Use Of Cooking Research Articles

Influence of the Socio-Economic Profile of the Head of Household on Domestic Energy Use for Cooking in the City of Uíge, Angola

The city of Uíge, capital of the province of Uíge in northern Angola, presents a diversity of lifestyles, socio-economic levels and domestic energy sources for cooking. The present study aimed to identify the different domestic energy sources used in cooking operations in households in the city of Uíge, both in urban and peri-urban areas, as well as the reasons for their choice. By means of a semi-structured survey, 384 heads of households residing in three neighborhoods of the city of Uíge were interviewed, 96 (Kituma), 192 (Papelão) and 96 (Popular No. 1). The majority of households in the city of Uíge are headed by men (75%), 77% in Papelão; 78% in Popular No. 1; 69% in Kituma. 98% of the men are literate, the majority having attended junior or senior-high school (50%) and higher education (34%). Only 84% of female heads of household are literate, 30% have attended junior-high school and 22% adult education. In addition, the majority (55%) of households in the city of Uíge use Liquefied Petroleum Gas (LPG) for cooking. LPG is the main source of domestic energy for public servants (79%) and traders (66%) in the city of Uíge. Firewood is the main (54%) source of domestic energy used by small farmer households. But, 79% of households headed by university students cook mainly with LPG. In addition, 67% of heads of households with senior-high school and 41% with junior-high school use LPG as their main source of household energy. On the other hand, about 60% of illiterate people use wood as their main source of energy. In contrast, none of the head of households with higher education level use firewood to prepare food. Moreover 68% of the respondents’ grill or roast with charcoal because it gives a better taste to the food and 25% of the respondents do so because of culinary or cultural habits. Charcoal is the main energy source (89%) for grilling and roasting. Households that cook with charcoal and firewood spend US$ 59.63 per month compared to US$ 13.24 for those who use LPG. Making modern commercial energy equipment available to all Angolan households would help low-income and poorly educated households to use the clean, modern energy they crave for cooking. Econometric studies should be conducted to estimate the correlation between household energy consumption and the number of inhabitants per household, for example.

Long-term solid fuel use and risks of major eye diseases in China: A population-based cohort study of 486,532 adults.

Over 3.5 billion individuals worldwide are exposed to household air pollution from solid fuel use. There is limited evidence from cohort studies on associations of solid fuel use with risks of major eye diseases, which cause substantial disease and economic burden globally. The China Kadoorie Biobank recruited 512,715 adults aged 30 to 79 years from 10 areas across China during 2004 to 2008. Cooking frequency and primary fuel types in the 3 most recent residences were assessed by a questionnaire. During median (IQR) 10.1 (9.2 to 11.1) years of follow-up, electronic linkages to national health insurance databases identified 4,877 incident conjunctiva disorders, 13,408 cataracts, 1,583 disorders of sclera, cornea, iris, and ciliary body (DSCIC), and 1,534 cases of glaucoma. Logistic regression yielded odds ratios (ORs) for each disease associated with long-term use of solid fuels (i.e., coal or wood) compared to clean fuels (i.e., gas or electricity) for cooking, with adjustment for age at baseline, birth cohort, sex, study area, education, occupation, alcohol intake, smoking, environmental tobacco smoke, cookstove ventilation, heating fuel exposure, body mass index, prevalent diabetes, self-reported general health, and length of recall period. After excluding participants with missing or unreliable exposure data, 486,532 participants (mean baseline age 52.0 [SD 10.7] years; 59.1% women) were analysed. Overall, 71% of participants cooked regularly throughout the recall period, of whom 48% used solid fuels consistently. Compared with clean fuel users, solid fuel users had adjusted ORs of 1.32 (1.07 to 1.37, p < 0.001) for conjunctiva disorders, 1.17 (1.08 to 1.26, p < 0.001) for cataracts, 1.35 (1.10 to 1.66, p = 0.0046) for DSCIC, and 0.95 (0.76 to 1.18, p = 0.62) for glaucoma. Switching from solid to clean fuels was associated with smaller elevated risks (over long-term clean fuel users) than nonswitching, with adjusted ORs of 1.21 (1.07 to 1.37, p < 0.001), 1.05 (0.98 to 1.12, p = 0.17), and 1.21 (0.97 to 1.50, p = 0.088) for conjunctiva disorders, cataracts, and DSCIC, respectively. The adjusted ORs for the eye diseases were broadly similar in solid fuel users regardless of ventilation status. The main limitations of this study include the lack of baseline eye disease assessment, the use of self-reported cooking frequency and fuel types for exposure assessment, the risk of bias from delayed diagnosis (particularly for cataracts), and potential residual confounding from unmeasured factors (e.g., sunlight exposure). Among Chinese adults, long-term solid fuel use for cooking was associated with higher risks of not only conjunctiva disorders but also cataracts and other more severe eye diseases. Switching to clean fuels appeared to mitigate the risks, underscoring the global health importance of promoting universal access to clean fuels.

