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Article: Coal use, stove improvement, and adult pneumonia mortality in Xuanwei, China: A retrospective cohort study

TitleCoal use, stove improvement, and adult pneumonia mortality in Xuanwei, China: A retrospective cohort study
Authors
KeywordsCohort study
Pneumonia
Indoor air pollution
Coal
Issue Date2009
Citation
Environmental Health Perspectives, 2009, v. 117, n. 2, p. 261-266 How to Cite?
AbstractBackground: In Xuanwei County, China, unvented indoor coal burning is strongly associated with increased risk of lung cancer and chronic obstructive pulmonary disease. However, the impact of coal burning and stove improvement on risk of pneumonia is not clear. Methods: We conducted a retrospective cohort study among all farmers born 1917 through 1951 and living in Xuanwei as of 1 January 1976. The analysis included a total of 42,422 cohort members. Follow-up identified all deaths in the cohort from 1976 through 1996. Ages at entry into and at exit from follow-up ranged from 24 to 59 years and from 25 to 80 years, respectively. The record search detected 225 deaths from pneumonia, and 32,332 (76%) were alive as of 31 December 1996. We constructed multivariable Cox models (time variable = age) to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results: Use of coal, especially smokeless coal, was positively associated with pneumonia mortality. Annual tonnage and lifetime duration of smoky and smokeless coal use were positively associated with pneumonia mortality. Stove improvement was associated with a 50% reduction in pneumonia deaths (smoky coal users: HR, 0.521; 95% CI, 0.340-0.798; smokeless coal users: HR, 0.449; 95% CI, 0.215-0.937). Conclusions: Our analysis is the first to suggest that indoor air pollution from unvented coal burning is an important risk factor for pneumonia death in adults and that improving ventilation by installing a chimney is an effective measure to decrease it.
Persistent Identifierhttp://hdl.handle.net/10722/207009
ISSN
2015 Impact Factor: 8.443
2015 SCImago Journal Rankings: 3.529
PubMed Central ID

 

DC FieldValueLanguage
dc.contributor.authorShen, Min-
dc.contributor.authorChapman, Robert Sedgwick-
dc.contributor.authorVermuelen, Roel-
dc.contributor.authorTian, Linwei-
dc.contributor.authorZheng, Tongzhang-
dc.contributor.authorChen, Bingshueric-
dc.contributor.authorEngels, Eric A.-
dc.contributor.authorHe, Xingzhou-
dc.contributor.authorBlair, Aaron E.-
dc.contributor.authorLan, Qing-
dc.date.accessioned2014-12-09T04:31:14Z-
dc.date.available2014-12-09T04:31:14Z-
dc.date.issued2009-
dc.identifier.citationEnvironmental Health Perspectives, 2009, v. 117, n. 2, p. 261-266-
dc.identifier.issn0091-6765-
dc.identifier.urihttp://hdl.handle.net/10722/207009-
dc.description.abstractBackground: In Xuanwei County, China, unvented indoor coal burning is strongly associated with increased risk of lung cancer and chronic obstructive pulmonary disease. However, the impact of coal burning and stove improvement on risk of pneumonia is not clear. Methods: We conducted a retrospective cohort study among all farmers born 1917 through 1951 and living in Xuanwei as of 1 January 1976. The analysis included a total of 42,422 cohort members. Follow-up identified all deaths in the cohort from 1976 through 1996. Ages at entry into and at exit from follow-up ranged from 24 to 59 years and from 25 to 80 years, respectively. The record search detected 225 deaths from pneumonia, and 32,332 (76%) were alive as of 31 December 1996. We constructed multivariable Cox models (time variable = age) to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results: Use of coal, especially smokeless coal, was positively associated with pneumonia mortality. Annual tonnage and lifetime duration of smoky and smokeless coal use were positively associated with pneumonia mortality. Stove improvement was associated with a 50% reduction in pneumonia deaths (smoky coal users: HR, 0.521; 95% CI, 0.340-0.798; smokeless coal users: HR, 0.449; 95% CI, 0.215-0.937). Conclusions: Our analysis is the first to suggest that indoor air pollution from unvented coal burning is an important risk factor for pneumonia death in adults and that improving ventilation by installing a chimney is an effective measure to decrease it.-
dc.languageeng-
dc.relation.ispartofEnvironmental Health Perspectives-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subjectCohort study-
dc.subjectPneumonia-
dc.subjectIndoor air pollution-
dc.subjectCoal-
dc.titleCoal use, stove improvement, and adult pneumonia mortality in Xuanwei, China: A retrospective cohort study-
dc.typeArticle-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1289/ehp.11521-
dc.identifier.pmid19270797-
dc.identifier.pmcidPMC2649229-
dc.identifier.scopuseid_2-s2.0-60749128137-
dc.identifier.volume117-
dc.identifier.issue2-
dc.identifier.spage261-
dc.identifier.epage266-
dc.identifier.eissn1552-9924-

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