Adult Cardiopulmonary Mortality and Indoor Air Pollution: A 10-Year
                        Retrospective Cohort Study in a Low-Income Rural Setting

Alam, Dewan S.; Chowdhury, Muhammad Ashique Haider; Siddiquee, Ali Tanweer; Ahmed, Shyfuddin; Hossain, Mohammad Didar; Pervin, Sonia; Streatfield, K; Cravioto, Alejandro; Niessen, Louis

doi:10.1016/j.gheart.2012.06.008

Cited by 41 publications

(31 citation statements)

References 6 publications

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“…1,2 While these deaths are traditionally attributed to pneumonia in children and chronic obstructive pulmonary disease and lung cancer in adults, 3 data attempting to show a direct link between HAP and cardiovascular disease (CVD) mortality are limited. 4 Inferences regarding the relationship between HAP and CVD are largely based on a growing body of evidence showing that HAP is associated with CVD risk factors and morbidity, 5-13 as well as known data associating ambient air pollution and direct tobacco inhalation with CVD mortality. 14-16 …”

Section: Introductionmentioning

confidence: 99%

Household Fuel Use and Cardiovascular Disease Mortality

et al. 2016

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Background Household air pollution is the third largest risk factor for global disease burden, but direct links with cardiovascular disease mortality are limited. This study aimed to evaluate the relationship between household fuel use and cardiovascular disease mortality. Methods and Results The Golestan Cohort Study in northeastern Iran enrolled 50045 individuals aged 40 to 75 years between 2004 and 2008, and collected data on lifetime household fuel use and other baseline exposures. Participants were followed through 2012 with a 99% successful follow-up rate. Cox proportional hazards models were fitted to calculate hazard ratios (HRs) for associations between pehen (local dung), wood, kerosene/diesel, or natural gas burning for cooking and heating and all-cause and cause-specific mortality, adjusting for lifetime exposure to each of these fuels and potential confounders. 3073 participants (6%) died during follow-up, 78% of which were attributable to non-communicable diseases, including cardiovascular, oncologic and respiratory illnesses. Adjusted 10-year HRs from kerosene/diesel burning were 1.06 (95% CI 1.02-1.10), and 1.11 (1.06-1.17), respectively, for all-cause and cardiovascular mortality. Subtype-specific analyses revealed a significant increase in ischemic heart disease (10-year HR 1.14 (1.06-1.21)) and a trend toward cerebrovascular accident (10-year HR 1.08 (0.99-1.17)) mortality. Stratification by sex revealed a potential signal for increased risk for all-cause and cardiovascular disease mortality among women versus men, with similar risk for ischemic heart disease mortality. Conclusions Household exposure to high-pollution fuels was associated with increased risk for all-cause and cardiovascular disease mortality. Replicating these results worldwide would support efforts to reduce such exposures.

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Section: Introductionmentioning

confidence: 99%

Household Fuel Use and Cardiovascular Disease Mortality

et al. 2016

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“…For example we do not have a measure of indoor air pollution, yet this measure may be contributing to the observed SES association. Solid fuel use, which contributes to indoor air pollution and negative health effects, is more likely among poorer households in Matlab [69]. …”

Section: Discussionmentioning

confidence: 99%

Effects of health intervention programs and arsenic exposure on child mortality from acute lower respiratory infections in rural Bangladesh

2016

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BackgroundRespiratory infections continue to be a public health threat, particularly to young children in developing countries. Understanding the geographic patterns of diseases and the role of potential risk factors can help improve future mitigation efforts. Toward this goal, this paper applies a spatial scan statistic combined with a zero-inflated negative-binomial regression to re-examine the impacts of a community-based treatment program on the geographic patterns of acute lower respiratory infection (ALRI) mortality in an area of rural Bangladesh. Exposure to arsenic-contaminated drinking water is also a serious threat to the health of children in this area, and the variation in exposure to arsenic must be considered when evaluating the health interventions.MethodsALRI mortality data were obtained for children under 2 years old from 1989 to 1996 in the Matlab Health and Demographic Surveillance System. This study period covers the years immediately following the implementation of an ALRI control program. A zero-inflated negative binomial (ZINB) regression model was first used to simultaneously estimate mortality rates and the likelihood of no deaths in groups of related households while controlling for socioeconomic status, potential arsenic exposure, and access to care. Next a spatial scan statistic was used to assess the location and magnitude of clusters of ALRI mortality. The ZINB model was used to adjust the scan statistic for multiple social and environmental risk factors.ResultsThe results of the ZINB models and spatial scan statistic suggest that the ALRI control program was successful in reducing child mortality in the study area. Exposure to arsenic-contaminated drinking water was not associated with increased mortality. Higher socioeconomic status also significantly reduced mortality rates, even among households who were in the treatment program area.ConclusionCommunity-based ALRI interventions can be effective at reducing child mortality, though socioeconomic factors may continue to influence mortality patterns. The combination of spatial and non-spatial methods used in this paper has not been applied previously in the literature, and this study demonstrates the importance of such approaches for evaluating and improving public health intervention programs.

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“…In a study of participants living in the Brazilian Amazon, elderly individuals with increased exposure to biomass fuel smoke had increased cardiovascular mortality when compared to age-matched controls 110 . However, large cohorts in Iran and Bangladesh have failed to demonstrate an association between chronic biomass fuel use and cardiovascular mortality 111,112 . Additional studies that prospectively study cardiovascular outcomes in biomass fuel users compared to nonusers are needed to better quantify the impact of household air pollution on cardiovascular disease.…”

Section: Household Air Pollution From Biomass Fuel Usementioning

confidence: 99%

Environmental Exposures and Cardiovascular Disease

2017

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Summary Environmental exposures in low- and middle-income countries lie at the intersection of increased economic development and the rising public health burden of cardiovascular disease. Increasing evidence suggests an association of exposure to ambient air pollution, household air pollution from biomass fuel, lead, arsenic, and cadmium with multiple cardiovascular disease outcomes including hypertension, coronary heart disease, stroke, and cardiovascular mortality. While populations in low- and middle-income countries are disproportionately exposed to environmental pollution, the bulk of evidence that links these exposures to cardiovascular disease is derived from populations in high-income countries. More research is needed to further characterize the extent of environmental exposures and develop targeted interventions towards reducing cardiovascular disease in at-risk populations in low- and middle-income countries.

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Adult Cardiopulmonary Mortality and Indoor Air Pollution: A 10-Year Retrospective Cohort Study in a Low-Income Rural Setting

Abstract: Household solid-fuel use is associated with increased respiratory mortality and nonsignificantly increased risk of cardiovascular mortality. Reduction of exposure to pollution due to in-household solid-fuel use is likely to improve survival in Bangladeshi and similar populations.

Cited by 41 publications

References 6 publications

Household Fuel Use and Cardiovascular Disease Mortality

Household Fuel Use and Cardiovascular Disease Mortality

Effects of health intervention programs and arsenic exposure on child mortality from acute lower respiratory infections in rural Bangladesh

Environmental Exposures and Cardiovascular Disease

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