Indoor solid fuel use for heating and cooking with blood pressure and hypertension: A cross-sectional study among middle-aged and older adults in China.

A cross-sectional study was conducted to investigate the impact of solid fuel use for heating and cooking on blood pressure (BP) and hypertension, using data from the China Health and Retirement Longitudinal Study (CHARLS). The primary fuels used for indoor heating and cooking were collected by questionnaires, respectively. Hypertension was defined based on self-report of physician's diagnosis, and/or measured BP, and/or anti-hypertensive medication use. Multivariate logistic regression models were constructed to assess the associations. Among 10450 eligible participants, 68.2% and 57.2% used indoor solid fuel for heating and cooking, respectively. Compared with none/clean fuel users, solid fuel for heating was associated with elevated BP (adjusted β: 2.02, 95% CI: 1.04-3.01 for systolic BP; adjusted β: 1.36, 95% CI: 0.78-1.94 for diastolic BP) and increased risk of hypertension (adjusted odds ratio: 1.15, 95% CI: 1.03-1.29). The impact of indoor solid fuel for heating on BP was more evident in rural and north residents, and hypertensive patients. We did not detect any significant associations between solid fuel use for cooking and BP/hypertension. Indoor solid fuel use is prevalent in China, especially in the rural areas. Its negative impact on BP suggested that modernization of household fuel use may help to reduce the burden of hypertension in China.

Association between household solid fuel use for cooking and sleep disturbance in rural China: findings from the China Kadoorie Biobank data

BackgroundSolid fuel use for cooking is a main source of household air pollution, particularly in rural China. Evidence on the association between household air pollution and sleep quality remains limited. This study aimed to examine the association between household solid fuels used for cooking and sleep disturbance. MethodsThe data of 283,170 adults from baseline survey of the China Kadoorie Biobank Study were included. Detailed information about exposure to solid fuels used for cooking were collected. Sleep disturbance was indicated as any of the three sleep disorders, including disorders of initiating and maintaining sleep, disorders of early morning awakening, and daytime dysfunction. Logistic regression analysis was used to examine the association between sleep disturbance and level of exposure to household solid fuels used for cooking. ResultsAbout 18% of participants reported sleep disturbance. Fully adjusted analysis indicated exposure to household solid fuels used for cooking was significantly associated with sleep disturbance. Compared to those with 0–3 years exposure (first tertile) to solid fuels used for cooking, the participants with 3–26 years exposure (second tertile) and >26 years exposure (third tertile) had greater odds of having sleep disturbance at 1.16 (95% CI: 1.12–1.19) and 1.33 (95% CI: 1.29–1.37) times, respectively. ConclusionsUse of household solid fuels is associated with prevalence of sleep disturbance; the longer duration of exposure to solid fuels use for cooking, the higher is the prevalence of sleep disturbance. Further study is warranted to examine the underlying mechanisms of the association.

