Impacts of Household Solid Fuel Combustion on Blood Pressure: Mechanisms and Implications

Rural households in northwest China rely on solid fuels as their main heating energy source in winter, leading to negative health outcomes. This study assessed the concentrations of personal exposure to size-resolved particulate matter and gaseous pollutants (NO₂, CO, and O₃) and their effects on biomarkers of inflammation and oxidative stress in 129 rural residents who use solid fuels in the Fenwei Plain in winter. The results showed that NO₂ exposure significantly increased IL-6 and TNF-α in urine (u), O₃ exposure significantly increased 8-OHdG and IL-10 in urine (u), and CO exposure caused significantly increased 8-OHdG in blood (b). Four urine biomarkers positively correlated with systolic blood pressure (SBP); 8-OHdG-b was significantly positively correlated with both SBP and diastolic blood pressure (DBP). Mediation analysis showed that O₃ and CO mediated the association between IL-10-u and SBP and 8-OHdG-b with SBP. O₃ and CO exposure caused by domestic solid fuel combustion may lead to an increase in human SBP by mediating systemic inflammation and oxidative stress. The study emphasizes the urgency of improving rural household heating methods and reducing air pollution to alleviate the burden of diseases associated with hypertension and provides a scientific basis for understanding the pathogenesis and early prevention of hypertension among rural residents in northwest China.