Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
Health Services and Systems Research, Duke-NUS Medical School, 8 College Road Level 4, Singapore, 169857, Singapore.
BMC Nephrol. 2019 Jan 9;20(1):9. doi: 10.1186/s12882-018-1186-9.
Experimental studies have shown that exposure to incense burning may have deleterious effects on kidney function and architecture. However, the association between chronic exposure to incense smoke and risk of end-stage renal disease (ESRD) has not been reported in epidemiologic studies.
We investigated this association in the Singapore Chinese Health Study, a prospective population-based cohort of 63,257 Chinese men and women of 45-74 years of age in Singapore during recruitment from 1993 to 1998. Information on the practice of incense burning at home, diet, lifestyle and medical history was collected at baseline interviews. ESRD cases were identified through linkage with the nationwide Singapore Renal Registry through 2015. We used Cox proportional hazards regression analysis to estimate hazard ratio (HR) and 95% confidence interval (CI) of ESRD associated with domestic incense burning.
Among cohort participants, 76.9% were current incense users. After an average 17.5 years of follow-up, there were 1217 incident ESRD cases. Compared to never users, the multivariable-adjusted HR for ESRD risk was 1.05 (95% CI, 0.80 to 1.38) for former users and 1.26 (95% CI, 1.02 to1.57) for current users of incense. In analysis by daily or non-daily use and duration, the increased ESRD risk was observed in daily users who had used incense for > 20 years; HR was 1.25 (95% CI, 1.07 to 1.46). Conversely, the risk was not increased in those who did not use incense daily or who had used daily but for ≤20 years.
Our findings demonstrate that long-term daily exposure to domestic incense burning could be associated with a higher risk of ESRD in the general population.
实验研究表明，焚香暴露可能对肾功能和结构产生有害影响。然而，在流行病学研究中，尚未有关于慢性吸入香烟雾与终末期肾病（ESRD）风险之间的关联的报道。
我们在新加坡华人健康研究中调查了这种关联，这是一项在新加坡进行的前瞻性基于人群的队列研究，共有 63257 名 45-74 岁的中国男性和女性在 1993 年至 1998 年期间招募。在基线访谈中收集了有关在家中焚香、饮食、生活方式和病史的信息。通过与 2015 年全国新加坡肾脏登记处的链接，确定了 ESRD 病例。我们使用 Cox 比例风险回归分析来估计与家庭焚香相关的 ESRD 的风险比（HR）和 95％置信区间（CI）。
在队列参与者中，76.9％为当前的焚香使用者。经过平均 17.5 年的随访，有 1217 例新发 ESRD 病例。与从不使用者相比，前使用者和当前使用者的 ESRD 风险的多变量调整 HR 分别为 1.05（95％CI，0.80 至 1.38）和 1.26（95％CI，1.02 至 1.57）。在按每日或非每日使用和持续时间进行的分析中，观察到每日使用超过 20 年的焚香者的 ESRD 风险增加；HR 为 1.25（95％CI，1.07 至 1.46）。相反，那些不每天使用香或每天使用但使用时间不超过 20 年的人的风险没有增加。
我们的研究结果表明，长期每天暴露于家庭焚香可能与普通人群中 ESRD 风险增加有关。
