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. 2022 May 17;12(5):e054170.
doi: 10.1136/bmjopen-2021-054170.

Indoor solid fuel use for cooking and the risk of incidental non-fatal cardiovascular disease among middle-aged and elderly Chinese adults: a prospective cohort study

Haoqiang Ji  1 , Qian Chen  2 , Ruiheng Wu  1 , Jia Xu  1 , Xu Chen  1 , Liang Du  1 , Yunting Chen  1 , Yuanping Pan  1 , Yuxin Duan  1 , Meng Sun  1 , Ling Zhou  3
Affiliations

Indoor solid fuel use for cooking and the risk of incidental non-fatal cardiovascular disease among middle-aged and elderly Chinese adults: a prospective cohort study

Haoqiang Ji et al. BMJ Open. .

Abstract

Objectives: The harm of indoor air pollution to health has gradually attracted attention, but the effect of indoor air pollution from burning solid fuels on incidental non-fatal cardiovascular disease (CVD) is not well understood. Under these circumstances, this study examined the association between solid fuel use and incidental non-fatal CVD.

Design: The prospective cohort study was conducted in 2011, 2013, 2015 and 2018.

Setting: The nationally representative survey was conducted in 28 provinces of China.

Participants: This study included 13 544 middle-aged and elderly adults without CVD in the baseline survey, and they were followed for 7 years.

Outcome measures: First incidence of non-fatal CVD (heart disease or stroke).

Methods: Based on longitudinal data, Cox proportional hazards models were used to assess the effects of solid fuel use and persistent use on incidental CVD events.

Results: During the 7-year follow-up period, there were 1533 non-fatal CVD cases. A total of 7310 (54%) participants used solid fuel for cooking at the baseline survey, and 2998 (41%) users continued to use solid fuel. Solid fuel use was associated with incidental non-fatal CVD (HR: 1.18; 95% CI: 1.05 to 1.32) compared with clean fuel, and persistent solid fuel use might lead to a higher risk of incidental non-fatal CVD (HR: 1.38; 95% CI: 1.18 to 1.61) and heart disease (HR: 1.49; 95% CI: 1.24 to 1.81). In the subgroup analysis, the relationship remained significant in the female, elderly, rural and hypertensive groups. However, we found no significant interaction between these risk factors and fuel use (all p<0.05).

Conclusions: This cohort study provides evidence for the effects of solid fuel use on incidental non-fatal CVD in middle-aged and elderly Chinese adults. Advocating for the use of clean energy and ventilation stoves is important to cardiovascular health.

Keywords: Cardiac Epidemiology; Epidemiology; Health policy; Public health.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow chart of sample exclusion. CVD, cardiovascular disease.
Figure 2
Figure 2
Association between solid fuel use and non-fatal CVD event risk stratified by different factors. CVD, cardiovascular disease.
See this image and copyright information in PMC

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