中国农村地区固体燃料使用与认知功能之间关联的性别差异。
Sex difference in the association between solid fuel use and cognitive function in rural China.
机构信息
Guangzhou Center for Disease Control and Prevention Guangzhou, China.
Georgia Prevention Institute, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA.
出版信息
Environ Res. 2021 Apr;195:110820. doi: 10.1016/j.envres.2021.110820. Epub 2021 Feb 1.
BACKGROUND
Whether indoor air pollution from solid fuel use is associated with cognitive function remains unclear.
OBJECTIVE
This study aims to examine the association of solid fuel use with the risk of cognitive impairment in males and females.
METHODS
The data was from the China Health and Retirement Longitudinal Study (CHARLS). Self-reported heating and cooking fuel were categorized as clean fuel (solar, liquefied gas, natural gas, or electricity) and solid fuel (coal, biomass charcoal, wood, or straw). Cognitive function, including orientation and attention, episodic memory, and visuospatial abilities, was assessed using standardized questionnaires.
RESULTS
A total of 7824 individuals were included in our study (aged 57.0 ± 9.3, 46.2% female), with 47.0% and 76.0% used solid fuel for cooking and heating, respectively. There was an interaction between sex and solid fuel use for cooking (P=0.008) for the progress of cognitive impairment. Solid fuel use for cooking was associated with a larger decrease in cognitive function score in females (β=-0.832; 95% CI: -1.043, -0.622; P < 0.001) than in males (β=-0.487; 95% CI: -0.671, -0.302; P < 0.001). The sex difference remained with further adjustment of covariates (β=-0.321; 95% CI: -0.503, -0.138; P=0.001 for males; β=-0.534; 95% CI: -0.745, -0.324; P < 0.001 for females). For heating, the interaction between sex and solid fuel was not statistically significant (P=0.156). After controlling for the covariates, solid fuel use for heating was inversely associated with a 0.321 unit of decrease of cognitive function score (β=-0.321; 95% CI: -0.652, 0.009; P=0.057) in males, and a 0.598 unit of decrease of cognitive function (β=-0.598; 95% CI: -0.978, -0.218; P=0.002) in females.
CONCLUSION
In conclusion, solid fuel use for cooking and heating was significantly associated with a higher risk of cognitive impairment. Furthermore, for the first time, we found that the effect of solid fuel use on cognitive function in females was greater than in males.
背景
固体燃料使用导致的室内空气污染是否与认知功能有关尚不清楚。
目的
本研究旨在探讨固体燃料使用与男性和女性认知障碍风险之间的关系。
方法
数据来自中国健康与养老追踪调查（CHARLS）。自我报告的取暖和烹饪燃料分为清洁燃料（太阳能、液化气、天然气或电）和固体燃料（煤、生物质炭、木材或秸秆）。认知功能包括定向和注意力、情景记忆和视空间能力，使用标准化问卷进行评估。
结果
本研究共纳入 7824 名参与者（年龄 57.0±9.3 岁，46.2%为女性），分别有 47.0%和 76.0%的参与者使用固体燃料烹饪和取暖。烹饪用固体燃料的使用与认知障碍的进展之间存在性别交互作用（P=0.008）。女性使用固体燃料烹饪与认知功能评分下降幅度更大（β=-0.832；95%CI：-1.043，-0.622；P<0.001），而男性则较小（β=-0.487；95%CI：-0.671，-0.302；P<0.001）。进一步调整协变量后，性别差异仍然存在（β=-0.321；95%CI：-0.503，-0.138；P=0.001 男性；β=-0.534；95%CI：-0.745，-0.324；P<0.001 女性）。对于取暖，性别和固体燃料之间的交互作用没有统计学意义（P=0.156）。在控制了协变量后，固体燃料取暖与认知功能评分下降 0.321 个单位有关（β=-0.321；95%CI：-0.652，0.009；P=0.057），男性认知功能评分下降 0.598 个单位（β=-0.598；95%CI：-0.978，-0.218；P=0.002），女性认知功能评分下降 0.598 个单位。
结论
总之，烹饪和取暖用固体燃料的使用与认知障碍风险显著相关。此外，我们首次发现，固体燃料使用对女性认知功能的影响大于男性。
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