Robert S Chapman1, Xingzhou He, Aaron E Blair, Qing Lan. 1. College of Public Health, Chulalongkorn University, Institute Building 3, 10th Floor, Soi Chulalongkorn 62, Phyathai Road, Patumwan, Bangkok 10330, Thailand.
Abstract
OBJECTIVE: To test whether improvement in household coal stoves affected the incidence of chronic obstructive pulmonary disease (COPD) in Xuanwei County, China. DESIGN: Retrospective cohort study (follow-up 1976-92) comparing incidence of COPD between groups with and without chimneys. PARTICIPANTS: 20,453 people born into homes with unvented coal stoves;16,606 (81.2%) subsequently changed to stoves with chimneys. INTERVENTION: Installation of a chimney in households in which unvented stoves had been used previously. RESULTS: Installation of a chimney was associated with distinct reduction in the incidence of COPD. Compared with people who did not have chimneys, the Cox-modelled risk ratio (relative risk) was 0.58 (95% confidence interval 0.49 to 0.70, P < 0.001) in men and 0.75 (0.62 to 0.92, P = 0.005) in women. Modelled risk ratios were robust to different Cox model specifications. Relative risks decreased with time since stove improvement. In both sexes, the reduction in risk became unequivocal about 10 years after stove improvement. CONCLUSIONS: In Xuanwei, incidence of COPD decreased markedly after household coal stoves were improved.
OBJECTIVE: To test whether improvement in household coal stoves affected the incidence of chronic obstructive pulmonary disease (COPD) in Xuanwei County, China. DESIGN: Retrospective cohort study (follow-up 1976-92) comparing incidence of COPD between groups with and without chimneys. PARTICIPANTS: 20,453 people born into homes with unvented coal stoves;16,606 (81.2%) subsequently changed to stoves with chimneys. INTERVENTION: Installation of a chimney in households in which unvented stoves had been used previously. RESULTS: Installation of a chimney was associated with distinct reduction in the incidence of COPD. Compared with people who did not have chimneys, the Cox-modelled risk ratio (relative risk) was 0.58 (95% confidence interval 0.49 to 0.70, P < 0.001) in men and 0.75 (0.62 to 0.92, P = 0.005) in women. Modelled risk ratios were robust to different Cox model specifications. Relative risks decreased with time since stove improvement. In both sexes, the reduction in risk became unequivocal about 10 years after stove improvement. CONCLUSIONS: In Xuanwei, incidence of COPD decreased markedly after household coal stoves were improved.
Authors: Majid Ezzati; Alan D Lopez; Anthony Rodgers; Stephen Vander Hoorn; Christopher J L Murray Journal: Lancet Date: 2002-11-02 Impact factor: 79.321
Authors: Majid Ezzati; Stephen Vander Hoorn; Anthony Rodgers; Alan D Lopez; Colin D Mathers; Christopher J L Murray Journal: Lancet Date: 2003-07-26 Impact factor: 79.321
Authors: Qing Lan; Robert S Chapman; Dina M Schreinemachers; Linwei Tian; Xingzhou He Journal: J Natl Cancer Inst Date: 2002-06-05 Impact factor: 13.506
Authors: Stephanie Boue; Brett Fields; Julia Hoeng; Jennifer Park; Manuel C Peitsch; Walter K Schlage; Marja Talikka; Ilona Binenbaum; Vladimir Bondarenko; Oleg V Bulgakov; Vera Cherkasova; Norberto Diaz-Diaz; Larisa Fedorova; Svetlana Guryanova; Julia Guzova; Galina Igorevna Koroleva; Elena Kozhemyakina; Rahul Kumar; Noa Lavid; Qingxian Lu; Swapna Menon; Yael Ouliel; Samantha C Peterson; Alexander Prokhorov; Edward Sanders; Sarah Schrier; Golan Schwaitzer Neta; Irina Shvydchenko; Aravind Tallam; Gema Villa-Fombuena; John Wu; Ilya Yudkevich; Mariya Zelikman Journal: F1000Res Date: 2015-01-29
Authors: Eric A Engels; Min Shen; Robert S Chapman; Ruth M Pfeiffer; Ying-Ying Yu; Xingzhou He; Qing Lan Journal: Int J Cancer Date: 2009-03-01 Impact factor: 7.396
Authors: Min Shen; Robert S Chapman; Roel Vermeulen; Linwei Tian; Tongzhang Zheng; Bingshu E Chen; Eric A Engels; Xingzhou He; Aaron Blair; Qing Lan Journal: Environ Health Perspect Date: 2008-09-19 Impact factor: 9.031