Li Bingsong, Sun Xiaotong, Wang Yue, Li Qinling, He Yizhan, Wang Menglu, Zhen Xuemei
Department of Social Medicine and Health Management, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China.
BMC Public Health. 2025 May 26;25(1):1933. doi: 10.1186/s12889-025-23141-0.
In low - and middle-income countries, a large number of people still use solid fuels, including crop residues such as biofuels/wood and coal, for heating and cooking. Compared with clean fuels(electric, liquefied petroleum gas, natural gas, marsh gas and solar), solid fuels can cause numerous health hazards. There is limited evidence suggesting that the use of solid fuel is associated with self-perceived low back pain (LBP) and neck pain (NP). This study aimed to analyze the association between household solid fuel use and the risk of LBP and NP in middle aged and elderly adults.
We used data from the China Health and Retirement Longitudinal Study for five cross-sectional and ten panel analyses. Multivariable logistic regression model and generalized estimation equation were used to elucidate the relationship between solid fuel and the number of solid fuels used and two pains(LBP and NP). Moreover, the effect of fuel type conversion on LBP and NP is also done.
The results indicate that users of solid fuels, particularly those using solid cooking fuels, may have a higher risk of LBP(OR: 1.13, 95% CI: 1.05-1.22 for 2011-2020) and NP(OR: 1.22, 95% CI: 1.13-1.31 for 2018-2020). The use of solid fuels for heating also raises the risk of LBP(OR: 1.15, 95% CI: 1.06-1.24 for 2011-2020) and NP(OR: 1.34, 95% CI: 1.22-1.46 for 2015-2020). Compared to complete clean fuel users, both mixed fuel and complete solid fuel users face a greater risk for LBP (OR: 1.29, 95% CI: 1.17-1.43 for complete solid fuel users) and NP(OR: 1.38, 95% CI: 1.22-1.55 for complete solid fuel users). Additionally, persistent solid fuel users and those who switch fuel types exhibit higher risks of LBP (OR: 1.33, 95% CI: 1.20-1.47 for persistent solid fuel heating; OR: 1.39, 95% CI: 1.26-1.54 for persistent solid fuel cooking) and NP (OR: 1.38, 95% CI: 1.20-1.59 for persistent solid fuel heating; OR: 1.34, 95% CI: 1.17-1.54 for persistent solid fuel cooking) than persistent clean fuel users.
Long-term exposure to household solid fuels is associated with a higher risk of LBP and NP. It is suggested that multiple departments cooperate to increase the global use of clean energy and thereby reduce the risk of LBP and NP among middle-aged and elderly people.
在低收入和中等收入国家，仍有大量人口使用固体燃料，包括生物燃料/木材和煤炭等作物残渣用于取暖和烹饪。与清洁燃料（电力、液化石油气、天然气、沼气和太阳能）相比，固体燃料会导致众多健康危害。仅有有限的证据表明使用固体燃料与自我感知的腰痛（LBP）和颈痛（NP）有关。本研究旨在分析家庭使用固体燃料与中老年人群中LBP和NP风险之间的关联。
我们使用了中国健康与养老追踪调查的数据进行五次横断面分析和十次面板分析。采用多变量逻辑回归模型和广义估计方程来阐明固体燃料及所使用固体燃料的数量与两种疼痛（LBP和NP）之间的关系。此外，还研究了燃料类型转换对LBP和NP的影响。
结果表明，固体燃料使用者，尤其是使用固体烹饪燃料的人，可能有更高的LBP风险（2011 - 2020年，比值比：1.13，95%置信区间：1.05 - 1.22）和NP风险（2018 - 2020年，比值比：1.22，95%置信区间：1.13 - 1.31）。使用固体燃料取暖也会增加LBP风险（2011 - 2020年，比值比：1.15，95%置信区间：1.06 - 1.24）和NP风险（2015 - 2020年，比值比：1.34，95%置信区间：1.22 - 1.46）。与完全使用清洁燃料的用户相比，混合燃料用户和完全使用固体燃料的用户患LBP（完全使用固体燃料的用户，比值比：1.29，95%置信区间：1.17 - 1.43）和NP（完全使用固体燃料的用户，比值比：1.38，95%置信区间：1.22 - 1.55）的风险更高。此外，持续使用固体燃料的用户以及转换燃料类型的用户患LBP（持续使用固体燃料取暖，比值比：1.33，95%置信区间：1.20 - 1.47；持续使用固体燃料烹饪，比值比：1.39，95%置信区间：1.26 - 1.54）和NP（持续使用固体燃料取暖，比值比：1.38，95%置信区间：1.20 - 1.59；持续使用固体燃料烹饪，比值比：1.34，95%置信区间：1.17 - 1.54）的风险高于持续使用清洁燃料的用户。
长期接触家庭固体燃料与较高的LBP和NP风险相关。建议多部门合作以增加全球清洁能源的使用，从而降低中老年人群中LBP和NP的风险。
