Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, Liaoning, China.
School of Nursing, Bengbu Medical College, Bengbu, Anhui, China.
Sci Total Environ. 2023 Jan 15;856(Pt 2):159035. doi: 10.1016/j.scitotenv.2022.159035. Epub 2022 Sep 30.
BACKGROUND: Few studies have been conducted on the association between domestic solid fuel combustion and incident nonfatal cardiovascular disease (CVD). We assessed the prospective association between domestic fuel type and incident nonfatal CVD among Chinese adults aged ≥45 years. METHODS: This was a prospective cohort study using data from the China Longitudinal Study of Health and Retirement (CHARLS) that recruited 8803 participants ≥45 years in 2013. Household fuel types were assessed based on self-reports, including solid fuel (coal, crop residue, or wood fuel) and clean fuel (central heating, solar power, natural gas, liquefied petroleum gas, electricity, or marsh gas). Nonfatal CVD was defined as self-reported physician-diagnosed nonfatal CVD. We established Cox proportional hazard regression models with age as the time scale and strata by sex to evaluate the hazard ratios (HRs) and 95 % confidence intervals (95 % CIs). RESULTS: After a median follow-up of five years, 970 (11.02 %) nonfatal CVD cases were documented, including 423 (9.96 %) in males and 547 (12.01 %) in females. Participants with exposure to solid fuel for cooking and clean fuel for heating [HR (95 % CI):2.01 (1.36-2.96)], solid fuel for heating and clean fuel for cooking [HR (95 % CI):1.45 (1.06-1.99)], and solid fuel for both heating and cooking [HR (95 % CI):1.43 (1.07-1.92)] had an elevated nonfatal CVD risk compared to users of cleaner fuel for both cooking and heating. Those whom self-reported switching from solid fuels to cleaner fuels for cooking had significantly decreased nonfatal CVD risk [HR (95 % CI):0.76 (0.58-0.99)] than participants who did not switch to cleaner fuels. CONCLUSIONS: Exposure to domestic solid fuel burning for cooking or heating is associated with an elevated nonfatal CVD risk. Notably, switching cooking fuels from solid to cleaner fuels is related to a reduced risk of nonfatal CVD.
背景:很少有研究关注家庭固体燃料燃烧与非致命性心血管疾病(CVD)事件之间的关联。我们评估了中国≥45 岁成年人中家庭燃料类型与非致命性 CVD 事件之间的前瞻性关联。 方法:这是一项使用中国健康与退休纵向研究(CHARLS)数据进行的前瞻性队列研究,该研究于 2013 年招募了 8803 名≥45 岁的参与者。家庭燃料类型是根据自我报告评估的,包括固体燃料(煤、农作物残余物或木柴燃料)和清洁燃料(集中供热、太阳能、天然气、液化石油气、电或沼气)。非致命性 CVD 定义为自我报告的经医生诊断的非致命性 CVD。我们建立了 Cox 比例风险回归模型,以年龄为时间尺度,并按性别分层,以评估危险比(HR)和 95%置信区间(95%CI)。 结果:在中位随访 5 年后,记录了 970 例(11.02%)非致命性 CVD 病例,其中男性 423 例(9.96%),女性 547 例(12.01%)。暴露于固体燃料烹饪和清洁燃料取暖[HR(95%CI):2.01(1.36-2.96)]、固体燃料取暖和清洁燃料烹饪[HR(95%CI):1.45(1.06-1.99)]以及固体燃料烹饪和取暖[HR(95%CI):1.43(1.07-1.92)]的参与者发生非致命性 CVD 的风险升高与同时使用清洁燃料烹饪和取暖的参与者相比。那些自我报告从固体燃料改用清洁燃料烹饪的人发生非致命性 CVD 的风险显著降低[HR(95%CI):0.76(0.58-0.99)],而未改用清洁燃料的人则没有。 结论:家庭固体燃料燃烧用于烹饪或取暖与非致命性 CVD 风险升高有关。值得注意的是,从固体燃料改为清洁燃料烹饪与非致命性 CVD 风险降低有关。
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