Abstract
Data collected in a large epidemiologic study were analyzed to examine respiratory health effects of residential coal use in 7058 school children living in the four Chinese cities of Chongqing, Guangzhou, Lanzhou, and Wuhan. A Scenario Evaluation Approach was used to develop two exposure variables, heating coal smoke and cooking coal smoke. Estimated lifetime exposures to heating coal smoke and cooking coal smoke were both classified into four-level ordinal scales, as follows: no reported exposure (control); lightly exposed; moderately exposed; and heavily exposed. Zero–one dummy variables were constructed for each exposure level other than the control level (total six variables). These variables were entered into the analytical model. We tested for exposure–response relationships using logistic regression models, while controlling for other relevant covariates, including an indicator variable of ambient air pollution levels. We observed monotonic and positive exposure–response relationships of exposure to heating coal smoke with modeled odds ratios (ORs) of phlegm, cough with phlegm, and bronchitis. Other health outcomes were not associated with such exposure in a monotonic exposure–response pattern. However, ORs for cough, wheeze, and asthma were all higher in the exposed groups than in the control group. We observed no consistent associations between cooking coal smoke and the examined health outcomes. We conclude that exposure to heating coal smoke could have adverse effects on children's respiratory symptoms and illnesses in these four Chinese cities.
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Acknowledgements
We are grateful for assistance from E. Teng, G. Wu, and W. Hu of the China National Environmental Monitoring Center (CNEMC), Q. He, L. Kong, F. Xu, K. Xu, and H. Guo of Wuhan Environmental Protection Research Institute, Q. Tian and L. Zhou of the Gansu Provincial Environmental Protection Research Institute, Y. Chen, Z. Liu, and L. Yan of the Guangzhou Environmental Monitoring Center, and Z. Peng, J. Chen, Y. Zhang and X. Meng of the Chongqing Environmental Protection Research Institute. We especially thank William E. Wilson for his support over the course of the study. This study was jointly funded by the US EPA and the Chinese Government through Cooperative Agreements CR822691 with CNEMC and CR826507 with the University of Medicine and Dentistry of New Jersey. Dr. Zhang's research is also supported in part by NIEHS center grant # ES05022-10 to EOHSI. The views expressed in this article are those of the authors and do not necessarily reflect the views or policies of either US EPA or the Chinese Government.
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Qian, Z., Zhang, J., Korn, L. et al. Exposure–response relationships between lifetime exposure to residential coal smoke and respiratory symptoms and illnesses in Chinese children. J Expo Sci Environ Epidemiol 14 (Suppl 1), S78–S84 (2004). https://doi.org/10.1038/sj.jea.7500362
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DOI: https://doi.org/10.1038/sj.jea.7500362
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