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Comparative Study
. 2005 Nov 5;331(7524):1050.
doi: 10.1136/bmj.38628.676088.55. Epub 2005 Oct 18.

Improvement in household stoves and risk of chronic obstructive pulmonary disease in Xuanwei, China: retrospective cohort study

Robert S Chapman  1 , Xingzhou He, Aaron E Blair, Qing Lan
Affiliations
Comparative Study

Improvement in household stoves and risk of chronic obstructive pulmonary disease in Xuanwei, China: retrospective cohort study

Robert S Chapman et al. BMJ. .

Abstract

Objective: To test whether improvement in household coal stoves affected the incidence of chronic obstructive pulmonary disease (COPD) in Xuanwei County, China.

Design: Retrospective cohort study (follow-up 1976-92) comparing incidence of COPD between groups with and without chimneys.

Participants: 20,453 people born into homes with unvented coal stoves;16,606 (81.2%) subsequently changed to stoves with chimneys.

Intervention: Installation of a chimney in households in which unvented stoves had been used previously.

Results: Installation of a chimney was associated with distinct reduction in the incidence of COPD. Compared with people who did not have chimneys, the Cox-modelled risk ratio (relative risk) was 0.58 (95% confidence interval 0.49 to 0.70, P < 0.001) in men and 0.75 (0.62 to 0.92, P = 0.005) in women. Modelled risk ratios were robust to different Cox model specifications. Relative risks decreased with time since stove improvement. In both sexes, the reduction in risk became unequivocal about 10 years after stove improvement.

Conclusions: In Xuanwei, incidence of COPD decreased markedly after household coal stoves were improved.

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Figures

Figure 1
Figure 1
Product limit survival plots showing probability of not having chronic obstructive pulmonary disease (COPD) by age in years in men and women according to whether they had a chimney, Xuanwei, 1976-92
See this image and copyright information in PMC

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