Association of biomass fuel use with the risk of vision impairment among Chinese older adults: a cohort study

Zhou, Ying; Xu, Minzhi; Ke, Peng; Di, Hongkun; Gan, Yong; Feng, Jiexiong; Meng, Xin; Su, Cheng; Tian, Qingfeng; Lu, Zuxun

doi:10.1007/s11356-023-26325-6

Cited by 2 publications

(5 citation statements)

References 47 publications

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“…The first important finding of our study is that solid fuel use for cooking is associated with an increased risk of two worsening SI transitions: from non-SI to single SI and from non-SI to DSI. A recent cohort study found that cooking with biomass fuels was associated with a greater risk of VI among older Chinese adults [ 22 ], which is similar to our study. In addition, a cross-sectional study in India found that the use of unclean cooking fuels was related to VI in older adults [ 23 ].…”

Section: Discussionsupporting

confidence: 91%

“…This may be related to different sample sources and cohort follow-up times. The mean age of the study population in the above study was 82.6 years [ 22 ], which is significantly higher than that of our study population (59.4 years). In China, people over 80 years of age may not cook for themselves due to their reduced self-care ability [ 39 ], thus making exposure to solid fuels less hazardous.…”

Section: Discussionmentioning

confidence: 56%

“…In China, people over 80 years of age may not cook for themselves due to their reduced self-care ability [ 39 ], thus making exposure to solid fuels less hazardous. In addition, the follow-up period of our study (7 years) was significantly longer than that of the aforementioned study (2 years) [ 22 ]. These differences in study design may account for the different results.…”

Section: Discussionmentioning

confidence: 91%

“…Another important finding of this study is that the transition from solid to clean fuel is associated with a lower risk of worsening SI transition. Although a previous study also explored the association between fuel switching and VI in older adults, no significant association was found between switching from biomass to clean fuel and VI [ 22 ]. This may be related to different sample sources and cohort follow-up times.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, it can be inferred that HAP from cooking fuels may be associated with a higher risk of SI. Several previous studies have explored the association between cooking fuel and a single SI, such as VI [ 22 , 23 ] and hearing loss [ 24 ]. However, it is important to mention that most existing studies focus on a single SI, and it is not clear whether HAP is associated with DSI.…”

Section: Introductionmentioning

confidence: 99%

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Associations between cooking fuel use, its transitions, and worsening sensory impairments among Chinese middle-aged and older adults: a cohort study

Li,

Cui,

et al. 2024

BMC Geriatr

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Background This study aimed to explore the associations between household air pollution (HAP), measured by cooking fuel use, sensory impairments (SI), and their transitions in Chinese middle-aged and older adults. Methods Participants were recruited from the 2011 China Health and Retirement Longitudinal Study (CHARLS) and were subsequently followed up until 2018. Data on SI were collected by self-reported hearing and vision impairments, which were divided into three categories: non-SI, single SI (hearing or vision impairment), and dual SI (DSI). Cooking fuels, including solid and clean fuels, are proxies for HAP. The transitions of cooking fuels and SI refer to the switching of the fuel type or SI status from baseline to follow-up. Cox proportional hazard regression models were used to explore associations, and hazard ratios (HRs) and 95% confidence intervals (CI) were used to evaluate the strength of the association. Results The prevalence of non-SI, single SI, and DSI was 59.6%, 31.8%, and 8.6%, respectively, among the 15,643 participants at baseline in this study. Over a median follow-up of 7.0 years, 5,223 worsening SI transitions were observed. In the fully adjusted model, solid fuel use for cooking was associated with a higher risk of worsening SI transitions, including from non-SI to single SI (HR = 1.08, 95% CI = 1.01–1.16) and from non-SI to DSI (HR = 1.26, 95% CI = 1.09–1.47), but not from single SI to DSI. In addition, compared to those who always used solid fuels, participants who switched from solid to clean fuel for cooking appeared to have attenuated the risk of worsening SI transitions. The statistical significance of the associations remained in the set of sensitivity analyses. Conclusion Solid fuel use was associated with higher risks of worsening SI transitions, while converting the type of cooking fuel from solid to clean fuels may reduce the risk of worsening SI transitions. Our study suggests that tailored clean fuel interventions, especially in developing countries, should be implemented to prevent sensory impairments and hence reduce the burden of sensory impairment-related disability.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Associations between cooking fuel use, its transitions, and worsening sensory impairments among Chinese middle-aged and older adults: a cohort study

