Cooking with biomass fuel and cardiovascular disease: a cross-sectional study among rural villagers in Phitsanulok, Thailand

Background: Burning biomass fuel is a major source of indoor air pollution; about 40% of Thai people still use biomass for cooking. There is increasing evidence of the association between biomass smoke exposure and serious health effects including cardiovascular disease. The object of this cross-sectional study was to investigate the association between biomass use for household cooking and cardiovascular outcome, including coronary heart disease, hypertension, high cholesterol, diabetes mellitus, and stroke among rural villagers in Phitsanulok, Thailand. Methods: Data from 1078 households were collected using a face-to-face interview questionnaire. In each household, data on cardiovascular disease, cooking practices, and cooking fuel, types of fuel they normally used for cooking, were collected. Results: After being adjusted for gender, age, cigarette smoke, secondhand smoke, and exposure to other sources of air pollution, it was found that the family members of cooks using biomass fuel were at risk of coronary heart disease (CHD; OR=4.35; 95%CI 0.10-18.97), hypertension (OR=1.61; 95%CI 1.10-2.35), high cholesterol (HC; OR=2.74; 95%CI 1.66-4.53), and diabetes (OR=1.88; 95%CI 1.03-3.46). Compared to LPG use, using wood was associated with stroke (OR=7.64; 95%CI 1.18-49.61), and using charcoal was associated with HC (OR=1.52; 95%CI 1.04-2.24). Compared to never user, household cooks who sometimes use charcoal had an increased risk of hypertension (OR=2.04; 95%CI 1.32-3.15), HC (OR=2.61; 95%CI 1.63-4.18), and diabetes (OR=2.09; 95%CI 1.17-3.73); and cooks who often use charcoal had an elevated risk of stroke (OR=3.17; 95%CI 1.04-9.71), and HC (OR=1.52; 95%CI 1.02-2.27) to their family members. Conclusions: The study results were consistent with those found in studies from other parts of the world, and supports that exposure to biomass smoke increase cardiovascular diseases. The issue should receive more attention, and promotion of clean fuel use is a prominent action.