Rate and Change in Household Solid Fuels Usage Among Residents Aged 40 and Older - China, from 2014-2015 to 2019-2020.

Introduction: Solid fuel combustion is a significant source of household air pollution and an important risk factor for chronic obstructive pulmonary disease (COPD). This study presents the rates and change in the use of solid fuels for cooking and heating in China.

Methods: Based on data from the Chinese Chronic Obstructive Pulmonary Disease Surveillance, the research estimated the rates and change of solid fuels usage for cooking and heating from 2014-2015 to 2019-2020 and the rate of primary cooking solid fuels usage in 2019-2020, and analyzed the association between solid fuels usage and COPD.

Results: The rates of solid fuels usage for cooking and heating significantly decreased, dropping from 45.3% to 28.0% and from 33.5% to 23.2%, respectively. Usage rates were higher among rural residents, with 47.2% using it for cooking and 37.7% for heating in 2019-2020. The usage of solid fuels for cooking is associated with increased risk of COPD. Among rural residents, combined usage of biomass and coal for cooking (OR=1.29, 95% CI: 1.12, 1.48) and using coal as primary fuel for cooking (OR=1.18, 95% CI: 1.00, 1.38) are associated with higher risk of COPD. The usage of biomass for cooking is associated with an increased risk of COPD in urban residents (OR=1.17, 95% CI: 1.03, 1.32).

Conclusions: The study demonstrates a significant decline in the use of household solid fuels. Nevertheless, high utilization rates persist among individuals in rural settings and those from lower socioeconomic backgrounds. It is of great public health importance to propose targeted fuel substitution measures for various solid fuels in different regions to reduce the risk of COPD.