Health Effects of Household Solid Fuel Use: Findings from 11 Countries within the Prospective Urban and Rural Epidemiology Study

Hystad, Perry and Duong, MyLinh and Brauer, Michael and Larkin, Andrew and Arku, Raphael and Kurmi, Om P. and Fan, Wen Qi and Avezum, Alvaro and Azam, Igbal and Chifamba, Jephat and Dans, Antonio and du Plessis, Johan L. and Gupta, Rajeev and Kumar, Rajesh and Lanas, Fernando and Liu, Zhiguang and Lu, Yin and Lopez-Jaramillo, Patricio and Mony, Prem and Mohan, V and Mohan, Deepa and Nair, Sanjeev and Puoane, Thandi and Rahman, Omar and Lap, Ah Tse and Wang, Yanga and Wei, Li and Yeates, Karen and Rangarajan, Sumathy and Teo, Koon and Yusuf, Salim (2019) Health Effects of Household Solid Fuel Use: Findings from 11 Countries within the Prospective Urban and Rural Epidemiology Study. Environmental Health Perspectives, 127 (5). 057003. ISSN 0091-6765



BACKGROUND: Household air pollution (HAP) from solid fuel use for cooking affects 2.5 billion individuals globally and may contribute substantially to disease burden. However, few prospective studies have assessed the impact of HAP on mortality and cardiorespiratory disease. OBJECTIVES: Our goal was to evaluate associations between HAP and mortality, cardiovascular disease (CVD), and respiratory disease in the prospective urban and rural epidemiology (PURE) study. METHODS: We studied 91,350 adults 35–70 y of age from 467 urban and rural communities in 11 countries (Bangladesh, Brazil, Chile, China, Colombia, India, Pakistan, Philippines, South Africa, Tanzania, and Zimbabwe). After a median follow-up period of 9.1 y, we recorded 6,595 deaths, 5,472 incident cases of CVD (CVD death or nonfatal myocardial infarction, stroke, or heart failure), and 2,436 incident cases of respiratory disease (respiratory death or nonfatal chronic obstructive pulmonary disease, pulmonary tuberculosis, pneumonia, or lung cancer). We used Cox proportional hazards models adjusted for individual, household, and community-level characteristics to compare events for individuals living in households that used solid fuels for cooking to those using electricity or gas. RESULTS: We found that 41.8% of participants lived in households using solid fuels as their primary cooking fuel. Compared with electricity or gas, solid fuel use was associated with fully adjusted hazard ratios of 1.12 (95% CI: 1.04, 1.21) for all-cause mortality, 1.08 (95% CI: 0.99, 1.17) for fatal or nonfatal CVD, 1.14 (95% CI: 1.00, 1.30) for fatal or nonfatal respiratory disease, and 1.12 (95% CI: 1.06, 1.19) for mortality from any cause or the first incidence of a nonfatal cardiorespiratory outcome. Associations persisted in extensive sensitivity analyses, but small differences were observed across study regions and across individual and household characteristics.

Item Type:Article
Official URL/DOI:
Uncontrolled Keywords:PURE
Subjects:Diabetes Epidemiology
Divisions:Department of Epidemiology
Department of Diabetology
ID Code:1164
Deposited By:surendar radha
Deposited On:04 Feb 2020 11:50
Last Modified:04 Feb 2020 11:50

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