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Background <p>Traditional solid fuels remain the primary energy sources for household across China, with particularly widespread use in rural areas. However, evidence linking household use of solid fuels to risk of chronic respiratory diseases (CRDs) remains insufficient.</p> Objective <p>This study aimed to investigate the association between solid cooking fuel use and risk of CRDs in middle aged and elderly adults.</p> Methods <p>Participants were recruited from the China Health and Retirement Longitudinal Study (CHARLS). Cooking fuel was categorized into solid fuel (e.g., wood and coal) and clean fuel (e.g., petroleum gas and electric). The diagnosis and timing of the first diagnosis of CRDs, mainly including incident chronic lung diseases (CLDs) or asthma, were ascertained by face-to-face computer-assisted personal interviews using standardized, validated questionnaires. Cox proportion hazards models were used to examine the association between solid cooking fuel use and risk of CRDs.</p> Results <p>A total of 13,686, 14,986, and 13,414 participants were included in the analysis for the outcome of CLDs, asthma and CRDs, respectively. Compared with clean cooking fuel users, solid cooking fuel users had an adjusted hazard ratios (HRs) of 1.26 (95% confidence intervals [CI]: 1.10–1.45) for CLDs and 1.20 (95%CI: 0.95–1.52) for asthma, respectively. Among all participants, 12.60% (95% CI: 5.39%-19.90%) of CLDs cases could be attributable to participants using solid cooking fuels. Meanwhile, the HRs were higher among users of biomass fuels (e.g., crop residue and wood) than coal users. Of note, participants who switched from solid to clean cooking fuel or persistent clean cooking fuel had a lower risk of CRDs, with the HRs of 0.81 (95%CI: 0.58–1.15) and 0.71 (95%CI: 0.52–0.97) for CLDs, and the corresponding HRs were 0.85 (95%CI: 0.43–1.65) and 1.06 (95%CI: 0.60–1.88) for asthma.</p> Conclusions <p>Use of solid cooking fuel is associated with a higher risk of CRDs, particularly for CLDs. Our findings suggest that decreasing dependence on solid fuels and transitioning to clean energy sources could contribute to alleviating the burden of CRDs.</p>

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Associations of household air pollution from solid cooking fuel use with risk of chronic respiratory diseases: evidence from the CHARLS study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月21日

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  • Luhua Yu,
  • Canlei Liu,
  • Jun Jiang,
  • Peng Guan,
  • Yonghao Wu,
  • Xin Zhang,
  • Shujuan Lin,
  • Jianbing Wang

摘要

Background

Traditional solid fuels remain the primary energy sources for household across China, with particularly widespread use in rural areas. However, evidence linking household use of solid fuels to risk of chronic respiratory diseases (CRDs) remains insufficient.

Objective

This study aimed to investigate the association between solid cooking fuel use and risk of CRDs in middle aged and elderly adults.

Methods

Participants were recruited from the China Health and Retirement Longitudinal Study (CHARLS). Cooking fuel was categorized into solid fuel (e.g., wood and coal) and clean fuel (e.g., petroleum gas and electric). The diagnosis and timing of the first diagnosis of CRDs, mainly including incident chronic lung diseases (CLDs) or asthma, were ascertained by face-to-face computer-assisted personal interviews using standardized, validated questionnaires. Cox proportion hazards models were used to examine the association between solid cooking fuel use and risk of CRDs.

Results

A total of 13,686, 14,986, and 13,414 participants were included in the analysis for the outcome of CLDs, asthma and CRDs, respectively. Compared with clean cooking fuel users, solid cooking fuel users had an adjusted hazard ratios (HRs) of 1.26 (95% confidence intervals [CI]: 1.10–1.45) for CLDs and 1.20 (95%CI: 0.95–1.52) for asthma, respectively. Among all participants, 12.60% (95% CI: 5.39%-19.90%) of CLDs cases could be attributable to participants using solid cooking fuels. Meanwhile, the HRs were higher among users of biomass fuels (e.g., crop residue and wood) than coal users. Of note, participants who switched from solid to clean cooking fuel or persistent clean cooking fuel had a lower risk of CRDs, with the HRs of 0.81 (95%CI: 0.58–1.15) and 0.71 (95%CI: 0.52–0.97) for CLDs, and the corresponding HRs were 0.85 (95%CI: 0.43–1.65) and 1.06 (95%CI: 0.60–1.88) for asthma.

Conclusions

Use of solid cooking fuel is associated with a higher risk of CRDs, particularly for CLDs. Our findings suggest that decreasing dependence on solid fuels and transitioning to clean energy sources could contribute to alleviating the burden of CRDs.