中年及以上中国人群中家庭固体燃料使用与抑郁的纵向关联：一项队列研究。

Longitudinal associations between household solid fuel use and depression in middle-aged and older Chinese population: A cohort study.

机构信息

State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.

Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.

出版信息

Ecotoxicol Environ Saf. 2021 Feb;209:111833. doi: 10.1016/j.ecoenv.2020.111833. Epub 2020 Dec 24.

DOI:10.1016/j.ecoenv.2020.111833

PMID:33360785

Abstract

BACKGROUND

Previous studies found that ambient air pollution was associated with a higher prevalence of depressive symptoms. However, the longitudinal associations between household solid fuel use, which is the main source of household air pollution, and depressive symptoms remain unclear. This cohort study aimed to explore the associations between household solid fuel use and incidence of depressive symptoms in China.

METHODS

In total, 8637 participants were enrolled in this prospective cohort study. Depressive symptoms were assessed using the 10-item Center for Epidemiological Studies Depression Scale. The associations between baseline household solid fuel use and the incidence of depressive symptoms were examined using Cox proportional hazards regression models.

RESULTS

During the 4-year of follow-up, 2074 of 8637 participants developed depressive symptoms. Compared with participants who used clean fuel for both heating and cooking, the multivariate-adjusted hazard ratio (HR) (95% confidence intervals [95% CI]) for depressive symptoms incidence in participants who used solid fuels for two purposes (cooking and heating) was 1.15 (1.01, 1.31). In the solid fuel use subgroup analysis, use of solid fuels for cooking (HR, 1.12; 95% CI, 1.02-1.24) was associated with a higher incidence of depressive symptoms after adjustments while use for heating (HR, 1.05; 95% CI, 0.93-1.18) was not. Moreover, compared with persistent solid fuel users, switching from solid to clean fuels for cooking resulted in a lower risk of depressive symptoms before adjustments (HR, 0.82; 95% CI, 0.71-0.95) and a non-significant association (HR, 0.90; 95% CI, 0.77-1.04) afterwards.

CONCLUSIONS

The results suggest that household solid fuel use for cooking was associated with a higher incidence of depressive symptoms. Preventive strategies based on improving household cooking environment for depressive symptoms should be established.

摘要

背景

先前的研究发现，环境空气污染与抑郁症状的患病率升高有关。然而，家庭固体燃料使用（这是家庭空气污染的主要来源）与抑郁症状之间的纵向关联仍不清楚。本队列研究旨在探讨中国家庭固体燃料使用与抑郁症状发生率之间的关系。

方法

这项前瞻性队列研究共纳入了 8637 名参与者。使用 10 项中心流行病学研究抑郁量表评估抑郁症状。使用 Cox 比例风险回归模型检查基线家庭固体燃料使用与抑郁症状发生率之间的关系。

结果

在 4 年的随访期间，8637 名参与者中有 2074 名出现了抑郁症状。与使用清洁燃料进行烹饪和取暖的参与者相比，同时使用固体燃料进行烹饪和取暖的参与者发生抑郁症状的多变量调整后风险比（HR）（95%置信区间[95%CI]）为 1.15（1.01，1.31）。在固体燃料使用亚组分析中，烹饪时使用固体燃料（HR，1.12；95%CI，1.02-1.24）与调整后抑郁症状发生率较高相关，而取暖时使用固体燃料（HR，1.05；95%CI，0.93-1.18）则不然。此外，与持续使用固体燃料的参与者相比，调整前从固体燃料转换为清洁燃料用于烹饪可降低抑郁症状的风险（HR，0.82；95%CI，0.71-0.95），调整后则无显著关联（HR，0.90；95%CI，0.77-1.04）。