Solid Fuel Use and Risks of All-Cause and Cardiovascular Disease Mortality in Urban Northern China: A 12-Year Cohort Study

IF 2.7 2区环境科学与生态学 Q1 CONSTRUCTION & BUILDING TECHNOLOGY

Indoor air Pub Date : 2026-09-29 DOI:10.1155/ina/9645092

Hongyue Sun, Yinuo Li, Zongqi Chi, Xiaofeng Zhang, Yishu Yang, Jia Ding, Honglu Zhang, Huajie Yang, Zinuo Wang, Yiqing Wang, Jingting Chen, Christiana Asante, Xuejiao Lv, Xueli Yang, Liwen Zhang, Xi Chen, Guanghui Dong, Qiang Zeng, Yamin Liu, Jie Chen, Tong Wang, Baoxin Zhao, Zhipeng Bai, Anqi Shan, Nai-Jun Tang

{"title":"Solid Fuel Use and Risks of All-Cause and Cardiovascular Disease Mortality in Urban Northern China: A 12-Year Cohort Study","authors":"Hongyue Sun, Yinuo Li, Zongqi Chi, Xiaofeng Zhang, Yishu Yang, Jia Ding, Honglu Zhang, Huajie Yang, Zinuo Wang, Yiqing Wang, Jingting Chen, Christiana Asante, Xuejiao Lv, Xueli Yang, Liwen Zhang, Xi Chen, Guanghui Dong, Qiang Zeng, Yamin Liu, Jie Chen, Tong Wang, Baoxin Zhao, Zhipeng Bai, Anqi Shan, Nai-Jun Tang","doi":"10.1155/ina/9645092","DOIUrl":null,"url":null,"abstract":"<div>\n \n <section>\n \n <h3> Background</h3>\n \n <p>Indoor pollution poses a potential health threat due to prolonged exposure, but evidence linking it to mortality from a wide range of cardiovascular subtypes remains limited, particularly in urban areas.</p>\n </section>\n \n <section>\n \n <h3> Objectives</h3>\n \n <p>This study is aimed at examining the association between indoor use of nonclean energy and various subtypes of cardiovascular mortality, and at identifying vulnerable populations, thereby providing scientific evidence for policymaking during energy transitions.</p>\n </section>\n \n <section>\n \n <h3> Method</h3>\n \n <p>This retrospective cohort study was conducted in four northern Chinese cities, namely, Tianjin, Shenyang, Taiyuan, and Rizhao, to track all-cause and selected cardiovascular mortality between 1998 and 2009. A Cox proportional hazards model was applied to assess the association between solid fuel use for cooking and heating and mortality from multiple cardiovascular subtypes, including total cardiovascular disease, cerebrovascular disease, ischemic heart disease, and heart failure. Stratified analyses were conducted to identify vulnerable subpopulations.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>During the 12-year follow-up of 39,054 participants, 1435 deaths (3.67%) from nonaccidental causes were recorded, including 677 (1.73%) from cardiovascular disease, 296 (0.76%) from cerebrovascular disease, 162 (0.41%) from ischemic heart disease, and 109 (0.28%) from heart failure. In the fully adjusted model, each additional year of solid fuel use for heating was associated with increased risks of nonaccidental mortality (hazard ratio [HR]: 1.15; 95% confidence interval [CI]: 1.14, 1.17), cardiovascular mortality (HR: 1.15; 95% CI: 1.13, 1.18), and cerebrovascular mortality (HR: 1.16; 95% CI: 1.12, 1.20). Similar associations were found for cooking with nonclean energy, with HRs slightly higher than those for heating. Individuals aged 60 years and older appeared to be more sensitive to pollution from nonclean energy sources.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>The use of nonclean energy for heating and cooking was positively associated with mortality across multiple cardiovascular subtypes, and vulnerable populations were identified through stratified analyses. These findings offer valuable evidence for developing countries undergoing energy transitions. However, because this historical cohort was followed from 1998 to 2009, the findings may have limited generalizability to contemporary China, where household energy use, ambient air quality, and population health profiles have changed substantially.</p>\n </section>\n </div>","PeriodicalId":13529,"journal":{"name":"Indoor air","volume":"2026 1","pages":""},"PeriodicalIF":2.7000,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ina/9645092","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indoor air","FirstCategoryId":"93","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1155/ina/9645092","RegionNum":2,"RegionCategory":"环境科学与生态学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CONSTRUCTION & BUILDING TECHNOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Indoor pollution poses a potential health threat due to prolonged exposure, but evidence linking it to mortality from a wide range of cardiovascular subtypes remains limited, particularly in urban areas.

