Ischaemic heart disease and stroke mortality by specific coal type among non-smoking women with substantial indoor air pollution exposure in China
Abstract Background Lifetime use of bituminous (‘smoky’) coal is associated with nearly a 100-fold higher risk of lung cancer mortality compared with anthracite (‘smokeless’) coal use in rural Xuanwei, China, among women. Risk of mortality from ischaemic heart disease (IHD) and stroke for these coal...
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| Veröffentlicht in: | International journal of epidemiology 2020-02, Vol.49 (1), p.56-68 |
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| creator | Bassig, Bryan A Dean Hosgood, H Shu, Xiao-Ou Vermeulen, Roel Chen, Bingshu E Katki, Hormuzd A Seow, Wei Jie Hu, Wei Portengen, Lützen Ji, Bu-Tian Wong, Jason Y Y Ning, Bofu Downward, George S Li, Jihua Yang, Kaiyun Yang, Gong Gao, Yu-Tang Xiang, Yong-Bing Nagaradona, Teja Zheng, Wei Silverman, Debra T Huang, Yunchao Lan, Qing |
| description | Abstract
Background
Lifetime use of bituminous (‘smoky’) coal is associated with nearly a 100-fold higher risk of lung cancer mortality compared with anthracite (‘smokeless’) coal use in rural Xuanwei, China, among women. Risk of mortality from ischaemic heart disease (IHD) and stroke for these coal types has not been evaluated.
Methods
A cohort of 16 323 non-smoking women in Xuanwei, who were lifetime users of either smoky or smokeless coal, were followed up from 1976 to 2011. We estimated hazard ratios (HRs) and 95% confidence intervals (CI) to evaluate lifetime use of coal types and stoves in the home in relation to risk of IHD and stroke mortality.
Results
Among lifetime users of smokeless coal, higher average exposure intensity (≥4 tons/year vs |
| doi_str_mv | 10.1093/ije/dyz158 |
| format | Article |
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Background
Lifetime use of bituminous (‘smoky’) coal is associated with nearly a 100-fold higher risk of lung cancer mortality compared with anthracite (‘smokeless’) coal use in rural Xuanwei, China, among women. Risk of mortality from ischaemic heart disease (IHD) and stroke for these coal types has not been evaluated.
Methods
A cohort of 16 323 non-smoking women in Xuanwei, who were lifetime users of either smoky or smokeless coal, were followed up from 1976 to 2011. We estimated hazard ratios (HRs) and 95% confidence intervals (CI) to evaluate lifetime use of coal types and stoves in the home in relation to risk of IHD and stroke mortality.
Results
Among lifetime users of smokeless coal, higher average exposure intensity (≥4 tons/year vs <2.5 tons/year, HR = 7.9, 95% CI = 3.5–17.8; Ptrend =<0.0001) and cumulative exposure (>64 ton-years vs ≤28 ton-years, HR = 6.5, 95% CI = 1.5–28.3; Ptrend =0.003) during follow-up and over their lifetime was associated with increased IHD mortality, and ventilated stove use dramatically reduced this risk (HR = 0.2, 95% CI 0.1–0.5). Higher cumulative exposure to smoky coal during follow-up showed positive associations with IHD mortality, but the evidence for other metrics was less consistent compared with associations with smokeless coal use.
