02-029 · EVIDENCE A · SOURCE-SENSITIVE
Switching from coal and wood to electricity or gas for cooking and heating
做饭、取暖不烧煤和柴，换成电或燃气
Rural households must replace their stoves and pay higher fuel costs, resulting in an annual expense of several hundred to over a thousand yuan. This is a one-time change that doesn’t require ongoing effort. In cities, most households already use electricity or gas.
People who cook with coal or wood face roughly a 10% higher chance of dying over the same period compared to those using electricity or gas. For those who heat their homes with coal or wood, the risk is about 14% higher. Those who have already switched to cleaner fuels have a mortality risk that is 13%–33% lower than those still relying on coal or wood.
A
Move “Switching from coal and wood to electricity or gas for cooking and heating” to Future Me's calendar
The excuse
Future Me has a clearer calendar, more patience, and apparently the same responsibilities.
What feels good now
Today I keep a little money, a few minutes and avoid interrupting my default routine.
What the source says
The source summarizes the return this way: “People who cook with coal or wood face roughly a 10% higher chance of dying over the same period compared to those using electricity or gas. For those who heat their homes with coal or wood, the risk is about 14% higher. Those who have already switched to cleaner fuels have a mortality risk that is 13%–33% lower than those still relying on coal or wood.” Evidence grade A. The original states the population, caveats, and sources; this is not a personal forecast.
Use the original facts and limits. For an urgent medical, safety, financial, or legal issue, contact a qualified local professional or service.
THE ENGLISH EDITION
Original recommendation and evidence
29. Switching from coal and wood to electricity or gas for cooking and heating
Cost: Rural households must replace their stoves and pay higher fuel costs, resulting in an annual expense of several hundred to over a thousand yuan. This is a one-time change that doesn’t require ongoing effort. In cities, most households already use electricity or gas.
In plain terms: People who cook with coal or wood face roughly a 10% higher chance of dying over the same period compared to those using electricity or gas. For those who heat their homes with coal or wood, the risk is about 14% higher. Those who have already switched to cleaner fuels have a mortality risk that is 13%–33% lower than those still relying on coal or wood.
Benefit: A Chinese longitudinal study tracked 271,000 adults without cardiovascular disease, recording their health outcomes without assigning them to groups. Individuals who cooked using solid fuels such as coal or wood had a mortality risk roughly 11% higher (HR 1.11) than those using electricity or gas. Those who used solid fuels for heating faced a 14% higher risk (HR 1.14). Among people who had switched from solid fuels to cleaner alternatives, the risk dropped by 13% for cooking (HR 0.87) and by 33% for heating (HR 0.67). Separate data also show that for every 10 µg/m³ increase in long-term exposure to outdoor PM2.5, the risk of death from natural causes rises by roughly 8% (RR 1.08). Natural causes refer to deaths not resulting from accidents.
Evidence grade: A
Sources: Yu K et al. (2018). Association of Solid Fuel Use With Risk of Cardiovascular and All-Cause Mortality in Rural China. JAMA. <https://doi.org/10.1001/jama.2018.2151>; Chen J, Hoek G (2020). Long-term exposure to PM and all-cause and cause-specific mortality: A systematic review and meta-analysis. Environment International. <https://doi.org/10.1016/j.envint.2020.105974>
Notes: These studies merely track health outcomes over time. Households that switch to cleaner fuels are often wealthier, so part of the observed 0.67-fold reduction in risk is likely linked to socioeconomic factors. Regarding outdoor PM2.5, individual actions such as relocating, wearing masks, or using air purifiers have limited impact. There are no studies evaluating air purifiers based on mortality rates, so no specific figures are provided here. 〔104〕
Source links
- Yu K 等 (2018). Association of Solid Fuel Use With Risk of Cardiovascular and All-Cause Mortality in Rural China. JAMA. ↗
- Chen J, Hoek G (2020). Long-term exposure to PM and all-cause and cause-specific mortality: A systematic review and meta-analysis. Environment International. ↗
- Pinned original chapter on GitHub ↗
Read the complete Chinese source and notes
29. 做饭、取暖不烧煤和柴，换成电或燃气
成本: 农村家庭要换灶具，加上燃料费，一年几百到上千元。换一次就完事，不长期占时间。城里人基本已经是电或燃气了。
说人话: 做饭烧煤或烧柴的人，同期死亡的概率高约一成；取暖烧煤柴的高约 14%。已经改用电或燃气的人，比还在烧煤柴的人死亡概率低 13%–33%。
收益: 中国有一项慢性病往后跟踪的研究，只记录、不分组，27.1 万名没有心血管病的成人。做饭用煤柴这类固体燃料的人，死亡风险比用电或燃气的人高约 11%（HR 1.11）。取暖用固体燃料的人高约 14%（HR 1.14）。已经从固体燃料换成清洁燃料的人，和还在烧的人比，做饭这项低约 13%（HR 0.87）。取暖这项低约 33%（HR 0.67）。室外的 PM2.5 另有一笔账。把 104 项跟踪研究合起来算，长期吸到的浓度每高 10 µg/m³，自然原因死亡风险高约 8%（RR 1.08）。自然原因就是非意外的病死。
证据等级: A
来源: Yu K 等 (2018). Association of Solid Fuel Use With Risk of Cardiovascular and All-Cause Mortality in Rural China. JAMA. <https://doi.org/10.1001/jama.2018.2151>；Chen J, Hoek G (2020). Long-term exposure to PM and all-cause and cause-specific mortality: A systematic review and meta-analysis. Environment International. <https://doi.org/10.1016/j.envint.2020.105974>
备注: 这类研究只是跟踪记录。换了燃料的家庭往往也更富裕，「风险降到 0.67 倍」这个数里混着家境的影响。至于室外的 PM2.5，个人能做的有限，无非是搬家、戴口罩、用净化器。空气净化器没有以死亡率为终点的研究，所以本节不给数字。
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