Household Air Pollution and Adult Lung Function Change, Respiratory Disease, and Mortality across Eleven Low- and Middle-Income Countries from the PURE Study.

2023  Journal Article

Household Air Pollution and Adult Lung Function Change, Respiratory Disease, and Mortality across Eleven Low- and Middle-Income Countries from the PURE Study.

This study examines the impact of household air pollution (HAP) from cooking with solid fuels on lung function, respiratory disease, and mortality in adults from 11 low- and middle-income countries. It found that using solid fuels is linked to lower lung function and higher risk of respiratory diseases. Switching to clean fuels improved some lung function measures and reduced respiratory events. The findings highlight the health benefits of reducing HAP exposure.

DOI: 10.1289/EHP11179    PubMed ID: 37126654
 

College of Health researcher(s)

Perry Hystad

College unit(s)

The Spatial Health Lab
Environmental and Occupational Health
Public Health
School of Nutrition and Public Health

Abstract

BACKGROUND: Globally, household air pollution (HAP) is a major environmental hazard that affects respiratory health. However, few studies have examined associations between HAP and lung function decline and respiratory disease and mortality.

METHODS: We used data from the Prospective Urban and Rural Epidemiology study and examined adults residing in 240 rural communities in 11 low- and middle-income countries where HAP from cooking with solid fuels is common. Spirometry was conducted for 28,574 individuals at baseline and 12,489 individuals during follow-up (mean of 8 y between spirometry measures). In cross-sectional analyses, we compared lung function measurements [forced expiratory volume in 1 s (), forced vital capacity (FVC), and /FVC ratio] in those who used solid fuels for cooking in comparison with clean fuels. Using repeated measurements of lung function, we examined the percent change in lung function measures per year, comparing individuals by baseline fuel type and individuals who used solid fuels at baseline but switched to clean fuels during follow-up. We also examined associations with prospective health events (any respiratory diseases, respiratory disease hospitalizations, and all-cause mortality).

RESULTS: In adjusted cross-sectional models, use of solid fuel in comparison with clean fuels was associated with lower of (95% CI: , ) and FVC of (95% CI: , 3.2), but not /FVC. In longitudinal analyses, individuals who switched from solid fuels to clean cooking fuels during follow-up (, 46% of those using solid fuel at baseline), showed no differences in the annual rate of change in or FVC, but had small improvements in /FVC change (0.2% per year, 95% CI: 0.03, 0.3). Individuals who switched from solid to clean fuels had a decreased hazard ratio for respiratory events of 0.76 (95% CI: 0.57, 1.00) in comparison with persistent solid fuel users, which was not attenuated by lung function measures.

CONCLUSION: We observed modest associations between HAP exposure and lung function, lung function change, and respiratory disease and mortality. https://doi.org/10.1289/EHP11179.

Wang, Ying, Duong, MyLinh, Brauer, Michael, Rangarajan, Sumathy, Dans, Antonio, Lanas, Fernando, Lopez-Jaramillo, Patricio, Puoane, Thandi, Yeates, Karen, Chifamba, Jephat, Yusuf, Rita, Liu, Zhiguang, Li, Yang, Tse, Lap Ah, Mohan, Deepa, Gupta, Rajeev, Nair, Sanjeev, Lakshmi, Pvm, Iqbal, Romaina, Anto, Taniya, Yusuf, Salim, Hystad, Perry (2023)  Household Air Pollution and Adult Lung Function Change, Respiratory Disease, and Mortality across Eleven Low- and Middle-Income Countries from the PURE Study.Environ Health Perspect131(4)