An Ecohealth approach to energy justice: Evidence from Malawi’s energy transition from biomass to electrification

Decarbonisation is essential to limiting the electricity sector’s contributions to CO2 emissions. Simultaneously, there is recognition of the need to increase electricity access in many parts of sub-Saharan Africa, such as in Malawi, with renewable energies suggested as capable of meeting these needs. However, the drive for low carbon electrification, especially in settings where biomass use for cooking is widespread, may act as a driver of new and intersecting injustices. The energy justice framework is well posited to recognise injustices which emerge across energy supply chains, though existing analysis has typically focused on single energy systems. In order to capture injustices emerging in settings of dual biomass use and hydroelectricity generation, it is necessary to consider how energy systems impact on both human health (e.g. air pollution from biomass burning) and the functionality of ecosystems (through deforestation and resulting siltation of rivers). Thus, we argue for an Ecohealth approach to energy justice research, drawing on evidence from Malawi’s transition towards electrification.

Association between biomass fuel use and the risk of cognitive impairment among older populations in China: a population-based cohort study

BackgroundCohort studies on the impact of biomass fuel use for cooking on cognitive impairment among older population are still lacking in China and elsewhere. The aim of this study was to examine whether biomass fuel use for cooking is associated with cognitive impairment in Chinese adults aged 65 years or older.MethodsThe prospective population-based cohort study of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) included participants aged 65 years or older in 2014 who were followed-up until 2018 in 23 provinces in China. The Mini-Mental State Examination (MMSE) was used to assess cognitive function, and cognitive impairment was defined as total MMSE scores less than 18. The association between biomass fuel use and cognitive impairment was evaluated using the Cox proportional hazards model.ResultsOf the 4145 participants included at baseline, participants who reported that they used biomass fuel for cooking (40.43%; IR: 3.11 versus 2.77 per 100 person-years; aHR: 1.27, 95% CI: 1.02–1.58) had a higher risk of cognitive impairment compared with participants who used clean fuels (53.75%). A stratified analyses showed greater effect estimates of cognitive impairment in the older people that lived in the rural areas (aHR: 1.444, 95% CI: 1.08–3.90) and never smoked (aHR: 1.33, 95% CI: 1.04–1.71).ConclusionsThese findings demonstrated that biomass fuel used for cooking was associated with cognitive impairment, as defined by MMSE, in a population-based study of elderly in China. To prevent cognitive impairment, the structure of cooking fuels requires improvements.

Association between solid fuel use and cognitive decline among middle-aged and elderly Chinese adults: a longitudinal study

This study was conducted to investigate (1) the association between solid fuel use for cooking and cognitive function; (2) the moderating effects of gender and residential area on cognitive scores among solid fuel users; and (3) the effects of solid fuel use on cognitive decline among different gender and age subgroups in 2011–2018. A total of 5140 Chinese middle-aged and elderly participants were successfully followed for 7 years (2011–2018). Solid fuel use was self-reported as using solid fuel for cooking at home, and cognitive function was assessed by 4 parts: episodic memory, time orientation, numerical ability and picture drawing. After adjusting for covariates, solid fuel users had lower cognitive scores, and the moderation effects of gender and residence on cognitive function were significant among the solid fuel users. In addition, compared with the group of clean fuel users, solid fuel users had a faster decline rate of cognitive function among the subgroups of female and elderly people.

Potential of using an assistive technology to address meal preparation difficulties following acquired brain injury: clients’ and caregivers’ perspectives