Conclusions
Higher use of smokeless coal, which is burned throughout China and is generally regarded to be a cleaner fuel type, is associated with IHD mortality. Use of cleaner fuels or stove interventions may be effective in reducing the increasing burden of IHD in developing regions that currently rely on smokeless coal for cooking and heating.</description><identifier>ISSN: 0300-5771</identifier><identifier>EISSN: 1464-3685</identifier><identifier>DOI: 10.1093/ije/dyz158</identifier><identifier>PMID: 31377785</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Adult ; Air Pollution ; Air Pollution, Indoor - adverse effects ; China - epidemiology ; Coal - adverse effects ; Cooking ; Female ; Heating - adverse effects ; Humans ; Middle Aged ; Myocardial Ischemia - etiology ; Myocardial Ischemia - mortality ; Proportional Hazards Models ; Rural Population ; Stroke - etiology ; Stroke - mortality</subject><ispartof>International journal of epidemiology, 2020-02, Vol.49 (1), p.56-68</ispartof><rights>Published by Oxford University Press on behalf of the International Epidemiological Association 2019. This work is written by US Government employees and is in the public domain in the US. 2019</rights><rights>Published by Oxford University Press on behalf of the International Epidemiological Association 2019. This work is written by US Government employees and is in the public domain in the US.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c408t-db6426dd5c3eb98d59c0d3f2130231e03317656912479ecc7b3728678f0633a33</citedby><cites>FETCH-LOGICAL-c408t-db6426dd5c3eb98d59c0d3f2130231e03317656912479ecc7b3728678f0633a33</cites><orcidid>0000-0003-1226-070X ; 0000-0003-4082-8163 ; 0000-0002-0711-8314</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,1584,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31377785$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bassig, Bryan A</creatorcontrib><creatorcontrib>Dean Hosgood, H</creatorcontrib><creatorcontrib>Shu, Xiao-Ou</creatorcontrib><creatorcontrib>Vermeulen, Roel</creatorcontrib><creatorcontrib>Chen, Bingshu E</creatorcontrib><creatorcontrib>Katki, Hormuzd A</creatorcontrib><creatorcontrib>Seow, Wei Jie</creatorcontrib><creatorcontrib>Hu, Wei</creatorcontrib><creatorcontrib>Portengen, Lützen</creatorcontrib><creatorcontrib>Ji, Bu-Tian</creatorcontrib><creatorcontrib>Wong, Jason Y Y</creatorcontrib><creatorcontrib>Ning, Bofu</creatorcontrib><creatorcontrib>Downward, George S</creatorcontrib><creatorcontrib>Li, Jihua</creatorcontrib><creatorcontrib>Yang, Kaiyun</creatorcontrib><creatorcontrib>Yang, Gong</creatorcontrib><creatorcontrib>Gao, Yu-Tang</creatorcontrib><creatorcontrib>Xiang, Yong-Bing</creatorcontrib><creatorcontrib>Nagaradona, Teja</creatorcontrib><creatorcontrib>Zheng, Wei</creatorcontrib><creatorcontrib>Silverman, Debra T</creatorcontrib><creatorcontrib>Huang, Yunchao</creatorcontrib><creatorcontrib>Lan, Qing</creatorcontrib><title>Ischaemic heart disease and stroke mortality by specific coal type among non-smoking women with substantial indoor air pollution exposure in China</title><title>International journal of epidemiology</title><addtitle>Int J Epidemiol</addtitle><description>Abstract
Background
Lifetime use of bituminous (‘smoky’) coal is associated with nearly a 100-fold higher risk of lung cancer mortality compared with anthracite (‘smokeless’) coal use in rural Xuanwei, China, among women. Risk of mortality from ischaemic heart disease (IHD) and stroke for these coal types has not been evaluated.
Methods
A cohort of 16 323 non-smoking women in Xuanwei, who were lifetime users of either smoky or smokeless coal, were followed up from 1976 to 2011. We estimated hazard ratios (HRs) and 95% confidence intervals (CI) to evaluate lifetime use of coal types and stoves in the home in relation to risk of IHD and stroke mortality.
Results
Among lifetime users of smokeless coal, higher average exposure intensity (≥4 tons/year vs <2.5 tons/year, HR = 7.9, 95% CI = 3.5–17.8; Ptrend =<0.0001) and cumulative exposure (>64 ton-years vs ≤28 ton-years, HR = 6.5, 95% CI = 1.5–28.3; Ptrend =0.003) during follow-up and over their lifetime was associated with increased IHD mortality, and ventilated stove use dramatically reduced this risk (HR = 0.2, 95% CI 0.1–0.5). Higher cumulative exposure to smoky coal during follow-up showed positive associations with IHD mortality, but the evidence for other metrics was less consistent compared with associations with smokeless coal use.
