Long-term exposure to household air pollution from burning kerosene and diesel fuel indoors was associated with an increased risk of heart disease death in a recent study led by Northwestern Medicine investigator Dr. Sumeet Mitter.
The findings, published in the journal Circulation, have important implications for residents of low- and middle- income countries where high-pollution fuels are still commonly used for lighting, cooking and heating.
“Up until this point, exposure to household air pollution was thought only to contribute to cardiovascular risk factors,” said Dr. Mitter, a fellow in the Advanced Heart Failure and Heart Transplant program in the department of cardiology. “In our study, we were able to show a link with all-cause, total cardiovascular and ischemic heart disease mortality with longer durations of kerosene and diesel burning over one’s lifetime.”
The investigators examined data collected during a span of 10 years from more than 50,000 people living in the Golestan province of northeastern Iran. They discovered that participants who burned kerosene or diesel had a 6 percent higher risk for all-cause mortality, an 11 percent higher risk for cardiovascular death and a 14 percent higher risk for ischemic heart (coronary artery) disease death. Participants in the study who used natural gases (liquefied petroleum gas) had a 6 percent lower risk of cardiovascular death, compared to other fuels.
These results point to risk factors for heart disease beyond well known contributors like outdoor air pollution and smoking tobacco.
“This helps establish household air pollution as a non-traditional risk factor for cardiovascular disease and death that should be assessed for in low- and middle-income countries where cardiovascular disease is the leading cause of death,” said Dr. Mitter, who began working on this study as an internal medicine resident at the Icahn School of Medicine at Mount Sinai. He finished data analysis and drafting the manuscript at Northwestern.
Altogether, the findings suggest that indoor air pollution may be a modifiable risk factor for physicians to assess and communities to consider, Dr. Mitter explained.
“Many countries are helping their communities transition to cleaner burning fuels and also install stoves with better ventilation systems into their homes to decrease the exposure to household air pollution,” he said.
Dr. Mitter and colleagues used data from the Golestan Cohort Study, which originally looked at esophageal cancer in the region. That study was funded by Tehran University of Medical Sciences grant 81/15, Cancer Research UK grant C20/A5860, the Intramural Research Program of the U.S. National Cancer Institute and through various collaborative research agreements with the International Agency for Research on Cancer in Lyon, France.