Objectives This study explored difficulties in meal preparation experienced by adults with moderate to severe acquired brain injury (ABI) and available compensatory strategies from both ABI individuals’ and caregivers’ perspectives. Further, this study investigated their opinions on potential benefits, barriers and facilitators to the use of the Cognitive Orthosis for coOKing (COOK) in their living environment. Methods Using a qualitative descriptive approach, semi-structured individual interviews and focus groups were carried out with adults with moderate to severe ABI (n = 20) and formal and informal caregivers (n = 13) in Ontario and Quebec, Canada. A qualitative analysis based on Miles et al.’s approach was used. Results According to participants, cognitive, physical, psychosocial dysfunctions and lack of availability of supportive caregivers were the main difficulties that impede persons with ABI from engaging effectively in meal preparation tasks. Memory aids on smartphones, and caregivers’ direct support were reported as the most commonly used compensatory strategies, though the latter do not provide adequate support. COOK was identified as a technology with great potential to improve independence and increase safety in meal preparation for these clients while decreasing caregiver burden. However, psychosocial issues and limited access to funding were considered as the main barriers to the use of COOK. Providing training and the availability of financial support were mentioned as the main facilitators to the use of this technology. Conclusions Findings of this study on difficulties of meal preparation following ABI and potential benefits and barriers of COOK will help improve this technology and customize it to the needs of clients with ABI and their caregivers. Implications for Rehabilitation Current compensatory strategies are not tailored to the specific needs of clients with ABI and cannot provide sufficient support for caregivers. COOK shows a high potential for increasing independence and safety during meal preparation in a living environment for clients with ABI via a sensor-based autonomous safety system and a cognitive assistance application. COOK has the potential to decrease caregivers’ burden by proving remote access to a stove/oven.

Sex difference in the association between solid fuel use and cognitive function in rural China

BackgroundWhether indoor air pollution from solid fuel use is associated with cognitive function remains unclear. ObjectiveThis study aims to examine the association of solid fuel use with the risk of cognitive impairment in males and females. MethodsThe data was from the China Health and Retirement Longitudinal Study (CHARLS). Self-reported heating and cooking fuel were categorized as clean fuel (solar, liquefied gas, natural gas, or electricity) and solid fuel (coal, biomass charcoal, wood, or straw). Cognitive function, including orientation and attention, episodic memory, and visuospatial abilities, was assessed using standardized questionnaires. ResultsA total of 7824 individuals were included in our study (aged 57.0 ± 9.3, 46.2% female), with 47.0% and 76.0% used solid fuel for cooking and heating, respectively. There was an interaction between sex and solid fuel use for cooking (P=0.008) for the progress of cognitive impairment. Solid fuel use for cooking was associated with a larger decrease in cognitive function score in females (β=−0.832; 95% CI: −1.043, −0.622; P < 0.001) than in males (β=−0.487; 95% CI: −0.671, −0.302; P < 0.001). The sex difference remained with further adjustment of covariates (β=−0.321; 95% CI: −0.503, −0.138; P=0.001 for males; β=−0.534; 95% CI: −0.745, −0.324; P < 0.001 for females). For heating, the interaction between sex and solid fuel was not statistically significant (P=0.156). After controlling for the covariates, solid fuel use for heating was inversely associated with a 0.321 unit of decrease of cognitive function score (β=−0.321; 95% CI: −0.652, 0.009; P=0.057) in males, and a 0.598 unit of decrease of cognitive function (β=−0.598; 95% CI: −0.978, −0.218; P=0.002) in females. ConclusionIn conclusion, solid fuel use for cooking and heating was significantly associated with a higher risk of cognitive impairment. Furthermore, for the first time, we found that the effect of solid fuel use on cognitive function in females was greater than in males.

A Systematic Review and Appraisal of Epidemiological Studies on Household Fuel Use and Its Health Effects Using Demographic and Health Surveys.

