Association of indoor solid fuel pollution with risk factors for cardiovascular disease among Chinese adults: A nationally multi-center study

Few studies have comprehensively assessed the associations of household air pollution (HAP) from solid fuel burning with cardiovascular risk factors (eg, hypertension, diabetes, dyslipidemia, and obesity). Moreover, whether these associations with cardiovascular disease (CVD) risk factors varied by residential environment characteristics remains unclear. Using two waves data (2011 and 2015) of 13,953 participants aged at least 45 years from 125 cities in the China Health and Retirement Longitudinal Study, we explored how solid fuel exposure is associated with CVD risk factors among Chinese adults. Blood pressure (BP), fasting blood glucose (FBG), lipid profiles, C-reactive protein, and body mass index (BMI) were measured using standard methods. Multivariate logistic regression and generalized linear models explored the associations of solid fuel use for heating and cooking with CVD risk factors. Stratified analyses examined whether the associations varied by sociodemographics and living environmental characteristics. Compared with clean fuels, solid fuel used for heating and cooking was associated with a higher risk of hypertension, diabetes, and dyslipidemia, respectively. Solid fuel was related to elevated systolic BP (adjusted β 1.369 mmHg, 0.481-2.258), diastolic BP (0.704 mmHg, 0.183-1.225), FBG (0.309 mmol/l, 0.218-0.399), total cholesterol (0.055 mmol/l, 0.012-0.099), and low-density lipoprotein (0.100 mmol/l, 0.061-0.139), while inversely with BMI (-0.437 kg/m2, -0.599--0.275). Women, who live in a house with poor cleanliness (according to the overall tidiness and whether have tap water in the house) had a stronger association for hypertension or dyslipidemia. Our findings provide implications for policymakers to implement interventions to improve cardiovascular health by reducing HAP.