Objectives We examined the association between household solid fuel exposure and lung function in a densely populated district in urban Shanghai, China.

Methods Spirometry was performed in 12 506 subjects, aged 18 and over, residing in the Putuo District in Shanghai, China, in a cross-sectional survey. Exposure to solid fuel use at home was assessed by an administered questionnaire, estimating duration and total amount of solid fuel use at home during the lifetime.

Results After adjusting for confounders, the subjects with exposure to household solid fuel had a 1.3% (95% CI 0.57 to 2.02) decrease in forced expiratory volume in 1 s (FEV₁) percent predicted and 3.5% (95% CI 2.74 to 4.18) decrease in forced vital capacity (FVC) percent predicted, respectively. Trends towards decreased pulmonary function measures were seen for longer duration and greater amount of household fuel use at home, in the highest compared with lowest tertile (p values for trend <0.001). We observed decrease in FEV₁ and FVC percent predicted across increase in tertile of body mass index in association with in-home solid fuel exposure.

Conclusions This study suggests that in-home solid fuel exposure is associated with reduced lung function in an urban population.