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目的 研究在中国家庭主妇中使用不同家庭烹饪燃料(固体燃料和清洁燃料)与高血压、脑卒中、慢性阻塞性肺疾病以及哮喘的关系。方法 数据来自“中国居民营养与健康状况监测(2015—2017年)”,采用多阶段分层整群抽样方法从全国选取15616名18岁及以上的家庭主妇，并对其进行基本信息调查、体格和实验室检查。采用逐步引入协变量进行校正的方法，使用多元Logistic回归分析比较使用清洁燃料与固体燃料在患高血压、脑卒中、慢性阻塞性肺疾病以及哮喘的风险差异，并以城乡作为分层因素做分层Logistic回归分析。结果 在15616名中国家庭主妇中，9539人(61.08%)使用清洁烹饪燃料，6077(38.92%)人使用固体烹饪燃料。使用清洁燃料和固体燃料者在城乡、年龄组、体质指数、文化程度、家庭人均年收入、吸烟及饮酒、二手烟暴露水平和一年内是否参加体检的构成比上差异有统计学意义(P<0.05)。经调整年龄、体质指数、居住地、家庭收入、文化程度、婚姻状况、吸烟、二手烟暴露、饮酒、一年内体检、糖尿病和血脂异常的患病情况后，使用固体燃料会增加高血压(OR=1.14, 95%CI 1.05～1.23)、脑卒中(OR=1.44, 95%CI 1.18～1.75)、慢性阻塞性肺疾病(OR=1.20, 95%CI 1.03～1.40)以及哮喘(OR=1.33, 95%CI 1.09～1.63)的患病风险。按城乡分层后，农村家庭主妇使用固体烹饪燃料会显著增加上述四种慢性病的患病风险(高血压：OR=1.11, 95%CI 1.01～1.22;脑卒中：OR=1.49, 95%CI 1.17～1.91;慢性阻塞性肺疾病：OR=1.20, 95%CI 1.00～1.42;哮喘：OR=1.40, 95%CI 1.09～1.79);而在城市家庭主妇中，除使用固体燃料可能使高血压风险升高外，脑卒中、慢性阻塞性肺疾病以及哮喘的患病风险并未见显著升高，但仍存在升高的趋势(高血压：OR=1.18, 95%CI 1.02～1.36;脑卒中：OR=1.37, 95%CI 0.99～1.90;慢性阻塞性肺疾病：OR=1.20, 95%CI 0.89～1.60;哮喘：OR=1.20, 95%CI 0.82～1.74)。结论 烹饪时使用固体烹饪燃料是中国家庭主妇在高血压、脑卒中、慢性阻塞性肺疾病以及哮喘的风险因素，且这种关联性在农村家庭主妇中更为显著。
Abstract：OBJECTIVE To analyze the association between the use of different household cooking fuels(including solid fuels and clean fuels) and hypertension, stroke, chronic obstructive pulmonary disease, and asthma among Chinese housewives.METHODS 15616 housewives aged over 18 years were selected from China Nutrition and Health Surveillance 2015-2017, and their basic information investigation, physical examination and laboratory examination were carried out. Using multiple adjustment logistic regression analysis to compare the risk of using clean fuels and solid fuels in hypertension, stroke, chronic obstructive pulmonary disease and asthma. And living areas(urban or rural) were used as stratified factors for stratified logistic regression analysis.RESULTS Among 15616 Chinese housewives, 9539(61.08%) used clean cooking fuels and 6077(38.92%) used solid cooking fuels at that time. There were significant differences in the composition of urban and rural areas, age groups, body mass index, education level, household annual income, smoking and drinking, second-hand smoke exposure level and whether to participate in physical examination within one year. After multivariable adjustment, using solid cooking fuels increased the risk of hypertension(OR=1.14, 95% CI 1.05-1.23), stroke(OR=1.44, 95% CI 1.18-1.75), chronic obstructive pulmonary disease(OR=1.20, 95% CI 1.03-1.40) and asthma(OR 1.33, 95% CI 1.09-1.63). After stratified by urban and rural areas, the result showed that using solid cooking fuels among rural housewives significantly increased the risk of the above four diseases(hypertension: OR=1.11, 95% CI 1.01-1.22; stroke: OR=1.49, 95% CI 1.17-1.91; chronic obstructive pulmonary disease: OR=1.20, 95% CI 1.00-1.42; asthma: OR=1.40, 95% CI 1.09-1.79). While in urban housewives, except that using solid cooking fuels might increase the risk of hypertension, the risk of stroke, chronic obstructive pulmonary disease and asthma has not increased significantly, but there was still an increasing tendencies(hypertension: OR=1.18, 95% CI 1.02-1.36; stroke: OR=1.37, 95% CI 0.99-1.90; chronic obstructive pulmonary disease: OR=1.20, 95% CI 0.89-1.60; asthma: OR=1.20, 95% CI 0.82-1.74).CONCLUSIONThe use of solid cooking fuels is a risk factor for Chinese housewives in hypertension, stroke, chronic obstructive pulmonary disease, and asthma, and is more significant among rural housewives.
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基本信息:
DOI：10.19813/j.cnki.weishengyanjiu.2023.03.005
中图分类号:R151.41
引用信息:
[1]杨宇祥,于冬梅,朴玮,等.2015—2017年中国家庭主妇慢性病与烹饪燃料的关系[J].卫生研究,2023,52(03):375-381.DOI:10.19813/j.cnki.weishengyanjiu.2023.03.005.
基金信息:
国家卫生健康委员会医改重大项目“中国居民营养与健康状况监测(2015—2017年)”
2023-05-30
2023-05-30