Background: Incense burning is common in many parts of the world. Although it is perceived that particulate matter from incense smoke is deleterious to health, there is no epidemiologic evidence linking domestic exposure to cardiovascular mortality.
Objective: We examined the association between exposure to incense burning and cardiovascular mortality in the Singapore Chinese Health Study.
Methods: We enrolled a total of 63,257 Singapore Chinese 45–74 years of age during 1993–1998. All participants were interviewed in person to collect information about lifestyle behaviors, including the practice of burning incense at home. We identified cardiovascular deaths via record linkage with the nationwide death registry through 31 December 2011.
Results: In this cohort, 76.9% were current incense users, and most of the current users (89.9%) had burned incense daily for ≥ 20 years. Relative to noncurrent users, current users had a 12% higher risk of cardiovascular mortality [multivariable adjusted hazard ratio (HR) = 1.12; 95% CI: 1.04, 1.20]. The HR was 1.19 (95% CI: 1.03, 1.37) for mortality due to stroke and 1.10 (95% CI: 1.00, 1.21) for mortality due to coronary heart disease. The association between current incense use and cardiovascular mortality appeared to be limited to participants without a history of cardiovascular disease at baseline (HR = 1.16; 95% CI: 1.07, 1.26) but not linked to those with a history (HR = 1.00; 95% CI: 0.86, 1.17). In addition, the association was stronger in never-smokers (HR = 1.12; 95% CI: 1.02, 1.23) and former smokers (HR = 1.19; 95% CI: 1.00, 1.42) than in current smokers (HR = 1.05; 95% CI: 0.91, 1.22).
Conclusions: Long-term exposure to incense burning in the home environment was associated with an increased risk of cardiovascular mortality in the study population.
1Saw Swee Hock School of Public Health, and 2Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore; 3Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado, USA; 4Epidemiology and Disease Control Division, Ministry of Health, Singapore; 5Keck School of Medicine, University of Southern California, Los Angeles, California, USA; 6Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania, USA; 7Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; 8Duke-NUS Graduate Medical School Singapore, Singapore
Recommended Citation:
An Pan,1,2 Maggie L. Clark,et al. Incense Use and Cardiovascular Mortality among Chinese in Singapore: The Singapore Chinese Health Study[J]. Environmental Health Perspectives,2014-01-01,Volume 122(Issue 12):1279