Conclusions
Higher use of smokeless coal, which is burned throughout China and is generally regarded to be a cleaner fuel type, is associated with IHD mortality. Use of cleaner fuels or stove interventions may be effective in reducing the increasing burden of IHD in developing regions that currently rely on smokeless coal for cooking and heating.</description><subject>Adult</subject><subject>Air Pollution</subject><subject>Air Pollution, Indoor - adverse effects</subject><subject>China - epidemiology</subject><subject>Coal - adverse effects</subject><subject>Cooking</subject><subject>Female</subject><subject>Heating - adverse effects</subject><subject>Humans</subject><subject>Middle Aged</subject><subject>Myocardial Ischemia - etiology</subject><subject>Myocardial Ischemia - mortality</subject><subject>Proportional Hazards Models</subject><subject>Rural Population</subject><subject>Stroke - etiology</subject><subject>Stroke - mortality</subject><issn>0300-5771</issn><issn>1464-3685</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcFO3DAQhq2KqrtQLjwA8oVLpXTt2ImTCxJaUVgJqZf2HDn2ZGNI7Mh2gPQx-sQ1WoropacZ6f_mm8OP0BklXymp2cbcw0Yvv2hRfUBrykuesbIqjtCaMEKyQgi6Qsch3BNCOef1J7RilAkhqmKNfu-C6iWMRuEepI9YmwAyAJZW4xC9ewA8Oh_lYOKC2wWHCZTpEq6cHHBcpoSOzu6xdTYLo3swaX9yI1j8ZGKPw9yGKG00iTZWO-exNB5PbhjmaJzF8Dy5MHtIKd72xsrP6GMnhwCnr_ME_fx2_WN7m919v9ltr-4yxUkVM92WPC-1LhSDtq50USuiWZdTRnJGgTBGRVmUNc25qEEp0TKRV6WoOlIyJhk7QZcH7zS3I2gFNno5NJM3o_RL46Rp_k2s6Zu9e2xEUvKKJ8GXg0B5F4KH7u2WkualmSY10xyaSfD5-29v6N8qEnBxANw8_U_0B6pAm8I</recordid><startdate>20200201</startdate><enddate>20200201</enddate><creator>Bassig, Bryan A</creator><creator>Dean Hosgood, H</creator><creator>Shu, Xiao-Ou</creator><creator>Vermeulen, Roel</creator><creator>Chen, Bingshu E</creator><creator>Katki, Hormuzd A</creator><creator>Seow, Wei Jie</creator><creator>Hu, Wei</creator><creator>Portengen, Lützen</creator><creator>Ji, Bu-Tian</creator><creator>Wong, Jason Y Y</creator><creator>Ning, Bofu</creator><creator>Downward, George S</creator><creator>Li, Jihua</creator><creator>Yang, Kaiyun</creator><creator>Yang, Gong</creator><creator>Gao, Yu-Tang</creator><creator>Xiang, Yong-Bing</creator><creator>Nagaradona, Teja</creator><creator>Zheng, Wei</creator><creator>Silverman, Debra T</creator><creator>Huang, Yunchao</creator><creator>Lan, Qing</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-1226-070X</orcidid><orcidid>https://orcid.org/0000-0003-4082-8163</orcidid><orcidid>https://orcid.org/0000-0002-0711-8314</orcidid></search><sort><creationdate>20200201</creationdate><title>Ischaemic heart disease and stroke mortality by specific coal type among non-smoking women with substantial indoor air pollution exposure in China</title><author>Bassig, Bryan A ; Dean Hosgood, H ; Shu, Xiao-Ou ; Vermeulen, Roel ; Chen, Bingshu E ; Katki, Hormuzd A ; Seow, Wei Jie ; Hu, Wei ; Portengen, Lützen ; Ji, Bu-Tian ; Wong, Jason Y Y ; Ning, Bofu ; Downward, George S ; Li, Jihua ; Yang, Kaiyun ; Yang, Gong ; Gao, Yu-Tang ; Xiang, Yong-Bing ; Nagaradona, Teja ; Zheng, Wei ; Silverman, Debra T ; Huang, Yunchao ; Lan, Qing</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c408t-db6426dd5c3eb98d59c0d3f2130231e03317656912479ecc7b3728678f0633a33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Air Pollution</topic><topic>Air Pollution, Indoor - adverse effects</topic><topic>China - epidemiology</topic><topic>Coal - adverse effects</topic><topic>Cooking</topic><topic>Female</topic><topic>Heating - adverse effects</topic><topic>Humans</topic><topic>Middle Aged</topic><topic>Myocardial Ischemia - etiology</topic><topic>Myocardial Ischemia - mortality</topic><topic>Proportional Hazards Models</topic><topic>Rural Population</topic><topic>Stroke - etiology</topic><topic>Stroke - mortality</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bassig, Bryan A</creatorcontrib><creatorcontrib>Dean Hosgood, H</creatorcontrib><creatorcontrib>Shu, Xiao-Ou</creatorcontrib><creatorcontrib>Vermeulen, Roel</creatorcontrib><creatorcontrib>Chen, Bingshu E</creatorcontrib><creatorcontrib>Katki, Hormuzd A</creatorcontrib><creatorcontrib>Seow, Wei Jie</creatorcontrib><creatorcontrib>Hu, Wei</creatorcontrib><creatorcontrib>Portengen, Lützen</creatorcontrib><creatorcontrib>Ji, Bu-Tian</creatorcontrib><creatorcontrib>Wong, Jason