong University, Jinan, 250061 China
| | - Yan Gao
- grid.27255.370000 0004 1761 1174School of Physical Education, Shandong University, Jinan, 250061 China
| | - Liangyu Zhao
- grid.27255.370000 0004 1761 1174School of Physical Education, Shandong University, Jinan, 250061 China
| | - Suyue Han
- grid.27255.370000 0004 1761 1174School of Physical Education, Shandong University, Jinan, 250061 China
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Jin X, He J, Liang Y, Sun X, Yan S, Wu Y, Li Y, Mei L, Song J, Pan R, Yi W, Tao J, Xu Z, Cheng J, Su H. Associations between household solid fuel use and activities of daily living trajectories: A nationwide longitudinal study of middle and older adults in China. ENVIRONMENT INTERNATIONAL 2022; 170:107605. [PMID: 36323064 DOI: 10.1016/j.envint.2022.107605] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 10/13/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND More studies focus on reporting the effects of ambient air pollution on physical activity while ignoring the hazards of indoor air pollution caused by household solid fuel use. Moreover, the impact of individual cognitive and depressive status on the health effects of air pollution is often overlooked. OBJECTIVE We examined the association between household solid fuel and activities of daily living (ADL) trajectories, and further examined this association in homogeneous subgroups of cognitive or depressive trajectories. METHODS Participants were from the China Health and Retirement Longitudinal Study, which conducted four waves of surveys from 2011 to 2018. We collected information on participants' household fuel use, then the ADL, cognitive and depressive performances were assessed in each wave. The latent growth mixture model (LGMM) was used to identify the optimal trajectory class for ADL, cognition, and depression. Then, the multinomial logistic regression was used to assess the association between solid fuel use and ADL trajectories in total population, as well as subgroups with different cognitive or depression trajectories. Furthermore, we examined the association between switching household fuel types and ADL trajectories across the four-wave survey. RESULTS The study sample included 7052 participants. We identified three ADL trajectory classes in total population: "Low-stable", "Moderate-anterior rise", and "Moderate-posterior rise". The multinomial logistic regression results showed that solid fuel use was associated with elevated odds for the adverse ADL trajectories, and this association was still shown in homogeneous subgroups of cognitive or depressive trajectories, while some effects were less significant. In addition, the risk of adverse ADL trajectories generally increases with the times of solid fuel use across the four-wave survey. CONCLUSIONS For middle and older adults in China, household solid fuel use was not conducive to physical activity development, which inspires that a further transformation to cleaner fuels is an important intervention.
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Affiliation(s)
- Xiaoyu Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Jun He
- Sanlian Street Community Health Service Center, Shushan District, Hefei City, Anhui Province, China
| | - Yunfeng Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Xiaoni Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Shuangshuang Yan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Yudong Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Yuxuan Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Lu Mei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Jian Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Junwen Tao
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Zhiwei Xu
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Jian Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, China.
