固体燃料取暖和吸烟与呼吸系统疾病发病关联的前瞻性队列研究

于洋; 田小草; 张华; 胡丹; 吕筠; 余灿清; 裴培; 孙点剑一; 高汝钦; 逄增昌; 段海平

Abstract

于洋,田小草,张华,胡丹,吕筠,余灿清,裴培,孙点剑一,高汝钦,逄增昌,段海平.固体燃料取暖和吸烟与呼吸系统疾病发病关联的前瞻性队列研究[J].Chinese journal of Epidemiology,2024,45(10):1356-1361

固体燃料取暖和吸烟与呼吸系统疾病发病关联的前瞻性队列研究

Association of solid fuel use for heating and smoking with respiratory diseases: a prospective cohort study

Received:May 08, 2024

DOI：10.3760/cma.j.cn112338-20240508-00246

KeyWord: 固体燃料吸烟呼吸系统疾病前瞻性队列

English Key Word: Solid fuel Smoking Respiratory system diseases Prospective cohort

FundProject:国家自然科学基金（82192900，82192901，82192904，81390540，91846303）；国家重点研发计划“精准医学研究”重点专项（2016YFC0900500）；中国香港Kadoorie Charitable基金；英国Wellcome Trust（202922/Z/16/Z，088158/Z/09/Z，104085/Z/14/Z）；中国青岛市科技惠民示范专项（23-2-8-smjk-18-nsh）

Author Name	Affiliation	E-mail
Yu Yang	Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
Tian Xiaocao	Department of Chronic and Non-communicable Disease Control and Prevention, Qingdao Municipal Center for Disease Control and Prevention, Qingdao 266033, China Qingdao Institute of Preventive Medicine, Qingdao 266033, China
Zhang Hua	Department of Chronic and Non-communicable Disease Control and Prevention, Qingdao Municipal Center for Disease Control and Prevention, Qingdao 266033, China Qingdao Institute of Preventive Medicine, Qingdao 266033, China
Hu Dan	Licang District Center for Disease Control and Prevention of Qingdao, Qingdao 266041, China
Lyu Jun	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
Yu Canqing	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
Pei Pei	Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China
Sun Dianjianyi	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing 100191, China
Gao Ruqin	Qingdao Institute of Preventive Medicine, Qingdao 266033, China Qingdao Municipal Center for Disease Control and Prevention, Qingdao 266033, China
Pang Zengchang	Qingdao Institute of Preventive Medicine, Qingdao 266033, China Qingdao Municipal Center for Disease Control and Prevention, Qingdao 266033, China
Duan Haiping	Qingdao Institute of Preventive Medicine, Qingdao 266033, China Qingdao Municipal Center for Disease Control and Prevention, Qingdao 266033, China	duan_hp@126.com

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Abstract:

目的研究固体燃料取暖、吸烟与呼吸系统疾病的关联。方法基于中国慢性病前瞻性研究中的青岛项目点。经过筛选，纳入26 165名研究对象。采用Cox比例风险回归模型，按风险年龄（以5年为间隔）和性别进行分层，并对职业、体力活动水平等协变量进行调整，分析固体燃料取暖、吸烟与呼吸系统疾病发病风险增加之间的关联。结果在26 165名研究对象中，使用固体燃料取暖者年龄为（52.57±10.31）岁，女性占58.04%，曾经/现在吸烟者占65.38%。研究结果显示，使用固体燃料组和曾经/现在吸烟组呼吸系统疾病发病风险都较高，风险比（HR）值（95%CI）分别为1.21（1.04~1.41）和1.41（1.16~1.71）。使用固体燃料取暖年限≥20年的HR值（95%CI）为1.27（1.07~1.51），固体燃料与吸烟的相乘交互项有统计学意义。结论使用固体燃料取暖、吸烟增加呼吸系统疾病发病风险，并且固体燃料使用与吸烟之间可能存在相乘交互作用。

English Abstract:

Objective To investigate the association between solid fuel use for heating, smoking, and respiratory diseases. Methods This study is based on the Qingdao project of the China Kadoorie Biobank. After screening, 26 165 individuals were included in the study. We employed Cox proportional hazards regression models, stratified by risk age (in 5-year intervals) and sex while adjusting for confounding variables such as occupation and physical activity level to analyze the association between solid fuel use for heating, smoking, and increased risk of respiratory diseases. Results Among the 26 165 participants, the average age of those using solid fuel for heating was (52.57±10.31) years, with females constituting 58.04% and former/current smokers accounting for 65.38%. The results indicated that both the solid fuel group and the former/current smoking group had a higher risk of respiratory diseases, with hazard ratios (HR) (95%CI) of 1.21 (1.04-1.41) and 1.41 (1.16-1.71), respectively. For the duration of solid fuel use, the HR (95%CI) for 20 years or more, it was 1.27 (1.07-1.51). The multiplicative interaction term between solid fuel use and smoking was statistically significant. Conclusions The use of solid fuel for heating and smoking significantly increases the risk of respiratory diseases, and there may be a multiplicative interaction between solid fuel use and smoking.

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