使用效率低下的固体燃料燃烧产生的家庭空气污染（HAP）是全球的一项重大健康问题。然而，有关固体燃料烹饪的健康影响和慢性消化疾病风险的前瞻性证据仍然很少。我们研究了自我报告的主要烹饪燃料对慢性消化疾病发生率的影响。中国卡多瑞生物库从中国10个地区招募了 512,726 名年龄在 30-79 岁之间的参与者。基线时通过自我报告收集了当前和以前两个住所的主要烹饪燃料信息。通过电子链接和积极的跟踪，确定了慢性消化疾病的发生率。使用 Cox 比例风险回归模型估计自我报告的长期烹饪燃料模式和固体烹饪燃料使用的加权持续时间与慢性消化疾病发病率之间的关联的调整危险比（HR）和 95% 置信区间（CI）。通过将每组加权持续时间的中位数分配为模型中的连续变量，进行线性趋势测试。在参与者基线特征的子组分析中进行了研究。在 9.1±1.6 年的随访期间，记录了 16,810 例新慢性消化疾病病例，其中 6,460 例被诊断为癌症。与长期使用清洁燃料相比，自我报告的长期使用固体烹饪燃料（如煤、木材）与慢性消化疾病（HR=1.08；95% CI：1.02，1.13）、包括非酒精性脂肪性肝病（NAFLD）（HR=1.43；95% CI：1.10，1.87）、肝纤维化/肝硬化（HR=1.35；95% CI：1.05，1.73）、胆囊炎（HR=1.19；95% CI：1.07，1.32）和消化性溃疡（HR=1.15；95% CI：1.00，1.33）的风险升高。自我报告的固体烹饪燃料使用加权持续时间越长，慢性消化疾病、肝纤维化/肝硬化、消化性溃疡和食管癌的风险越高（p趋势<0.05）。上述关联与性别和身体质量指数（BMI）有关。固体烹饪燃料的长期使用与慢性消化疾病的风险增加有关，这表明需要通过推广清洁燃料来进行公共卫生干预。 https://doi.org/10.1289/EHP10486。

Household air pollution (HAP) from inefficient combustion of solid fuels is a major health concern worldwide. However, prospective evidence on the health impacts of solid cooking fuels and risks of chronic digestive diseases remains scarce.We explored the effects of self-reported primary cooking fuels on the incidence of chronic digestive diseases.The China Kadoorie Biobank recruited 512,726 participants 30-79 years of age from 10 regions across China. Information on primary cooking fuels at the current and previous two residences was collected via self-reporting at baseline. Incidence of chronic digestive diseases was identified through electronic linkage and active follow-up. Cox proportional hazards regression models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations of self-reported long-term cooking fuel patterns and weighted duration of self-reported solid cooking fuel use with chronic digestive diseases incidence. Linear trend was tested by assigning the medians of weighted duration in each group and then taking those as continuous variables in the models. Subgroup analyses were undertaken across the baseline characteristics of participants.During 9.1±1.6 y of follow-up, 16,810 new cases of chronic digestive diseases were documented, among which 6,460 were diagnosed as cancers. Compared with long-term cleaner fuel use, self-reported long-term use of solid cooking fuels (i.e., coal, wood) was associated with elevated risks of chronic digestive diseases (HR=1.08; 95% CI: 1.02, 1.13), including nonalcoholic fatty liver disease (NAFLD) (HR=1.43; 95% CI: 1.10, 1.87), hepatic fibrosis/cirrhosis (HR=1.35; 95% CI: 1.05, 1.73), cholecystitis (HR=1.19; 95% CI: 1.07, 1.32), and peptic ulcers (HR=1.15; 95% CI: 1.00, 1.33). The longer the weighted duration of self-reported solid cooking fuel use, the higher the risks of chronic digestive diseases, hepatic fibrosis/cirrhosis, peptic ulcers, and esophageal cancer (pTrend<0.05). The aforementioned associations were modified by sex and body mass index (BMI). Positive associations of always solid cooking fuel use with chronic digestive disease, hepatic fibrosis/cirrhosis, NAFLD, and cholecystitis were observed among women but not men. The longer the weighted duration of self-reported solid cooking fuel use, the higher the risk of NAFLD among those with a BMI ≥28 kg/m2.Long-term self-reported solid cooking fuels use was associated with higher risks of chronic digestive diseases. The positive association of HAP from solid cooking fuels with chronic digestive diseases indicates for an imminent promotion of cleaner fuels as public health interventions. https://doi.org/10.1289/EHP10486.