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11
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Ren Z, Sun W, Shan S, Hou L, Zhu S, Yi Q, Wu Y, Guo C, Liu J, Song P. Risk of functional disability associated with solid fuel use and population impact of reducing indoor air pollution in China: A national cohort study. Front Public Health 2022; 10:976614. [PMID: 36262231 PMCID: PMC9575675 DOI: 10.3389/fpubh.2022.976614] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 09/08/2022] [Indexed: 01/25/2023] Open
Abstract
Background In China, numerous people still rely on solid fuel for household use. To date, the association between household solid fuel use and functional disability, and what benefit reducing household solid fuel usage could bring at the population level to China remain unclear. Method Data were from the China Health and Retirement Longitudinal Study. Household fuel was classified as clean or solid for cooking or heating. Functional disability was defined as difficulties in any item of activities of daily living (ADL) or instrumental activities of daily living (IADL). The associations of household fuel use in 2011 and its transitions between 2011 and 2013 with subsequent ADL or IADL disability were assessed with Cox proportional-hazards models. The number of events prevented in a population (NEPP) was generated to estimate how many functionally disabled patients could be prevented by reducing solid fuel usage. Results A total of 6,216 and 9,716 participants without prior ADL or IADL disability in 2011 were included. Solid (vs. clean) fuel users were more likely to develop ADL and IADL disability, with hazard ratios (HRs) and 95% confidence intervals (CIs) of 1.37 (1.28~1.45) and 1.38 (1.31~1.46) for using both solid cooking and heating fuel. Furthermore, participants that switched heating fuel from solid to clean (vs. keep solid) were about 20% less likely to develop functional disability. Cooking fuel use switching from solid to clean (vs. keep solid) was also negatively associated with IADL disability (HR = 0.84, 95% CI 0.74~0.96). Over the next 7 years, raising clean fuel usage to 80% could prevent about 4.9 million ADL disability and 2.6 million IADL disability among Chinese aged 45 and older. Conclusion Household solid fuel use was a risk factor for functional disability. Reducing solid fuel usage could help reduce the burden of functional disability in the current aging society of China.
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Affiliation(s)
- Ziyang Ren
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China,Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Peking University, Beijing, China,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Weidi Sun
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China,Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Shiyi Shan
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Leying Hou
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Siyu Zhu
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qian Yi
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - You Wu
- School of Medicine, Tsinghua University, Beijing, China,Institute for Hospital Management, Tsinghua University, Shenzhen, China
| | - Chao Guo
- Institute of Population Research, Peking University, Beijing, China,APEC Health Science Academy (HeSAY), Peking University, Beijing, China
| | - Jufen Liu
- Institute of Reproductive and Child Health/Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Peking University, Beijing, China,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China,Jufen Liu
| | - Peige Song
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China,*Correspondence: Peige Song
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12
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Hou X, Mao Z, Song X, Kang N, Zhang C, Li R, Yuchi Y, Liao W, Liu X, Huo W, Wang C, Hou J. Kitchen ventilation alleviated adverse associations of domestic fuel use and long-duration cooking with platelet indices as biomarkers of cardiovascular diseases. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 834:155341. [PMID: 35452724 DOI: 10.1016/j.scitotenv.2022.155341] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 03/28/2022] [Accepted: 04/13/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Abnormal platelet activity is considered as a potential mechanism of cardiovascular diseases (CVDs) related to household air pollution (HAP). However, evidence remains lacking for the association of HAP with platelet activity in low-middle income countries. METHODS 27,349 individuals were obtained from the Henan Rural Cohort Study. A questionnaire was used to collect data on cooking fuel types, cooking frequency and time as well as kitchen ventilation which indirectly reflected HAP. Platelet activity was indicated by platelet count (PLT), platelet distribution width (PDW), mean platelet volume (MPV), ratio of mean platelet volume to platelet count (MPVP), platelet-large cell ratio (P-LCR) and plateletcrit (PCT). Associations of HAP with platelet activity were assessed by generalized linear mixed models. RESULTS Compared with the ones without cooking, participants who cooking using solid fuel, clean fuel, short- and long-duration cooking were at a high risk for increased platelet size (PDW, MPV, MPVP and P-LCR) but decreased PLT and PCT; long-duration cooking participants with non-using exhaust hood/extractor by solid fuel use were associated with a 0.259 f. (95%CI: 0.100, 0.418 fL), 0.115 f. (95%CI: 0.050, 0.181 fL), 0.001 (95%CI: 0.000, 0.003) and 0.928% (95%CI: 0.425, 1.431%) increment in PDW, MPV, MPVP and P-LCR values and these associations were prominent in women relative than that in men. CONCLUSION Using exhaust hood/extractor attenuated the positive associations of solid fuel use and long-duration cooking with increased platelet size in all participants and these associations were prominent in women, indicating that improving kitchen ventilation may be an effective strategy to reduce platelet dysfunction related to HAP, especially for women.