The domestic combustion of polluting fuels is associated with an estimated 3 million premature deaths each year and contributes to climate change. In many low- and middle-income countries (LMICs), valid and representative estimates of people exposed to household air pollution (HAP) are scarce. The Demographic and Health Survey (DHS) is an important and consistent source of data on household fuel use for cooking and has facilitated studies of health effects. However, the body of research based on DHS data has not been systematically identified, nor its strengths and limitations critically assessed as a whole. We aimed to systematically review epidemiological studies using DHS data that considered cooking fuel type as the main exposure, including the assessment of the extent and key drivers of bias. Following PRISMA guidelines, we searched PubMed, Web of Science, Scopus and the DHS publication portal. We assessed the quality and risk of bias (RoB) of studies using a novel tool. Of 2748 records remaining after removing duplicates, 63 were read in full. A total of 45 out of 63 studies were included in our review, spanning 11 different health outcomes and representing 50 unique analyses. In total, 41 of 45 (91%) studies analysed health outcomes in children <5 years of age, including respiratory infections (n = 17), death (all-cause) (n = 14), low birthweight (n = 5), stunting and anaemia (n = 5). Inconsistencies were observed between studies in how cooking fuels were classified into relatively high- and low-polluting. Overall, 36/50 (80%) studies reported statistically significant adverse associations between polluting fuels and health outcomes. In total, 18/50 (36%) of the analyses were scored as having moderate RoB, while 16/50 (32%) analyses were scored as having serious or critical RoB. Although HAP exposure assessment is not the main focus of the DHS, it is the main, often only, source of information in many LMICs. An appreciable proportion of studies using it to analyse the association between cooking fuel use and health have potential for high RoB, mostly related to confounder control, exposure assessment and misclassification, and outcome ascertainment. Based on our findings, we provide some suggestions for ways in which revising the information collected by the DHS could make it even more amenable to studies of household fuel use and health, and reduce the RoB, without being onerous to collect and analyse.

A Review of Cooking Systems and Energy Efficiencies

Accessing affordable and reliable energy services for cooking is important in most developing countries. Improving access to affordable energy reduces effects on human health and environmental influences caused by burning of various biomasses. This review examines the energy resources available in the world and their use in cooking. It also looks at challenges and the ways these energy resources are used as well as possible solutions to such challenges. The major challenges facing the use of available fuels are low efficiencies, high cost, un-sustainability and indoor house pollution that affect many people. The paper has identified that the use of combustion-less cooking, the use of solar for cooking, hydrogen and electrical systems that improve cooking activities and therefore overcome indoor and environmental pollution. Research findings indicate that the pressure-cooking concept improves energy efficiencies in boiling operations. Other energy efficiency improvement techniques in cooking are insulation, containment of escaping steam while cooking and automating the cooking vessel with micro-controllers. The overall efficiencies for electrical induction heating, natural gas, traditional cooking stoves, fuel wood stoves and electrical resistive heating was found to be 90%, 45-60%, 10%, 23-40% and 75% respectively. Induction cooking is both faster and more efficient than gas cooking, while electrical energy systems as a whole were found to be the cleanest, offering ease of control and versatility. The combination of a micro-controller automated insulated pressure cooker and induction cooker can highly improve the cooking efficiency. This is done by cutting a power supply using a relay controlling an induction cooker and therefore preventing the exit of steam. It is therefore identified that zero emission release during cooking will reduce both indoor and environmental pollution significantly.

Исследования по изучению улучшения растворимости при разработке лекарственной формы с метионином и экстрактом куркумы длинной (Curcuma Longa)

Introduction. Turmeric (Curcuma longa) is a medicinal plant and seasoning in Asia. Curcumin (diferuloylmethane) is the main active ingredient; a hydrophobic bioactive component contains in the rhizomes of turmeric (Curcuma longa). In recent years, curcumin has attracted tremendous attention not only for its use in cooking, but also for pleiotropic biological and pharmacological effects. However, its poor water solubility, low bioavailability and rapid metabolism are serious disadvantages for implementation in therapeutic practice. Therefore, researchers are attempting to increase the biological and pharmacological activity of curcumin using effective delivery systems and the addition of bioenhancers. Aim. Generalization and analysis of data presented in the databases PubMed, Web of science, Scopus, Google Scholar on methods of increasing the solubility and bioavailability of curcumin in the development of pharmaceutical compositions based on it. Materials and methods. Materials and methods. The object of research and search in the PubMed, Web of science, Scopus, Google Scholar databases was the substance curcumin, obtained from plant raw materials of long turmeric (Curcuma longa). We analyzed the data presented in the open press for the last 20 years (2000-2021), the request included indicators of the solubility and bioavailability of curcumin in vitro and in vivo. Conclusion. Various pharmaceutical studies of the use of oral combinations, including solid dispersions, nano/microparticles, polymer micelles, nanosuspensions, lipid-based nanocarriers, cyclodextrins, conjugates, have been developed to improve the oral bioavailability of curcumin. They have been shown to increase the solubility of curcumin, improve intestinal stability, and alter the absorption pathway.