Li,

Cui,

et al. 2024

BMC Geriatr

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The Association Between Solid Fuel Use and Visual Impairment Among Middle-Aged and Older Chinese Adults: Nationwide Population-Based Cohort Study

Jiang¹,

Wang²,

Zhang³

et al. 2023

JMIR Public Health Surveill

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Background Indoor air pollution has been reported to have adverse effects on the eye; however, the health effects of exposure to cooking with solid fuels on visual impairment remain unclear in China. Objective We aimed to examine the association between cooking with solid fuels and visual impairment, including distance visual impairment (DVI) and near visual impairment (NVI). Methods Data were obtained from the China Health and Retirement Longitudinal Study, a nationwide survey of adults aged over 45 years who were enrolled in 2011 (Wave 1) and followed up in Wave 2 (2013), Wave 3 (2015), and Wave 4 (2018). We used Cox proportional hazards models to determine the association between solid fuels use and visual impairment. Additionally, the impact of switching cooking fuel types on vision function were examined through wave-specific data analysis (Wave 1 and Wave 4). Interaction and subgroup analyses were performed to explore the potential effect modifiers. Data were collected using the stratified multistage random sampling method and further analyzed using SPSS 27.0 and R 4.2.1 statistical software packages. Results A total of 9559 middle-aged and older Chinese adults without visual impairment at baseline were included in the study, with 51.2% (n=4914) of the participants reporting that they cooked with solid fuels. During the follow-up period, 2644 (27.5%) and 3130 (32.6%) participants developed DVI and NVI, respectively. Compared with the clean fuel users, participants who cooked with solid fuels had a higher risk of DVI (hazards ratio [HR] 1.38, 95% CI 1.28-1.50) and NVI (HR 1.18, 95% CI 1.10-1.27). In addition, switching the cooking fuel type from clean to solid fuels was associated with an elevated risk of DVI (HR 1.51, 95% CI 1.15-1.98) and NVI (HR 1.39, 95% CI 1.06-1.82) compared to persistently using clean fuels during the follow-up period, although no protective effect of switching from solid to clean fuels on NVI was found (P=.52). In subgroup analysis, we found that cooking with solid fuels increased the risk of DVI in participants younger than 65 years (HR 1.41, 95% CI 1.28-1.55), men (HR 1.45, 95% CI 1.28-1.65), urban residents (HR 1.41, 95% CI 1.08-1.75), and smokers (HR 1.43, 95% CI 1.25-1.64). By contrast, negative effects of cooking with solid fuels on NVI were found in nonsmokers (HR 1.21, 95% CI 1.11-1.33) and urban residents (HR 1.20, 95% CI 1.10-1.37). Conclusions Cooking with solid fuels was associated with an increased risk of visual impairment among middle-aged and older Chinese adults. These findings indicate that promoting the utilization of clean fuels is conducive to reducing the burden of visual impairment for the public.

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Association of biomass fuel use with the risk of vision impairment among Chinese older adults: a cohort study

Cited by 2 publications

References 47 publications

Associations between cooking fuel use, its transitions, and worsening sensory impairments among Chinese middle-aged and older adults: a cohort study

Associations between cooking fuel use, its transitions, and worsening sensory impairments among Chinese middle-aged and older adults: a cohort study

The Association Between Solid Fuel Use and Visual Impairment Among Middle-Aged and Older Chinese Adults: Nationwide Population-Based Cohort Study

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