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Affiliation(s)
- Xiaoyu Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Zhenxing Mao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xiaoqin Song
- Physical Examination Center, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, PR China
| | - Ning Kang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Caiyun Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Ruiying Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Yinghao Yuchi
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Wei Liao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Wenqian Huo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
| | - Jian Hou
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, PR China.
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Chen T, Zou C, Yuan Y, Pan J, Zhang B, Qiao L, Li Y, Qian JY, Guo Q, Yuan Y, Ding C. Indoor air pollution from solid fuel on children pneumonia in low- and middle-income countries: a systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:24574-24588. [PMID: 35066845 DOI: 10.1007/s11356-021-18293-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 12/19/2021] [Indexed: 06/14/2023]
Abstract
An updated systematic review was conducted to assessing on the association between indoor air pollution caused by household energy consumption and childhood pneumonia in low- and middle-income countries. We performed a meta-analysis from the electronic databases of PubMed, Cochrane library, Web of Science, EMBASE. Studies were selected when they reported childhood pneumonia or ALRI in relation to indoor air pollution resulted from solid fuel. Studies must provide results on exposure prevalence of children aged below 5 years from Asia or Africa. We devoted ourselves to identifying randomized controlled experiments and observational epidemiological researches, which revealed the relation between household usage of solid fuel and childhood pneumonia. Among 1954 articles, 276 were reviewed thoroughly and 16 conduced to such a meta-analysis. It was found that there is a significant relationship between the solid fuel combustion and increasing risk of childhood pneumonia (OR = 1.66, 95%CI 1.36-2.02). The summary odds ratios from biomass use and mixed fuel use were, respectively, 1.86 (95%CI 1.15-3.02) and 1.58 (95%CI 1.38-1.81), with substantial between study heterogeneity (I2 = 87.2% and 29.2%, respectively). According to the subgroup analysis along with the meta-regression analysis, the risk of using solid fuel in Asian regions is higher than that in African regions. Studies based on non-hospital participates (I2 = 49.5%) may also a source of heterogeneity. We found that indoor air pollution generated by the usage of solid fuel might be a significant risk factor for pneumonia in children and suggested improving the indoor air quality by promoting cleaner fuel will be important in undeveloped countries.
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Affiliation(s)
- Tianming Chen
- School of Environmental Science and Engineering, Yancheng Institute of Technology, P.O.Box NO.211 Jianjun Road, Yancheng, 224051, Jiangsu Province, China
- Jiangsu Province Engineering Research Center of Intelligent Environmental Protection Equipment, Yancheng, 224051, Jiangsu Province, China
| | - Chao Zou
- School of Environmental Science and Engineering, Yancheng Institute of Technology, P.O.Box NO.211 Jianjun Road, Yancheng, 224051, Jiangsu Province, China
- Jiangsu Province Engineering Research Center of Intelligent Environmental Protection Equipment, Yancheng, 224051, Jiangsu Province, China
| | - Yang Yuan
- Yancheng Hospital of Traditional Chinese Medicine, Yancheng, 224001, Jiangsu, China
| | - Jingjing Pan
- School of Environmental Science and Engineering, Yancheng Institute of Technology, P.O.Box NO.211 Jianjun Road, Yancheng, 224051, Jiangsu Province, China
- Jiangsu Province Engineering Research Center of Intelligent Environmental Protection Equipment, Yancheng, 224051, Jiangsu Province, China
| | - Baoping Zhang
- School of Environmental Science and Engineering, Yancheng Institute of Technology, P.O.Box NO.211 Jianjun Road, Yancheng, 224051, Jiangsu Province, China
| | - Liang Qiao
- School of Environmental Science and Engineering, Yancheng Institute of Technology, P.O.Box NO.211 Jianjun Road, Yancheng, 224051, Jiangsu Province, China
- Jiangsu Province Engineering Research Center of Intelligent Environmental Protection Equipment, Yancheng, 224051, Jiangsu Province, China
| | - Yanping Li
- Department of Pharmacy, Jiangsu Vocational College of Medicine, Jiangsu, 224005, China
| | - Jia-Yan Qian
- Nantong Production Quality Supervising & Inspection Institute, Jiangsu, 226005, China
| | - Qingyuan Guo
- School of Environmental Science and Engineering, Yancheng Institute of Technology, P.O.Box NO.211 Jianjun Road, Yancheng, 224051, Jiangsu Province, China
- Jiangsu Province Engineering Research Center of Intelligent Environmental Protection Equipment, Yancheng, 224051, Jiangsu Province, China
| | - Ye Yuan
- School of Environmental Science and Engineering, Yancheng Institute of Technology, P.O.Box NO.211 Jianjun Road, Yancheng, 224051, Jiangsu Province, China.