Sub-multiplicative interaction between polygenic risk score and household coal use in relation to lung adenocarcinoma among never-smoking women in Asia

We previously identified 10 lung adenocarcinoma susceptibility loci in a genome-wide association study (GWAS) conducted in the Female Lung Cancer Consortium in Asia (FLCCA), the largest genomic study of lung cancer among never-smoking women to date. Furthermore, household coal use for cooking and heating has been linked to lung cancer in Asia, especially in Xuanwei, China. We investigated the potential interaction between genetic susceptibility and coal use in FLCCA. We analyzed GWAS-data from Taiwan, Shanghai, and Shenyang (1472 cases; 1497 controls), as well as a separate study conducted in Xuanwei (152 cases; 522 controls) for additional analyses. We summarized genetic susceptibility using a polygenic risk score (PRS), which was the weighted sum of the risk-alleles from the 10 previously identified loci. We estimated associations between a PRS, coal use (ever/never), and lung adenocarcinoma with multivariable logistic regression models, and evaluated potential gene-environment interactions using likelihood ratio tests. There was a strong association between continuous PRS and lung adenocarcinoma among never coal users (Odds Ratio (OR) = 1.69 (95% Confidence Interval (CI) = 1.53, 1.87), p=1 × 10−26). This effect was attenuated among ever coal users (OR = 1.24 (95% CI: 1.03, 1.50), p = 0.02, p-interaction = 6 × 10−3). We observed similar attenuation among coal users from Xuanwei. Our study provides evidence that genetic susceptibility to lung adenocarcinoma among never-smoking Asian women is weaker among coal users. These results suggest that lung cancer pathogenesis may differ, at least partially, depending on exposure to coal combustion products. Notably, these novel findings are among the few instances of sub-multiplicative gene-environment interactions in the cancer literature.

Longitudinal associations between household solid fuel use and depression in middle-aged and older Chinese population: A cohort study

BackgroundPrevious studies found that ambient air pollution was associated with a higher prevalence of depressive symptoms. However, the longitudinal associations between household solid fuel use, which is the main source of household air pollution, and depressive symptoms remain unclear. This cohort study aimed to explore the associations between household solid fuel use and incidence of depressive symptoms in China. MethodsIn total, 8637 participants were enrolled in this prospective cohort study. Depressive symptoms were assessed using the 10-item Center for Epidemiological Studies Depression Scale. The associations between baseline household solid fuel use and the incidence of depressive symptoms were examined using Cox proportional hazards regression models. ResultsDuring the 4-year of follow-up, 2074 of 8637 participants developed depressive symptoms. Compared with participants who used clean fuel for both heating and cooking, the multivariate-adjusted hazard ratio (HR) (95% confidence intervals [95% CI]) for depressive symptoms incidence in participants who used solid fuels for two purposes (cooking and heating) was 1.15 (1.01, 1.31). In the solid fuel use subgroup analysis, use of solid fuels for cooking (HR, 1.12; 95% CI, 1.02–1.24) was associated with a higher incidence of depressive symptoms after adjustments while use for heating (HR, 1.05; 95% CI, 0.93–1.18) was not. Moreover, compared with persistent solid fuel users, switching from solid to clean fuels for cooking resulted in a lower risk of depressive symptoms before adjustments (HR, 0.82; 95% CI, 0.71–0.95) and a non-significant association (HR, 0.90; 95% CI, 0.77–1.04) afterwards. ConclusionsThe results suggest that household solid fuel use for cooking was associated with a higher incidence of depressive symptoms. Preventive strategies based on improving household cooking environment for depressive symptoms should be established.

