Skip to main content

Coal for cooking and all-cause and cause-specific mortality in a prospective study of women in Shanghai, China

Tuesday, September 23, 2014 — Poster Session III

12:00 p.m. – 2:00 p.m.

FAES Academic Center



* FARE Award Winner


  • C Kim
  • XO Shu
  • HD Hosgood
  • BA Bassig
  • YB Xiang
  • WJ Seow
  • HL Li
  • BT Ji
  • W Hu
  • C Wen
  • WH Chow
  • G Yang
  • YT Gao
  • W Zheng
  • N Rothman
  • Q Lan


Introduction: Household air pollution was responsible for 3.5 million deaths in 2010. Previous studies were retrospective, under developed populations. We assessed the association between historic coal use and mortality in the prospective Shanghai Women’s Health Study cohort. Methods: A cohort of 73,363 women was followed from 1996 through December 2009 with linkage to a vital statistics registry. A total of 3808 deaths were identified. Cox proportional hazards models estimated risk of mortality associated with in-home coal use. Results: Ever use of coal was associated with all-cause (Hazard Ratio (HR): 1.16; 95% CI: 1.06-1.27), cancer-related (HR: 1.15; 95% CI: 1.00-1.32), cardiovascular (HR: 1.22; 95% CI: 1.03-1.45), and diabetes (HR: 1.48; 95% CI: 1.01-2.19) mortality compared to never-coal users. There was also an exposure-dependent increase (P-trends > 0.05). All-cause mortality risk decreased as years since last coal use increased (P-trend: 0.0006). Discussion: This is the first study of mortality and in-home coal use in a prospective study after much of Shanghai transitioned into a developed and urban city with little current coal use. Evidence from this study suggests that past use of coal could be related to excess cardiovascular, cancer, and diabetes deaths among women in Shanghai.

back to top