The burden of cardiovascular disease attributed to household air pollution from solid fuels in China from 1990 to 2019_Chinese Journal of Evidence-Based Medicine

Authors：

GUO Shanshan ^1,2,3 , YIN Zheng ^1,2,3 ,  WAN Jun ^1,2,3

1. Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, P. R. China;
2. Cardiovascular Research Institute, Wuhan University, Wuhan 430060, P. R. China;
3. Hubei Key Laboratory of Cardiology, Wuhan 430060, P. R. China;

Corresponding author：

WAN Jun, Email: wanjun@whu.edu.cn

Keywords：

Household air pollution; Mortality; Disability-adjusted life year; Disease burden; Disease prevention

DOI：

10.7507/1672-2531.202206006

Video：

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Objective To analyze the burden of cardiovascular diseases (CVDs) and its trend attributed to household air pollution (HAP) from solid fuels in China from 1990 to 2019. Methods Using the data derived from the Global Burden of Disease Study 2019 (GBD 2019), including mortality rates, disability-adjusted life years (DALY), age-standardized mortality rates, age-standardized DALY rates, annual percentage change (APC), and average annual percentage change rate (AAPC), we analyzed the CVD burden and its trend attributed to HAP in China from 1990 to 2019. Results In 2019, HAP in China resulted in 227 000 deaths and 5 182 200 DALYs of CVD; the mortality rate attributed to HAP was 15.96 per 100 000, and the DALY rate was 364.34 per 100 000. In 2019, the age-standardized mortality and DALY rates in China were 12.52 and 262.65 per 100 000, respectively, which were lower than the rates globally, and the rates for males were higher than those for females (13.90 vs. 11.32 per 100 000, 291.76 vs. 234.50 per 100 000). In 2019, both mortality and DALY rates attributed to HAP increased with age, peaking in the age groups of 95 plus and 85-89, respectively. From 1990 to 2019 in China, both age-standardized mortality and DALY rates of CVD attributed to HAP showed a downward trend over time. The average annual percentage change rate (AAPC) of the age-standardized mortality rate was −6.0% (95%CI: −6.2% to −5.8%), and the APCC of the age-standardized DALY rate was −5.8% (95%CI: −6.1% to −5.6%). The burden of the CVD subclass also showed a downward trend. Conclusion From 1990 to 2019, the burden of CVD attributed to HAP from solid fuels in China shows a significant downward trend, with sex and age differences. Females and the elderly are the key groups of disease burden, so effective interventions should be taken for these groups.

Citation： GUO Shanshan, YIN Zheng, WAN Jun. The burden of cardiovascular disease attributed to household air pollution from solid fuels in China from 1990 to 2019. Chinese Journal of Evidence-Based Medicine, 2022, 22(12): 1386-1392. doi: 10.7507/1672-2531.202206006 Copy

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15.	Erqou S, Clougherty JE, Olafiranye O, et al. Particulate matter air pollution and racial differences in cardiovascular disease risk. Arterioscler Thromb Vasc Biol, 2018, 38(4): 935-942.
16.	Yusuf S, Joseph P, Rangarajan S, et al. Modifiable risk factors, cardiovascular disease, and mortality in 155 722 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study. Lancet, 2020, 395(10226): 795-808.
17.	王燕逍翔, 白建军, 宇传华. 基于全球视角的中国心血管病疾病负担现状及趋势. 公共卫生与预防医学, 2021, 32(6): 6-11.
18.	李颖欣, 许瑞君, 张海, 等. 大气细颗粒物组分暴露对缺血性心脏病的影响研究进展. 公共卫生与预防医学, 2021, 32(4): 120-125.
19.	Yu K, Qiu G, Chan KH, et al. Association of solid fuel use with risk of cardiovascular and all-cause mortality in rural China. JAMA, 2018, 319(13): 1351-1361.
20.	何敏, 齐金蕾, 殷鹏, 等. 1990年与2019年中国归因于室外PM_(2. 5)暴露的心血管疾病负担分析. 中国循环杂志, 2021, 36(5): 488-493.
21.	Gall ET, Carter EM, Earnest CM, et al. Indoor air pollution in developing countries: research and implementation needs for improvements in global public health. Am J Public Health, 2013, 103(4): e67-72.
22.	殷鹏, 齐金蕾, 刘韫宁, 等. 2005~2017年中国疾病负担研究报告. 中国循环杂志, 2019, 34(12): 1145-1154.
23.	Liu Y, Pan J, Fan C, et al. Short-term exposure to ambient air pollution and mortality from myocardial infarction. J Am Coll Cardiol, 2021, 77(3): 271-281.
24.	Baumgartner J, Smith KR, Chockalingam A. Reducing CVD through improvements in household energy: implications for policy-relevant research. Glob Heart, 2012, 7(3): 243-247.
25.	Meng W, Zhong Q, Chen Y, et al. Energy and air pollution benefits of household fuel policies in northern China. Proc Natl Acad Sci U S A, 2019, 116(34): 16773-16780.

