Objective: To investigate the association between solid fuel use for heating, smoking, and respiratory diseases. Methods: This study is based on the Qingdao project of the China Kadoorie Biobank. After screening, 26 165 individuals were included in the study. We employed Cox proportional hazards regression models, stratified by risk age (in 5-year intervals) and sex while adjusting for confounding variables such as occupation and physical activity level to analyze the association between solid fuel use for heating, smoking, and increased risk of respiratory diseases. Results: Among the 26 165 participants, the average age of those using solid fuel for heating was (52.57±10.31) years, with females constituting 58.04% and former/current smokers accounting for 65.38%. The results indicated that both the solid fuel group and the former/current smoking group had a higher risk of respiratory diseases, with hazard ratios (HR) (95%CI) of 1.21 (1.04-1.41) and 1.41 (1.16-1.71), respectively. For the duration of solid fuel use, the HR (95%CI) for 20 years or more, it was 1.27 (1.07-1.51). The multiplicative interaction term between solid fuel use and smoking was statistically significant. Conclusions: The use of solid fuel for heating and smoking significantly increases the risk of respiratory diseases, and there may be a multiplicative interaction between solid fuel use and smoking.
目的： 研究固体燃料取暖、吸烟与呼吸系统疾病的关联。 方法： 基于中国慢性病前瞻性研究中的青岛项目点。经过筛选，纳入26 165名研究对象。采用Cox比例风险回归模型，按风险年龄（以5年为间隔）和性别进行分层，并对职业、体力活动水平等协变量进行调整，分析固体燃料取暖、吸烟与呼吸系统疾病发病风险增加之间的关联。 结果： 在26 165名研究对象中，使用固体燃料取暖者年龄为（52.57±10.31）岁，女性占58.04%，曾经/现在吸烟者占65.38%。研究结果显示，使用固体燃料组和曾经/现在吸烟组呼吸系统疾病发病风险都较高，风险比（HR）值（95%CI）分别为1.21（1.04~1.41）和1.41（1.16~1.71）。使用固体燃料取暖年限≥20年的HR值（95%CI）为1.27（1.07~1.51），固体燃料与吸烟的相乘交互项有统计学意义。 结论： 使用固体燃料取暖、吸烟增加呼吸系统疾病发病风险，并且固体燃料使用与吸烟之间可能存在相乘交互作用。.