Long-term incense use and the risk of end-stage renal disease among Chinese in Singapore: the Singapore Chinese health study

Abstract

BackgroundExperimental studies have shown that exposure to incense burning may have deleterious effects on kidney function and architecture. However, the association between chronic exposure to incense smoke and risk of end-stage renal disease (ESRD) has not been reported in epidemiologic studies.MethodsWe investigated this association in the Singapore Chinese Health Study, a prospective population-based cohort of 63,257 Chinese men and women of 45–74 years of age in Singapore during recruitment from 1993 to 1998. Information on the practice of incense burning at home, diet, lifestyle and medical history was collected at baseline interviews. ESRD cases were identified through linkage with the nationwide Singapore Renal Registry through 2015. We used Cox proportional hazards regression analysis to estimate hazard ratio (HR) and 95% confidence interval (CI) of ESRD associated with domestic incense burning.ResultsAmong cohort participants, 76.9% were current incense users. After an average 17.5 years of follow-up, there were 1217 incident ESRD cases. Compared to never users, the multivariable-adjusted HR for ESRD risk was 1.05 (95% CI, 0.80 to 1.38) for former users and 1.26 (95% CI, 1.02 to1.57) for current users of incense. In analysis by daily or non-daily use and duration, the increased ESRD risk was observed in daily users who had used incense for > 20 years; HR was 1.25 (95% CI, 1.07 to 1.46). Conversely, the risk was not increased in those who did not use incense daily or who had used daily but for ≤20 years.ConclusionsOur findings demonstrate that long-term daily exposure to domestic incense burning could be associated with a higher risk of ESRD in the general population.Electronic supplementary materialThe online version of this article (10.1186/s12882-018-1186-9) contains supplementary material, which is available to authorized users.

The Adverse Impact of Incense Smoke on Human Health: From Mechanisms to Implications

“…This risk further increased in cases of daily users with more than 20 years of incense burning. 19 Consistently, the adverse effects of chronic exposure to incense smoke on kidney function and architecture were observed in previous experimental study. In particular, exposed rats exhibited significantly persistent inflammation as well as abnormal functions and ultrastructural changes of kidney.…”

“… 14 In contrast, lesser effects of incense burning on kidney function was observed in smokers who were already exposed to the strong and harmful substances from cigarette smoking as compared to non-smokers. 19 In addition to incense smoke, incense stick ash is also of health concern as a product of burning process that needs more understanding. Summing up all the potential effects of incense use on human health and environmental ambience, further investigations in the future are desirable to be implemented.…”

Incense Smoke Exposure: An Appraisal of Organ Toxicity

“…Furthermore, a significant increase in tissue gene expression of both CYP1A1 and CYP1A2 were noted in incense exposed rats (19) . In Singapore, the long-term daily exposure of the Chinese population to domestic incense burning has been associated with an increased development of end stage renal disease (52) .…”

Epitomizing mercury concentrations in incenses as a potential marker to respiratory ailments

“…Many investigations (Lorena 2020;Geng et al, 2019;Al-Yasiry et al, 2016;Vudanna et al, 2016;Al-Hararasi et al, 2014;Zarshenas et al, 2013) observed these incenses (a) to alleviate stress and emotion, (b) boost and balance immune and hormone system, (c) anti-aging properties, (d) catalyze the secretion of digestive enzymes and, (e) decrease inflammation.…”

“…However, the local statutory bodies did not undertake any precautionary measures or standardized regulations to burn incense. Nonetheless, the effects of burning such incenses in Kuwait were least described (Wolter 2015;Geng et al, 2019;Amoatey et al, 2018;OSHA 2017;Yuan et al, 2020;Bahloul and Gevao 2014;Wu et al, 2012).…”