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

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...

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Autores principales: Hystad, Perry, Duong, MyLinh, Brauer, Michael, Larkin, Andrew, Arku, Raphael, Kurmi, Om P., Fan, Wen Qi, Avezum, Alvaro, Azam, Igbal, Chifamba, Jephat, Dans, Antonio, du Plessis, Johan L., Gupta, Rajeev, Kumar, Rajesh, Lanas, Fernando, Liu, Zhiguang, Lu, Yin, Lopez-Jaramillo, Patricio, Mony, Prem, Mohan, Viswanathan, Mohan, Deepa, Nair, Sanjeev, Puoane, Thandi, Rahman, Omar, Lap, Ah Tse, Wang, Yanga, Wei, Li, Yeates, Karen, Rangarajan, Sumathy, Teo, Koon, Yusuf, Salim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Environmental Health Perspectives 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6791569/
https://www.ncbi.nlm.nih.gov/pubmed/31067132
http://dx.doi.org/10.1289/EHP3915
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author Hystad, Perry
Duong, MyLinh
Brauer, Michael
Larkin, Andrew
Arku, Raphael
Kurmi, Om P.
Fan, Wen Qi
Avezum, Alvaro
Azam, Igbal
Chifamba, Jephat
Dans, Antonio
du Plessis, Johan L.
Gupta, Rajeev
Kumar, Rajesh
Lanas, Fernando
Liu, Zhiguang
Lu, Yin
Lopez-Jaramillo, Patricio
Mony, Prem
Mohan, Viswanathan
Mohan, Deepa
Nair, Sanjeev
Puoane, Thandi
Rahman, Omar
Lap, Ah Tse
Wang, Yanga
Wei, Li
Yeates, Karen
Rangarajan, Sumathy
Teo, Koon
Yusuf, Salim
author_facet Hystad, Perry
Duong, MyLinh
Brauer, Michael
Larkin, Andrew
Arku, Raphael
Kurmi, Om P.
Fan, Wen Qi
Avezum, Alvaro
Azam, Igbal
Chifamba, Jephat
Dans, Antonio
du Plessis, Johan L.
Gupta, Rajeev
Kumar, Rajesh
Lanas, Fernando
Liu, Zhiguang
Lu, Yin
Lopez-Jaramillo, Patricio
Mony, Prem
Mohan, Viswanathan
Mohan, Deepa
Nair, Sanjeev
Puoane, Thandi
Rahman, Omar
Lap, Ah Tse
Wang, Yanga
Wei, Li
Yeates, Karen
Rangarajan, Sumathy
Teo, Koon
Yusuf, Salim
author_sort Hystad, Perry
collection PubMed
description 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. DISCUSSION: Use of solid fuels for cooking is a risk factor for mortality and cardiorespiratory disease. Continued efforts to replace solid fuels with cleaner alternatives are needed to reduce premature mortality and morbidity in developing countries. https://doi.org/10.1289/EHP3915
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spelling pubmed-67915692019-11-01 Health Effects of Household Solid Fuel Use: Findings from 11 Countries within the Prospective Urban and Rural Epidemiology Study Hystad, Perry Duong, MyLinh Brauer, Michael Larkin, Andrew Arku, Raphael Kurmi, Om P. Fan, Wen Qi Avezum, Alvaro Azam, Igbal Chifamba, Jephat Dans, Antonio du Plessis, Johan L. Gupta, Rajeev Kumar, Rajesh Lanas, Fernando Liu, Zhiguang Lu, Yin Lopez-Jaramillo, Patricio Mony, Prem Mohan, Viswanathan Mohan, Deepa Nair, Sanjeev Puoane, Thandi Rahman, Omar Lap, Ah Tse Wang, Yanga Wei, Li Yeates, Karen Rangarajan, Sumathy Teo, Koon Yusuf, Salim Environ Health Perspect Research 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. DISCUSSION: Use of solid fuels for cooking is a risk factor for mortality and cardiorespiratory disease. Continued efforts to replace solid fuels with cleaner alternatives are needed to reduce premature mortality and morbidity in developing countries. https://doi.org/10.1289/EHP3915 Environmental Health Perspectives 2019-05-08 /pmc/articles/PMC6791569/ /pubmed/31067132 http://dx.doi.org/10.1289/EHP3915 Text en EHP is an open-access journal published with support from the National Institute of Environmental Health Sciences, National Institutes of Health. All content is public domain unless otherwise noted.
spellingShingle Research
Hystad, Perry
Duong, MyLinh
Brauer, Michael
Larkin, Andrew
Arku, Raphael
Kurmi, Om P.
Fan, Wen Qi
Avezum, Alvaro
Azam, Igbal
Chifamba, Jephat
Dans, Antonio
du Plessis, Johan L.
Gupta, Rajeev
Kumar, Rajesh
Lanas, Fernando
Liu, Zhiguang
Lu, Yin
Lopez-Jaramillo, Patricio
Mony, Prem
Mohan, Viswanathan
Mohan, Deepa
Nair, Sanjeev
Puoane, Thandi
Rahman, Omar
Lap, Ah Tse
Wang, Yanga
Wei, Li
Yeates, Karen
Rangarajan, Sumathy
Teo, Koon
Yusuf, Salim
Health Effects of Household Solid Fuel Use: Findings from 11 Countries within the Prospective Urban and Rural Epidemiology Study
title Health Effects of Household Solid Fuel Use: Findings from 11 Countries within the Prospective Urban and Rural Epidemiology Study
title_full Health Effects of Household Solid Fuel Use: Findings from 11 Countries within the Prospective Urban and Rural Epidemiology Study
title_fullStr Health Effects of Household Solid Fuel Use: Findings from 11 Countries within the Prospective Urban and Rural Epidemiology Study
title_full_unstemmed Health Effects of Household Solid Fuel Use: Findings from 11 Countries within the Prospective Urban and Rural Epidemiology Study
title_short Health Effects of Household Solid Fuel Use: Findings from 11 Countries within the Prospective Urban and Rural Epidemiology Study
title_sort health effects of household solid fuel use: findings from 11 countries within the prospective urban and rural epidemiology study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6791569/
https://www.ncbi.nlm.nih.gov/pubmed/31067132
http://dx.doi.org/10.1289/EHP3915
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