Trans-generational changes and rural-urban inequality in household fuel use and cookstove ventilation in China: A multi-region study of 0.5 million adults

Chan, Ka Hung; Lam, Hubert; Kurmi, Om; Guo, Yu; Bennett, Derrick; Zheng, Bin; Sherliker, Paul; Chen, J; Li, L; Chen, Z

doi:10.1016/j.ijheh.2017.09.010

Cited by 45 publications

(33 citation statements)

References 20 publications

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“…Notably, fuel-stacking was much less common for heating compared to cooking and the prevalence of solid fuel use for heating remained high among rural participants. This corroborates with our previous observations that heating fuel modernised more slowly than cooking fuels ( Chan et al, 2017 ), and it could be an under-recognised source of HAP in China and other LMICs ( Chen et al, 2018 ).…”

Section: Discussionsupporting

confidence: 92%

“…In CKB-Air, about half of the non-cooking participants were “exposed” to regular cooking in the household, highlighting the potential bias of considering them as the unexposed group ( Sidhu et al, 2017 , Li et al, 2016 ). We also revealed a fuel-stacking phenomenon alongside increased clean fuel use (compared with previous CKB data ( Chan et al, 2017 ) in line with a few recent Chinese studies ( Ni et al, 2016 , Tao et al, 2018 ). Fuel-stacking in CKB-Air was exclusive to rural participants, who were still undergoing fuel transition.…”

Section: Discussionsupporting

confidence: 90%

“…exhaled carbon monoxide [COex]) and administered an electronic questionnaire assessing a range of characteristics (socioeconomic, lifestyle, environment, medical history), including long-term fuel use behaviour as described previously. ( Chan et al, 2017 ) Periodic resurveys are being undertaken in ~ 5% randomly selected subset of surviving participants every 4–5 years since baseline, to repeat the baseline assessments and collect additional data for enhancement. Participants are being followed-up indefinitely since baseline, for fatal and non-fatal events via linkages to established death and disease registries and national health insurance databases.…”

Section: Methodsmentioning

confidence: 99%

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Regional and seasonal variations in household and personal exposures to air pollution in one urban and two rural Chinese communities: A pilot study to collect time-resolved data using static and wearable devices

Chan

Xia

et al. 2021

Environment International

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 90%

Section: Methodsmentioning

confidence: 99%

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Regional and seasonal variations in household and personal exposures to air pollution in one urban and two rural Chinese communities: A pilot study to collect time-resolved data using static and wearable devices

Chan

Xia

et al. 2021

Environment International

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“…Among all household SES variables included in this analysis, increasing household size (number of rooms) was the strongest independent predictor of polluting-to-clean fuel switching in all countries. Participants in the youngest age group (35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45) also had significantly higher odds of switching than participants in the oldest age group (55-70) ( figure 3(a)), in line with results from several studies [53,74,75].…”

Section: Household Factorssupporting

confidence: 87%

Household, community, sub-national and country-level predictors of primary cooking fuel switching in nine countries from the PURE study

Shupler

Hystad

Gustafson

et al. 2019

Environ. Res. Lett.

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Introduction. Switching from polluting (e.g. wood, crop waste, coal) to clean (e.g. gas, electricity) cooking fuels can reduce household air pollution exposures and climate-forcing emissions. While studies have evaluated specific interventions and assessed fuel-switching in repeated cross-sectional surveys, the role of different multilevel factors in household fuel switching, outside of interventions and across diverse community settings, is not well understood. Methods. We examined longitudinal survey data from 24 172 households in 177 rural communities across nine countries within the Prospective Urban and Rural Epidemiology study. We assessed household-level primary cooking fuel switching during a median of 10 years of follow up (∼2005-2015). We used hierarchical logistic regression models to examine the relative importance of household, community, sub-national and national-level factors contributing to primary fuel switching. Results. One-half of study households (12 369) reported changing their primary cooking fuels between baseline and follow up surveys. Of these, 61% (7582) switched from polluting (wood, dung, agricultural waste, charcoal, coal, kerosene) to clean (gas, electricity) fuels, 26% (3109) switched between different polluting fuels, 10% (1164) switched from clean to polluting fuels and 3% (522) switched between different clean fuels. Among the 17 830 households using polluting cooking fuels at baseline, household-level factors (e.g. larger household size, higher wealth, higher education level) were most strongly associated with switching from polluting to clean fuels in India; in all other countries, community-level factors (e.g. larger population density in 2010, larger increase in population density between 2005 and 2015) were the strongest predictors of polluting-to-clean fuel switching. Conclusions. The importance of community and sub-national factors relative to household characteristics in determining polluting-to-clean fuel switching varied dramatically across the nine countries examined. This highlights the potential importance of national and other contextual factors in shaping large-scale clean cooking transitions among rural communities in low-and middle-income countries.

