title: In-home solid fuel use and cardiovascular disease: a cross-sectional analysis of the Shanghai Putuo study.
abstract: BACKGROUND
  Although recent research evidence suggests an association between household air pollution from solid fuel use, such as coal or biomass, and cardiovascular events such as hypertension, little epidemiologic data are available concerning such exposure effects on cardiovascular endpoints other than hypertension. We explored the association between in-home solid fuel use and self-reported diagnoses of cardiovascular endpoints, such as hypertension, coronary heart disease (CHD), stroke, and diabetes.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Environmental and Occupational Medicine and Epidemiology Program, Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA.
authors.forename: Mi-Sun
authors.initials: MS
authors.lastname: Lee
authors.forename: Jing-qing
authors.initials: JQ
authors.lastname: Hang
authors.forename: Feng-ying
authors.initials: FY
authors.lastname: Zhang
authors.forename: He-lian
authors.initials: HL
authors.lastname: Dai
authors.forename: Li
authors.initials: L
authors.lastname: Su
authors.forename: David C
authors.initials: DC
authors.lastname: Christiani
mesh_terms: D000293:Adolescent; D000328:Adult; D016902:Air Pollution, Indoor / Q000009:adverse effects*; D018533:Biomass; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D002681:China / Q000453:epidemiology; D003031:Coal / Q000009:adverse effects; D003296:Cooking / Q000379:methods; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005390:Fires; D006361:Heating / Q000379:methods; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D055815:Young Adult
chemical_list: D003031:Coal