Exposure to household air pollution and cognitive function among older adults in northern China
Bibliographic record
Abstract
Background: Accumulating evidence indicates that exposure to urban air pollution can reduce cognitive abilities in children and adults, and increase risk of dementia. Less understood is whether exposure to household air pollution emitted from solid fuel (i.e., coal and biomass) burning is also associated with reduced cognitive function. Almost half (49%) of the world’s population, including over 450 million Chinese, live in homes that cook and space heat with highly-polluting solid fuel stoves. Methods: Among 401 peri-urban adults in northern China (mean age=62.5 y, 58% women) enrolled in the INTERMAP China Prospective (ICP) study, exposure to household air pollution was assessed by 1) measuring personal exposures to fine particulate matter ≤ 2.5 µm in diameter (PM2.5) and black carbon for up to 4 days in the heating and non-heating seasons via air samplers; and 2) collecting detailed information on current and historical household fuel use practices via an image-based household energy questionnaire. Cognitive function was assessed using the modified Beijing version of the Montreal Cognitive Assessment survey that was developed to detect MCI. I investigated associations between measures of household air pollution and domain-specific and overall cognitive function, expressed as z scores, using mixed-effects regression models while adjusting for key sociodemographic, behavioral, and environmental confounding variables. Results: Participants’ average 24-h exposures ranged from 17.2-484.4 μg/m3 (geometric mean=91.3) for PM2.5 and from 0.1-8.5 μg/m3 (geometric mean=1.4) for black carbon. The two pollutants were moderately correlated (Spearman r=0.46). Almost half (45%) of the participants currently used solid fuel for cooking and a larger proportion (62%) for heating, while the remaining participants used clean fuel stoves (electricity/gas) exclusively. Current and long-term solid fuel use intensities were moderately correlated (Spearman r=0.55). An interquartile range increase in exposure to PM2.5 (53.2 μg/m3) was linearly associated with lower overall cognitive function [-0.11 (95% CI: -0.19, -0.02)], an effect size similar to a difference in age of 4.4 years. Similar but slightly smaller exposure-response associations were found for black carbon. Using solid fuel for cooking or heating (relative to exclusive clean fuel use), and using them at higher intensities, were suggestive of inverse associations with overall cognitive function though all the confidence intervals included zero. Among the individual cognitive domains, attention has the largest association with nearly all measures of exposure to household air pollution. Conclusion: My thesis identifies exposure to household air pollution as a potential modifiable risk factor for cognitive impairment among peri-urban adults in northern China, results of which may extend to other regions of the world where household solid fuel use persists. My exposure-response findings can help inform future risk assessments that aim to estimate potential cognitive health benefits of reducing solid fuel use intensity and eventually adopting exclusive use of clean household energy
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".