Coal Use, Stove Improvement, and Adult Pneumonia Mortality in Xuanwei, China: A Retrospective Cohort Study
2009

Coal Use and Pneumonia Mortality in Xuanwei, China

Sample size: 42422 publication 10 minutes Evidence: high

Author Information

Author(s): Shen Min, Chapman Robert S., Vermeulen Roel, Tian Linwei, Zheng Tongzhang, Chen Bingshu E., Engels Eric A., He Xingzhou, Blair Aaron, Lan Qing

Primary Institution: National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services

Hypothesis

Is indoor air pollution from coal burning a risk factor for pneumonia mortality in adults?

Conclusion

Indoor air pollution from unvented coal burning is a significant risk factor for pneumonia death in adults, and improving ventilation can reduce this risk.

Supporting Evidence

  • Stove improvement was associated with a 50% reduction in pneumonia deaths.
  • Use of smokeless coal was linked to a 50% higher risk of pneumonia death.
  • Age-adjusted mortality rates of pneumonia were higher in smokeless coal users.
  • History of chronic bronchitis, emphysema, or asthma significantly increased pneumonia death risk.

Takeaway

Burning coal indoors can make people very sick and even cause pneumonia, but using better stoves with chimneys can help keep them safe.

Methodology

A retrospective cohort study was conducted among farmers born between 1917 and 1951 in Xuanwei, tracking deaths from pneumonia from 1976 to 1996.

Potential Biases

Potential misclassification of pneumonia diagnosis with other respiratory diseases.

Limitations

Lack of detailed exposure assessment data for households before and after stove improvement.

Participant Demographics

The cohort included 21,701 men and 20,721 women, primarily using smoky or smokeless coal.

Statistical Information

P-Value

0.005

Confidence Interval

95% CI, 0.340–0.798

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1289/ehp.11521

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