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Xia Y, Zhang H, Cao L, Zhao Y. Household solid fuel use and peak expiratory flow in middle-aged and older adults in China: A large cohort study (2011-2015). ENVIRONMENTAL RESEARCH 2021; 193:110566. [PMID: 33278475 DOI: 10.1016/j.envres.2020.110566] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 11/29/2020] [Accepted: 11/29/2020] [Indexed: 06/12/2023]
Abstract
Indoor air pollution caused by solid fuel use in cooking and heating in China is common. The relationship between household solid fuel use and peak expiratory flow (PEF) in middle-aged and older adults in China has not been clarified. The aim of this study was to assess the relationship between long-term household solid fuel use (clean for both cooking and heating, solid for either cooking or heating, and solid for both cooking and heating) and PEF changes in middle-aged and older adults using a nationally representative prospective cohort. Covariance analysis was used to compare PEF changes in different indoor air pollution exposure groups. Separate analysis of cooking and heating as well as sub-group analyses by age, sex and smoking status were conducted, linear mixed growth model analysis was used to evaluate the association between cooking fuel type and PEF. A total of 6818 participants were enrolled in the cohort analysis. Results revealed that solid fuel use in cooking and heating separately or conjointly were associated with reduced PEF (solid fuel use in cooking: least square mean [LSM] = 19.9, 95% confidence interval [CI]: 11.5-28.2, P = 0.03; solid fuel use in heating: LSM = 19.4, 95% CI:11.2-27.5, P = 0.04; both solid fuel use: LSM = 17.6, 95% CI: 9.3-25.9, P for trend <0.0001), especially in participants aged >65 years (LSM = -9.22, 95% CI: 27.9-69.52, P for trend <0.0001), females (LSM = -6.41, 95% CI: 19.12-6.30, P for trend <0.0001) and current or former smokers (LSM = -21.55, 95% CI: 36.14 to -6.97, P < 0.02). Compared to that of participants using clean fuels for cooking, PEF of participants using solid fuels were decreased by 3.5 l/min per 2 years over a 4-year follow-up. This cohort study highlights the adverse effects of indoor air pollution on lung function in middle aged and older adults in China.
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Affiliation(s)
- Yang Xia
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Heping District, Sanhao Street, No. 36, Shenyang, Liaoning province, 110004, China
| | - Hehua Zhang
- Clinical Research Center, Shengjing Hospital of China Medical University, Heping District, Sanhao Street, No. 36, Shenyang City, Liaoning province, 110004, China
| | - Limin Cao
- The Third Central Hospital of Tianjin, Hedong District, Jintang Road, No. 83, Tianjin, 300170, China
| | - Yuhong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Heping District, Sanhao Street, No. 36, Shenyang, Liaoning province, 110004, China; Clinical Research Center, Shengjing Hospital of China Medical University, Heping District, Sanhao Street, No. 36, Shenyang City, Liaoning province, 110004, China.
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