Associations between household solid fuel use and hearing loss in a Chinese population: A population-based prospective cohort study

Hearing loss, a common chronic condition, severely affects the quality of human life. However, the longitudinal relationships between household solid fuel use and hearing loss are unclear. To explore the associations between household solid fuel use and hearing loss in a Chinese population. There were 8835 participants enrolled in this prospective cohort study. Hearing function was assessed by asking the following self-reported question. Cox proportional hazards regression models were used to examine the relationships between baseline household solid fuel use and hearing loss incidence. After 6 (range, 2-7) years of follow-up, 1654 (18.72%) of 8835 participants developed hearing loss. This study demonstrated that increasing baseline solid fuel exposure was associated with a higher rate of poor hearing function (P for trend < 0.01). Compared with the clean fuel group (both cooking and heating), the hazard ratios (HR) (95% confidence intervals) of poor hearing function for the solid fuel group (cooking or heating) and both solid fuel groups (both cooking and heating) were 1.17 (1.01, 1.37) and 1.26 (1.09, 1.45) after adjustments, respectively. In subgroup analysis of household energy sources, the use of solid fuels for both heating (HR, 1.21; 1.07, 1.37) and cooking (HR, 1.12; 1.01, 1.26) was related to a higher incidence of poor hearing function. In subgroup analysis of place of residence, more solid fuel use was associated with a higher rate of poor hearing function in urban communities (HR, 1.39; 1.12, 1.74) but not in rural villages (HR, 1.18; 0.97, 1.45). Moreover, compared with the population that used solid fuel for cooking at both baseline and follow-up, those who switched from solid to clean fuel had a lower risk of developing poor hearing function (HR, 0.54, 0.46-0.63). This study demonstrates that household solid fuel use is closely associated with poor hearing function. Programs that educate individuals on the effects of household fuel use on hearing function should be established, especially in urban communities.