Use of solid fuels for heating, cooking in China associated with increased risk of death

Bottom Line: Use of coal, wood or charcoal for cooking and heating in rural China was associated with a greater risk of death, with that risk decreased by having switched to gas, electricity or central heating, or using ventilation.

Why The Research Is Interesting: Worldwide, it has been estimated that more than 2.7 billion individuals were using solid fuels for domestic purposes in 2015, mostly in low- and middle-income countries including China, where an estimated 450 million people still heavily rely on solid fuels, such as wood, charcoal and coal. When combusted indoors, solid fuels generate a large amount of pollutants such as fine particulate matter.

Who and When: 271,217 adults without cardiovascular disease at study entry were recruited from five rural areas across China between June 2004 and July 2008; mortality follow-up was until January 2014. A random subset (10,892) participated in a resurvey after an average interval of 2.7 years.

What (Study Measures): Self-reported cooking and heating fuels (solid: coal, wood, or charcoal; clean: gas, electricity, or central heating), switching of fuel type before study entry, and use of ventilated cookstoves (exposures); death from cardiovascular and all causes (outcomes)

How (Study Design): This was an observational study. Researchers were not intervening for purposes of the study and cannot control all the natural differences that could explain the study findings.

Authors: Tangchun Wu, M.D., Ph.D., Huazhong University of Science and Technology, Wuhan, China; Liming Li, M.D., M.P.H., Peking University, Beijing, China, and coauthors

Study Limitations: Self-reported fuel use was used as a measure for household air pollution exposure, which could vary by level and efficiency of ventilation, climate, and fuel properties.

For more details and to read the full study, please visit the For The Media website.

(doi:10.1001/jama.2018. 2151)

Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

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