In-home solid fuel use and cardiovascular disease: a cross-sectional analysis of the Shanghai Putuo study

We analyzed 14,068 Chinese adults, aged 18 years and older. Odds ratios (OR) and the corresponding 95% confidence intervals (CI) were estimated using logistic regression models for the risk of each outcome after adjusting for potential confounders.The use of solid fuel in home was significantly associated with an increased risk for hypertension (OR 1.70, 95% CI 1.40 to 2.07), CHD (OR 2.58, 95% CI 1.53 to 4.32), and diabetes (OR 2.48, 95% CI 1.59 to 3.86), after adjusting for potential confounders. Compared with individuals in the lowest tertile of the duration of solid fuel exposure, those in the highest tertile of the duration of solid fuel exposure had an increased odds of hypertension (OR 1.73, 95% CI 1.45 to 2.06), stroke (OR 1.87, 95% CI 1.03 to 3.38), and diabetes (OR 3.18, 95% CI 2.11 to 4.78).Our data suggest that in-home solid fuel exposure maybe associated with increased risk for hypertension, CHD, stroke, and diabetes in the Chinese adult population. Further large-scale longitudinal studies are warranted to confirm these findings.Indoor air pollution (IAP) from solid fuels, mainly biomass and coal, ranked as one of top ten environmental risk factors of global burden of disease by the World Health Organization [1]. Epidemiologic studies have shown that indoor pollution from the use of solid fuels is associated with acute respiratory infections (ARIs), chronic obstructive pulmonary disease (COPD), and lung cancer [2-5], but limited studies are available on the cardiovascular disease (CVDs), which remains the leading cause of death worldwide. Potential biological mechanisms include oxidative stress, promotion of inflammation with a systemic release of cytokines, and blood coagulation [6].The combustion of solid fuels in the home release substantial pollutants such as respirable particulate matter (PM), polycyclic aromatic hydrocarbons (PAHs), heavy metals, and many other organic pollutants [7] which have been linked to CVDs. According to recent update to the