Abstract
The association between indoor air pollution resulting from household solid fuel use for heating and cooking with hypertension or blood pressure (BP) remains less clear. This study aims to rectify these knowledge gaps in a large Chinese population. During 2005-2009, 44 007 individuals aged 35-70 years with complete information on household solid fuel use for cooking and heating were recruited from 279 urban and rural communities of 12 centers. Solid fuel referred to charcoal, coal, wood, agriculture crop, animal dung or shrub. Annual concentration of ambient atmospheric particulate matter that have a diameter of less than 2.5 μm for all communities was collected. Generalized linear mixed models using community as the random effect were performed to estimate the association with hypertension prevalence or BP after considering ambient atmospheric particulate matter that have a diameter of less than 2.5 μm and a comprehensive set of potential confounding factors at the individual and household level. A total of 47.6 and 61.2% of participants used household solid fuel for heating and cooking, respectively. Solid fuel use for heating was not associated with an increase in hypertension prevalence (adjusted odds ratio = 1.08, 95% confident interval: 0.98, 1.20) or elevated SBP (0.62 mmHg, 95% confident interval: -0.24, 1.48). No association was found between solid fuel for cooking and hypertension or BP, and no additional risk was observed among participants who had both exposures to solid fuel for heating and cooking compared with those used for heating only. The current large Chinese study revealed a statistically insignificant increase in the association between solid fuel use for heating and hypertension prevalence or BP. As this cross-sectional study has its inherent limitation on causality, findings from this study would have to be confirmed by prospective cohort studies.
Highlights
Indoor air pollution resulting from burning fuels for heating and cooking has been a major public health problem in China and other developing countries for decades [1,2,3]
A study examining 137,809 individuals from ten countries in the Prospective Urban and Rural Epidemiology (PURE) study observed no association between cooking with solid fuels and hypertension or blood pressure [9]
Only two cross-sectional studies conducted in China have examined the association between using household solid fuels and hypertension prevalence and reported a positive association [15, 16], but both of them were not distinguish the effect of cooking from heating, or the combined effect of using solid fuels for heating and cooking
Summary
Indoor air pollution resulting from burning fuels for heating and cooking has been a major public health problem in China and other developing countries for decades [1,2,3]. Burning fuels for heating in winter or rainy season is especially common in many northern rural areas of China [4, 5], which generates large amounts of particulate matter (e.g., PM2.5, PM10), carbon monoxide nitrogen dioxide, sulfur dioxide, polycyclic aromatic hydrocarbons and/or other volatile organic compounds [6, 7]. Many of these chemical substances are known to increase oxidative stress and systematic inflammation, and could potentially increase blood pressure (BP) and promote vascular atherosclerosis [7, 8]. The aim of this study is to investigate the association of household solid fuel for heating and cooking with hypertension prevalence in a large diverse Chinese population
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