- Jiangsu Province Engineering Research Center of Intelligent Environmental Protection Equipment, Yancheng, 224051, Jiangsu Province, China.
| | - Cheng Ding
- School of Environmental Science and Engineering, Yancheng Institute of Technology, P.O.Box NO.211 Jianjun Road, Yancheng, 224051, Jiangsu Province, China.
- Jiangsu Province Engineering Research Center of Intelligent Environmental Protection Equipment, Yancheng, 224051, Jiangsu Province, China.
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14
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Cao L, Zhai D, Kuang M, Xia Y. Indoor air pollution and frailty: A cross-sectional and follow-up study among older Chinese adults. ENVIRONMENTAL RESEARCH 2022; 204:112006. [PMID: 34499891 DOI: 10.1016/j.envres.2021.112006] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 08/31/2021] [Accepted: 09/01/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Previous studies have suggested that ambient air pollution negatively affects frailty, but whether indoor air pollution exposure affects frailty is unknown. METHOD This study was conducted on 4946 older adults (≥60 years) followed from baseline to 4 years in the Chinese Longitudinal Healthy Longevity Survey. Household fuel types and frailty were assessed with self-rated questionnaires and physical examination. The relationships between indoor air pollution and frailty via phenotypic frailty and a frailty index were explored with logistic regression models and Cox proportional hazard regression models in both a cross-sectional and follow-up design. Additionally, the effects of indoor air pollution on phenotypic frailty together with mild cognitive impairment (MCI) were further investigated. RESULTS In the cross-sectional study, the adjusted ORs (95% CIs) for frailty assessment with the frailty index and phenotypic frailty were 1.28 (1.12, 1.46) and 1.36 (1.18, 1.57), respectively. Solid fuel use was a risk factor in prefrail/frail patients with [OR and 95% CI, 1.88 (1.41, 2.50)], or without MCI [OR and 95% CI, 1.37 (1.17, 1.61)], as compared with the groups with no phenotypic prefrailty/frailty and no MCI. Moreover, solid cooking fuel use was positively associated with the incidence of phenotypic prefrailty and frailty. The adjusted HRs (95% CIs) for phenotypic prefrailty and frailty were 1.26 (1.03, 1.55). CONCLUSIONS Solid cooking fuels can be regarded as a risk factor for frailty. Moreover, our findings suggest that more attention should be paid to solid cooking fuel using as it relates to phenotypic frailty together with MCI.
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Affiliation(s)
- Limin Cao
- The Third Central Hospital of Tianjin, 83 Jintang Road, Hedong District, Tianjin, 300170, China; Tianjin Key Laboratory of Extracorporeal Life Support for Critical Disease, China
| | - Daokuan Zhai
- The Third Central Hospital of Tianjin, 83 Jintang Road, Hedong District, Tianjin, 300170, China; Tianjin Key Laboratory of Extracorporeal Life Support for Critical Disease, China
| | - Mingjie Kuang
- Department of Orthopedics, Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250014, China.
| | - Yang Xia
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
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