A strategic model to identify the factors and risks of solar cooker manufacturing and use: A case study of Razavi Khorasan, Iran

Solar energy is the Earth's primary source of energy and the most widely available source of renewable energy. Its use in cooking is just one of its numerous applications and benefits. By concentrating solar energy into a small area, a solar cooker is capable of generating sufficient heat to cook, pasteurise and sterilise food items. This paper aims to identify factors affecting solar cooker 1) manufacturing and development and 2) project implementation in the Razavi Khorasan province of Iran. The necessary data was collected via an expert panel and a questionnaire. Confirmatory factor analysis (CFA) showed that factors such as Capital, Financial support, Economy, Technology and infrastructure, and Interactions directly impacted the successful promotion of solar cookers in Iran. While all these factors affected solar cooker development positively, Interactions had the most profoundly positive influence. The results of this research would benefit solar cooker manufacturers and users either living in the region and in other suitable locations.

Household solid fuel use and peak expiratory flow in middle-aged and older adults in China: A large cohort study (2011–2015)

Indoor air pollution caused by solid fuel use in cooking and heating in China is common. The relationship between household solid fuel use and peak expiratory flow (PEF) in middle-aged and older adults in China has not been clarified. The aim of this study was to assess the relationship between long-term household solid fuel use (clean for both cooking and heating, solid for either cooking or heating, and solid for both cooking and heating) and PEF changes in middle-aged and older adults using a nationally representative prospective cohort. Covariance analysis was used to compare PEF changes in different indoor air pollution exposure groups. Separate analysis of cooking and heating as well as sub-group analyses by age, sex and smoking status were conducted, linear mixed growth model analysis was used to evaluate the association between cooking fuel type and PEF. A total of 6818 participants were enrolled in the cohort analysis. Results revealed that solid fuel use in cooking and heating separately or conjointly were associated with reduced PEF (solid fuel use in cooking: least square mean [LSM] = 19.9, 95% confidence interval [CI]: 11.5–28.2, P = 0.03; solid fuel use in heating: LSM = 19.4, 95% CI:11.2–27.5, P = 0.04; both solid fuel use: LSM = 17.6, 95% CI: 9.3–25.9, P for trend <0.0001), especially in participants aged >65 years (LSM = −9.22, 95% CI: 27.9–69.52, P for trend <0.0001), females (LSM = −6.41, 95% CI: 19.12–6.30, P for trend <0.0001) and current or former smokers (LSM = −21.55, 95% CI: 36.14 to −6.97, P < 0.02). Compared to that of participants using clean fuels for cooking, PEF of participants using solid fuels were decreased by 3.5 l/min per 2 years over a 4-year follow-up. This cohort study highlights the adverse effects of indoor air pollution on lung function in middle aged and older adults in China.

Association between solid fuel use and cognitive impairment: A cross-sectional and follow-up study in a middle-aged and older Chinese population

BackgroundTo date, few studies have focused on the influence of indoor air pollution on cognitive impairment. Thus, we aimed to explore the association of household fuel use, the major cause of household air pollution, with cognitive functioning among a sample of middle-aged and older Chinese individuals. MethodsA total of 10,372 and 8,397 participants from the China Health and Retirement Longitudinal Study (CHARLS) were enrolled in the cross-sectional and follow-up analyses, respectively. Cognitive functioning was evaluated via a structured questionnaire in three dimensions: orientation and attention, episodic memory, and visuo-construction. The associations between household solid fuel use (for cooking and heating) and cognitive functioning were elucidated by generalized linear models. Furthermore, we explored the combined effect of solid fuel use in cooking and heating and examined the effects of switching cooking fuel types on a 4-year change in cognitive functioning. ResultsIn the cross-sectional study, solid fuel use for cooking or heating, separately or simultaneously, was positively associated with cognitive impairment, after adjusting for potential confounders. Similarly, in the follow-up study, solid cooking fuel use was associated with a greater decline in cognitive score overall (β = −0.24, 95% confidence interval [CI]: −0.45, −0.04), mostly in the episodic memory (β = −0.19, 95% CI: −0.34, −0.03) and visuo-construction (β = −0.03, 95% CI: −0.05, −0.01) dimensions; solid heating fuel use was associated only with a greater decrease in the orientation and attention dimension (β = −0.13, 95% CI: −0.25, −0.01). A combined effect of household fuel use was also observed (P < 0.05). Moreover, subjects who switched from solid to cleaner cooking fuel displayed a significantly lower degree of cognitive decline for all dimensions than did persistent solid fuel users over a 4-year period (P < 0.05). ConclusionOur findings show that household solid fuel use is a risk factor for the development of cognitive impairment. Improving the structure of cooking fuel may therefore have great public health value for the prevention of cognitive impairment.