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“…At baseline, each participant was asked to recall, for up to their three most recent residences, how many years they had lived there, cooking frequency (no cooking facility/never/rarely, monthly, weekly, or daily), and ownership of ventilated cookstoves ( 17 ). Participants who cooked at least monthly, in each of their respective residences, were asked about the primary fuel type used (electricity, gas, coal, wood, charcoal, or other unspecified).…”

Section: Methodsmentioning

confidence: 99%

Solid Fuel Use and Risks of Respiratory Diseases. A Cohort Study of 280,000 Chinese Never-Smokers

Chan

Kurmi

Bennett

et al. 2019

Am J Respir Crit Care Med

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Rationale: Little evidence from large-scale cohort studies exists about the relationship of solid fuel use with hospitalization and mortality from major respiratory diseases. Objectives: To examine the associations of solid fuel use and risks of acute and chronic respiratory diseases. Methods: A cohort study of 277,838 Chinese never-smokers with no prior major chronic diseases at baseline. During 9 years of follow-up, 19,823 first hospitalization episodes or deaths from major respiratory diseases, including 10,553 chronic lower respiratory disease (CLRD), 4,398 chronic obstructive pulmonary disease (COPD), and 7,324 acute lower respiratory infection (ALRI), were recorded. Cox regression yielded adjusted hazard ratios (HRs) for disease risks associated with self-reported primary cooking fuel use. Measurements and Main Results: Overall, 91% of participants reported regular cooking, with 52% using solid fuels. Compared with clean fuel users, solid fuel users had an adjusted HR of 1.36 (95% confidence interval, 1.32–1.40) for major respiratory diseases, whereas those who switched from solid to clean fuels had a weaker HR (1.14, 1.10–1.17). The HRs were higher in wood (1.37, 1.33–1.41) than coal users (1.22, 1.15–1.29) and in those with prolonged use (≥40 yr, 1.54, 1.48–1.60; <20 yr, 1.32, 1.26–1.39), but lower among those who used ventilated than nonventilated cookstoves (1.22, 1.19–1.25 vs. 1.29, 1.24–1.35). For CLRD, COPD, and ALRI, the HRs associated with solid fuel use were 1.47 (1.41–1.52), 1.10 (1.03–1.18), and 1.16 (1.09–1.23), respectively. Conclusions: Among Chinese adults, solid fuel use for cooking was associated with higher risks of major respiratory disease admissions and death, and switching to clean fuels or use of ventilated cookstoves had lower risk than not switching.

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Trans-generational changes and rural-urban inequality in household fuel use and cookstove ventilation in China: A multi-region study of 0.5 million adults

Cited by 45 publications

References 20 publications

Regional and seasonal variations in household and personal exposures to air pollution in one urban and two rural Chinese communities: A pilot study to collect time-resolved data using static and wearable devices

Regional and seasonal variations in household and personal exposures to air pollution in one urban and two rural Chinese communities: A pilot study to collect time-resolved data using static and wearable devices

Household, community, sub-national and country-level predictors of primary cooking fuel switching in nine countries from the PURE study

Solid Fuel Use and Risks of Respiratory Diseases. A Cohort Study of 280,000 Chinese Never-Smokers

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