Objectives

This study is aimed at examining the association between indoor use of nonclean energy and various subtypes of cardiovascular mortality, and at identifying vulnerable populations, thereby providing scientific evidence for policymaking during energy transitions.

Method

This retrospective cohort study was conducted in four northern Chinese cities, namely, Tianjin, Shenyang, Taiyuan, and Rizhao, to track all-cause and selected cardiovascular mortality between 1998 and 2009. A Cox proportional hazards model was applied to assess the association between solid fuel use for cooking and heating and mortality from multiple cardiovascular subtypes, including total cardiovascular disease, cerebrovascular disease, ischemic heart disease, and heart failure. Stratified analyses were conducted to identify vulnerable subpopulations.

Results

During the 12-year follow-up of 39,054 participants, 1435 deaths (3.67%) from nonaccidental causes were recorded, including 677 (1.73%) from cardiovascular disease, 296 (0.76%) from cerebrovascular disease, 162 (0.41%) from ischemic heart disease, and 109 (0.28%) from heart failure. In the fully adjusted model, each additional year of solid fuel use for heating was associated with increased risks of nonaccidental mortality (hazard ratio [HR]: 1.15; 95% confidence interval [CI]: 1.14, 1.17), cardiovascular mortality (HR: 1.15; 95% CI: 1.13, 1.18), and cerebrovascular mortality (HR: 1.16; 95% CI: 1.12, 1.20). Similar associations were found for cooking with nonclean energy, with HRs slightly higher than those for heating. Individuals aged 60 years and older appeared to be more sensitive to pollution from nonclean energy sources.

Conclusions

The use of nonclean energy for heating and cooking was positively associated with mortality across multiple cardiovascular subtypes, and vulnerable populations were identified through stratified analyses. These findings offer valuable evidence for developing countries undergoing energy transitions. However, because this historical cohort was followed from 1998 to 2009, the findings may have limited generalizability to contemporary China, where household energy use, ambient air quality, and population health profiles have changed substantially.

查看原文本刊更多论文

中国北方城市固体燃料使用与全因心血管疾病死亡率风险：一项12年队列研究

室内污染由于长期接触而对健康构成潜在威胁，但将其与各种心血管亚型的死亡率联系起来的证据仍然有限，特别是在城市地区。本研究旨在探讨室内非清洁能源的使用与各类心血管死亡率之间的关系，并确定弱势群体，从而为能源转型期间的政策制定提供科学依据。方法回顾性队列研究在中国北方4个城市天津、沈阳、太原和日照进行，追踪1998 - 2009年间的全因死亡率和部分心血管死亡率。应用Cox比例风险模型评估烹饪和取暖使用固体燃料与多种心血管亚型（包括总心血管疾病、脑血管疾病、缺血性心脏病和心力衰竭）死亡率之间的关系。进行分层分析以确定易感亚群。结果在对39,054名参与者的12年随访中，记录了1435例（3.67%）非意外原因死亡，其中心血管疾病677例（1.73%），脑血管疾病296例（0.76%），缺血性心脏病162例（0.41%），心力衰竭109例（0.28%）。在完全调整的模型中，每增加一年用于取暖的固体燃料使用与非意外死亡率（风险比[HR]: 1.15； 95%置信区间[CI]: 1.14, 1.17）、心血管死亡率（HR: 1.15; 95% CI: 1.13, 1.18）和脑血管死亡率（HR: 1.16; 95% CI: 1.12, 1.20）的风险增加相关。在使用非清洁能源烹饪时也发现了类似的关联，其hr略高于取暖。60岁及以上的人似乎对非清洁能源的污染更敏感。结论：在多种心血管亚型中，使用非清洁能源取暖和烹饪与死亡率呈正相关，并通过分层分析确定了弱势群体。这些发现为正在经历能源转型的发展中国家提供了宝贵的证据。然而，由于这一历史队列是在1998年至2009年期间进行的，因此研究结果可能对当代中国的普遍性有限，因为中国的家庭能源使用、环境空气质量和人口健康状况都发生了实质性变化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Indoor air 环境科学-工程：环境

CiteScore

10.80

自引率

10.30%

发文量

175

审稿时长

3 months

期刊介绍： The quality of the environment within buildings is a topic of major importance for public health. Indoor Air provides a location for reporting original research results in the broad area defined by the indoor environment of non-industrial buildings. An international journal with multidisciplinary content, Indoor Air publishes papers reflecting the broad categories of interest in this field: health effects; thermal comfort; monitoring and modelling; source characterization; ventilation and other environmental control techniques. The research results present the basic information to allow designers, building owners, and operators to provide a healthy and comfortable environment for building occupants, as well as giving medical practitioners information on how to deal with illnesses related to the indoor environment.