1. Roth GA, Mensah GA, Johnson CO, et al. Global burden of cardiovascular diseases and risk factors, 1990-2019: update from the GBD 2019 study. J Am Coll Cardiol, 2020, 76(25): 2982-3021.
2. Mortimer K. Household air pollution: the importance of intervening early. Chest, 2021, 160(5): 1579-1580.
3. Perez-Padilla R. Household air pollution: consider lifelong exposure. Am J Respir Crit Care Med, 2019, 199(5): 553-555.
4. McCracken JP, Wellenius GA, Bloomfield GS, et al. Household air pollution from solid fuel use: evidence for links to CVD. Glob Heart, 2012, 7(3): 223-234.
5. Rajagopalan S, Brook RD. The indoor-outdoor air-pollution continuum and the burden of cardiovascular disease: an opportunity for improving global health. Glob Heart, 2012, 7(3): 207-213.
6. Chockalingam A, Tolunay HE, Prabhakaran D, et al. Household air pollution: an emerging risk factor for CVD. Glob Heart, 2012, 7(3): 197-199.
7. Martin WJ. On the global epidemic of CVD and why household air pollution matters. Glob Heart, 2012, 7(3): 201-206.
8. Yu K, Lv J, Qiu G, et al. Cooking fuels and risk of all-cause and cardiopulmonary mortality in urban China: a prospective cohort study. Lancet Glob Health, 2020, 8(3): e430-e439.
9. GBD 2019 Demographics Collaborators. Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019. Lancet, 2020, 396(10258): 1160-1203.
10. GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet, 2020, 396(10258): 1204-1222.
11. GBD 2019 Risk Factors Collaborators. Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet, 2020, 396(10258): 1223-1249.
12. Kim HJ, Fay MP, Feuer EJ, et al. Permutation tests for joinpoint regression with applications to cancer rates. Stat Med, 2000, 19(3): 335-351.
13. 曾四清, 李艳, 刘珺, 等. 两组序列数据趋势变化特征对比分析的Joinpoint回归模型方法及应用. 中国卫生统计, 2021, 38(2): 307-311.
14. Cong X, Zhang J, Sun R, et al. Indoor unclean fuel cessation linked with adult cognitive performance in China. Sci Total Environ, 2021, 775: 145518.
15. Erqou S, Clougherty JE, Olafiranye O, et al. Particulate matter air pollution and racial differences in cardiovascular disease risk. Arterioscler Thromb Vasc Biol, 2018, 38(4): 935-942.
16. Yusuf S, Joseph P, Rangarajan S, et al. Modifiable risk factors, cardiovascular disease, and mortality in 155 722 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study. Lancet, 2020, 395(10226): 795-808.
17. 王燕逍翔, 白建军, 宇传华. 基于全球视角的中国心血管病疾病负担现状及趋势. 公共卫生与预防医学, 2021, 32(6): 6-11.
18. 李颖欣, 许瑞君, 张海, 等. 大气细颗粒物组分暴露对缺血性心脏病的影响研究进展. 公共卫生与预防医学, 2021, 32(4): 120-125.
19. Yu K, Qiu G, Chan KH, et al. Association of solid fuel use with risk of cardiovascular and all-cause mortality in rural China. JAMA, 2018, 319(13): 1351-1361.
20. 何敏, 齐金蕾, 殷鹏, 等. 1990年与2019年中国归因于室外PM_(2. 5)暴露的心血管疾病负担分析. 中国循环杂志, 2021, 36(5): 488-493.
21. Gall ET, Carter EM, Earnest CM, et al. Indoor air pollution in developing countries: research and implementation needs for improvements in global public health. Am J Public Health, 2013, 103(4): e67-72.
22. 殷鹏, 齐金蕾, 刘韫宁, 等. 2005~2017年中国疾病负担研究报告. 中国循环杂志, 2019, 34(12): 1145-1154.
23. Liu Y, Pan J, Fan C, et al. Short-term exposure to ambient air pollution and mortality from myocardial infarction. J Am Coll Cardiol, 2021, 77(3): 271-281.
24. Baumgartner J, Smith KR, Chockalingam A. Reducing CVD through improvements in household energy: implications for policy-relevant research. Glob Heart, 2012, 7(3): 243-247.
25. Meng W, Zhong Q, Chen Y, et al. Energy and air pollution benefits of household fuel policies in northern China. Proc Natl Acad Sci U S A, 2019, 116(34): 16773-16780.

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