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Household diesel, kerosene use may raise risk for MI, death
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Household air pollution generated from fuels such as kerosene and diesel was associated with increased risk for MI and death, according to study data published in Circulation.
“Within any country, there are different economic strata,” Sumeet Singh Mitter, MD, told Cardiology Today in an interview. “Communities in low- and middle-income countries are burning more high-polluting fuels. But, that doesn’t mean it never occurs in the United States. This is a modifiable risk factor for CVD that we don’t often think about. Many patients we see in the U.S. originally come from other countries and may have this condition in their backgrounds. We have to be aware of it.”
Sumeet Singh Mitter
Mitter, a cardiovascular disease fellow at Northwestern University Feinberg School of Medicine, and colleagues analyzed 50,045 members of a community in northeastern Iran (aged 40-75 years; 58% women) monitored from 2004 to 2008.
Seventy-four percent of the participants were of Turkmen ancestry. Most (80%) lived in rural areas. Participants were followed up at a 99% rate through 2012.
Mitter and colleagues collected data on lifetime household fuel use and other exposures, and assessed the relationship between local dung, wood, kerosene or diesel, and cooking- or heating-related natural gas burning and mortality from any cause and specific causes.
During follow-up, 6% of participants died, and the researchers attributed 78% of deaths to noncommunicable diseases such as CV, oncological and respiratory illnesses.
Kerosene, diesel culprits
The researchers found kerosene or diesel burning was associated with an increased risk for CVD death (adjusted 10-year HR = 1.11; 95% CI, 1.06-1.17) and all-cause mortality (adjusted 10-year HR = 1.06; 95% CI, 1.02-1.1). However, cleaner-burning natural gas was linked to a reduced risk for CV death (adjusted 10-year HR = 0.94; 95% CI, 0.89-0.99).
Women exposed to kerosene or diesel burning faced a greater risk for all-cause mortality (adjusted 10-year HR = 1.09; 95% CI, 1.03-1.15) and total CVD mortality (adjusted 10-year HR = 1.14; 95% CI, 1.06-1.22) compared with men (adjusted 10-year HR for all-cause mortality = 1.04; 95% CI, 0.99-1.09; adjusted 10-year HR for CVD mortality = 1.08; 95% CI, 1.01-1.16), the study showed.
For both men and women, exposure to kerosene or diesel was associated with a significant rise in ischemic heart disease (adjusted 10-year HR = 1.14; 95% CI, 1.06-1.21) and a trend toward a rise in cerebrovascular accident mortality (adjusted 10-year HR = 1.08; 95% CI, 0.99-1.17).
The researchers wrote that, according to WHO, 3 billion people worldwide, mostly in low- and middle-income countries, heat their homes and cook with solid fuels and open fires; approximately 500 million households worldwide use kerosene to heat their homes; and, in urban areas, kerosene use outpaces coal and biomass for cooking.
Mitter told Cardiology Today the problem is being addressed by the Global Alliance for Clean Cookstoves, launched by the U.N. Foundation to help 100 million impoverished homes worldwide use clean and efficient stoves and fuels by 2020.
“That’s the next step,” Mitter said. “We have to get these stoves into the homes and then study the effects of the ventilation. We need to take a closer look at the particulate matter of household air pollution.” – by James Clark
For more information:
Sumeet Singh Mitter, MD, can be reached at Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, 676 N. St. Clair St., Suite 600, Chicago, IL 60611; email: sumeet.mitter@northwestern.edu
Disclosure: The researchers report no relevant financial disclosures.
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