Y Y</creatorcontrib><creatorcontrib>Ning, Bofu</creatorcontrib><creatorcontrib>Downward, George S</creatorcontrib><creatorcontrib>Li, Jihua</creatorcontrib><creatorcontrib>Yang, Kaiyun</creatorcontrib><creatorcontrib>Yang, Gong</creatorcontrib><creatorcontrib>Gao, Yu-Tang</creatorcontrib><creatorcontrib>Xiang, Yong-Bing</creatorcontrib><creatorcontrib>Nagaradona, Teja</creatorcontrib><creatorcontrib>Zheng, Wei</creatorcontrib><creatorcontrib>Silverman, Debra T</creatorcontrib><creatorcontrib>Huang, Yunchao</creatorcontrib><creatorcontrib>Lan, Qing</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International journal of epidemiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bassig, Bryan A</au><au>Dean Hosgood, H</au><au>Shu, Xiao-Ou</au><au>Vermeulen, Roel</au><au>Chen, Bingshu E</au><au>Katki, Hormuzd A</au><au>Seow, Wei Jie</au><au>Hu, Wei</au><au>Portengen, Lützen</au><au>Ji, Bu-Tian</au><au>Wong, Jason Y Y</au><au>Ning, Bofu</au><au>Downward, George S</au><au>Li, Jihua</au><au>Yang, Kaiyun</au><au>Yang, Gong</au><au>Gao, Yu-Tang</au><au>Xiang, Yong-Bing</au><au>Nagaradona, Teja</au><au>Zheng, Wei</au><au>Silverman, Debra T</au><au>Huang, Yunchao</au><au>Lan, Qing</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ischaemic heart disease and stroke mortality by specific coal type among non-smoking women with substantial indoor air pollution exposure in China</atitle><jtitle>International journal of epidemiology</jtitle><addtitle>Int J Epidemiol</addtitle><date>2020-02-01</date><risdate>2020</risdate><volume>49</volume><issue>1</issue><spage>56</spage><epage>68</epage><pages>56-68</pages><issn>0300-5771</issn><eissn>1464-3685</eissn><abstract>Abstract
Background
Lifetime use of bituminous (‘smoky’) coal is associated with nearly a 100-fold higher risk of lung cancer mortality compared with anthracite (‘smokeless’) coal use in rural Xuanwei, China, among women. Risk of mortality from ischaemic heart disease (IHD) and stroke for these coal types has not been evaluated.
Methods
A cohort of 16 323 non-smoking women in Xuanwei, who were lifetime users of either smoky or smokeless coal, were followed up from 1976 to 2011. We estimated hazard ratios (HRs) and 95% confidence intervals (CI) to evaluate lifetime use of coal types and stoves in the home in relation to risk of IHD and stroke mortality.
Results
Among lifetime users of smokeless coal, higher average exposure intensity (≥4 tons/year vs <2.5 tons/year, HR = 7.9, 95% CI = 3.5–17.8; Ptrend =<0.0001) and cumulative exposure (>64 ton-years vs ≤28 ton-years, HR = 6.5, 95% CI = 1.5–28.3; Ptrend =0.003) during follow-up and over their lifetime was associated with increased IHD mortality, and ventilated stove use dramatically reduced this risk (HR = 0.2, 95% CI 0.1–0.5). Higher cumulative exposure to smoky coal during follow-up showed positive associations with IHD mortality, but the evidence for other metrics was less consistent compared with associations with smokeless coal use.
Conclusions
Higher use of smokeless coal, which is burned throughout China and is generally regarded to be a cleaner fuel type, is associated with IHD mortality. Use of cleaner fuels or stove interventions may be effective in reducing the increasing burden of IHD in developing regions that currently rely on smokeless coal for cooking and heating.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>31377785</pmid><doi>10.1093/ije/dyz158</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0003-1226-070X</orcidid><orcidid>https://orcid.org/0000-0003-4082-8163</orcidid><orcidid>https://orcid.org/0000-0002-0711-8314</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current); EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Adult Air Pollution Air Pollution, Indoor - adverse effects China - epidemiology Coal - adverse effects Cooking Female Heating - adverse effects Humans Middle Aged Myocardial Ischemia - etiology Myocardial Ischemia - mortality Proportional Hazards Models Rural Population Stroke - etiology Stroke - mortality |
| title | Ischaemic heart disease and stroke mortality by specific coal type among non-smoking women with substantial indoor air pollution exposure in China |
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