Associations of household solid fuel for heating and cooking with hypertension in Chinese adults.

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.

Potential advantages, barriers, and facilitators of implementing a cognitive orthosis for cooking for individuals with traumatic brain injury: the healthcare providers’ perspective

Purpose Considering the key role of health care providers in integrating assistive technologies into clinical settings (e.g., in/outpatient rehabilitation) and home, this study explored the care providers’ perspectives on benefits, barriers and facilitators to the implementation of the Cognitive Orthosis for coOking (COOK) for adults with traumatic brain injury (TBI) within clinical contexts and homes. Methods Using a qualitative descriptive approach, semi-structured individual interviews and focus groups were carried out with experienced care providers of adults with TBI (n = 30) in Ontario-Canada. Qualitative analysis based on the Miles et al approach was used. Results According to the participants, COOK could potentially be used with individuals with cognitive impairments (TBI and non-TBI) to increase safety and independence in meal preparation and support healthcare providers. However, limited access to funding, clients’ lack of motivation/knowledge, and the severity of their cognitive and motor impairments were perceived as potential barriers. Facilitators to the use of COOK include training sessions, availability of private/provincial financing, and comprehensive assessments by a clinical team prior to use. Conclusions Health care providers’ perspectives will help develop implementation strategies to facilitate the adoption of COOK within homes and clinical contexts for individuals with TBI and improve the next version of this technology. IMPLICATIONS FOR REHABILITATION COOK shows a high potential for increasing independence and safety during meal preparation with its sensor-based monitoring of the environment and cognitive-based assistance, for adults with TBI. Comprehensive clinical assessments to identify individuals’ therapeutic goals, clinical characteristics, and living environments are necessary to facilitate the deployment of COOK.

Household Air Pollution (HAP) and Esophageal Squamous Cell Carcinoma: findings from a case-control study in Western Kenya

Background/Aim. Esophageal Cancer (EC) is the most common cancer in Kenya with age standardised rates of 17.6 per 100,000 in both sexes, compared to 5.9 worldwide. Traditional risk factors (e.g. smoking and alcohol) are less prevalent in women. Exposure to HAP from solid fuel combustion may be part of the aetiology in this part of the population. Here, we test this hypothesis using data from a large case control study of EC conducted in Eldoret, Kenya.Methods. A total of 430 cases and 440 age- and sex- frequency matched controls were recruited between 2014 and 2018 from Moi Teaching and Referral hospital. Risk factor profiles were collected (including on fuel use, and exposure to HAP from cooking and heating) along with biospecimens (urinary polycyclic aromatic hydrocarbons (PAHs)).Results. Fire wood was the most prevalent fuel (n=393; 91.8% in cases and n=360; 82.4% in controls). A higher proportion of cases reported sleeping by the fire all year as a child (n=27; 6.3%) than controls (n=15; 3.4%). Use of firewood as the main cooking fuel was associated with an almost 2-fold increased risk of EC (OR=1.89, 95% CI 1.16-3.28). Sleeping by the fire all year as a child was associated with more than a doubling in risk of EC (OR=2.21, 95% CI=1.01-5.08). Levels of urinary PAHs were higher in healthy women (mean =2.78; sd=5.53) than men (1.67; sd=3.76) (p=0.02) and also in those who report being the main cook in the household (mean=3.43; sd=7.49) than those who did not (mean = 1.84; sd= 3.77) although not significantly (p=0.09).Conclusions. These results are indicative that HAP from biomass use for cooking and heating is potentially associated in the aetiology of EC. Given their higher exposure due to traditional domestic duties, the HAP-associated risk might be greater in women.