Analysis of the association between hearing loss and types of indoor fuel applications in middle-aged and older adults in China: based on the China Health and Retirement Longitudinal Study
10.3760/cma.j.cn115330-20250103-00005
- VernacularTitle:中国中老年人听力损失与室内燃料应用类型之间关系的分析：基于CHARLS数据
- Author:
Qiao HAN
1
;
Xiaoyu ZHOU
;
Yuchen TAO
;
Haiyan YIN
;
Qian LIU
;
Qianqian YANG
Author Information
1. 苏州大学附属第一医院耳鼻咽喉科，苏州 215006
- Publication Type:Journal Article
- Keywords:
Hearing loss;
Middle aged;
Aged;
Solid fuels;
Clean fuels;
CHARLS
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2025;60(10):1267-1274
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the association between hearing loss and the type of indoor fuel applications in Chinese middle-aged and elderly people through longitudinal cohort study.Methods:Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS), including adults aged 45 years and older enrolled in 2011, with follow-up for cooking and heating analyses extending to 2018 and 2015, respectively. The study calculated the incidence of hearing loss based on an indoor cooking or heating fuel type and expressed in terms of per 100 person-years. The Cox proportional hazard model was used to assess the association between solid fuel use and hearing loss, and covariates such as gender, education, and economy were controlled. We also analyzed the impact of indoor fuel type and its switching on hearing loss.Results:A total of 6, 772 participants using household fuels for cooking (2011-2018) and 4, 618 for heating (2011-2015) were included. Those using solid fuels for cooking [(58.0±8.2) years] and heating [(58.1±8.5) years] were generally slightly older than that of those who used clean fuels. In the cooking analysis, the overall incidence of hearing loss was higher among solid fuel users compared to clean fuel users (Clean fuel: 2.6 cases per 100 person-years; solid fuel: 3.6 cases per 100 person-years; the difference between the two was statistically significant, P<0.05). However, no significant difference was observed in the heating analysis ( P>0.05). Further classification of fuel-type use revealed that the incidence of hearing loss was the highest among people who had been using solid fuels consistently. Compared to the clean fuel group, the fully adjusted hazard ratio (HR) was 1.5 (95% CI: 1.3-1.7) in the cooking analysis and 1.5 (95% CI: 1.1-2.0) in the heating analysis. Compared with using clean fuels, switching from clean fuels to solid fuels increased the risk of hearing loss both during cooking and heating processes. Conclusion:In the CHARLS database, individuals who use solid fuels for indoor cooking and heating are older than those who use clean fuels. Compared with clean fuel use, the use of solid fuels increases the risk of hearing loss in middle-aged and elderly people. Reducing the use of solid fuels, choosing clean fuels as substitutes for solid fuels, and avoiding the switch from clean fuels to solid fuels will help protect the hearing health of middle-aged and elderly individuals.
