Evidence map›Paper›PMID 42085295›Full record

ArticleAmerican journal of respiratory and critical care medicine2026

Effects of China's Clean Heating Policy on respiratory symptoms and airway inflammation in adults: a quasi-experimental study in rural Beijing.

Kaibing Xue, Jill Baumgartner, Sam Harper, Talia Sternbach, Xiaoying Li, Jing Shang, Wenlu Yuan, Jian Ma, Xiang Zhang, Ellison Carter and 2 more

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In one paragraph

Article in American journal of respiratory and critical care medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Kaibing XueCollege of Resources and Environment, University of Chinese Academy of Sciences, Beijing, China.
Jill BaumgartnerDepartment of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.
Sam HarperDepartment of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.ORCID 0000-0002-2767-1053
Talia SternbachDepartment of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.
Xiaoying LiDepartment of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.
Jing ShangInstitute of Urban Meteorology, China Meteorological Administration, Beijing, China.
Wenlu YuanDepartment of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.
Jian MaCollege of Resources and Environment, University of Chinese Academy of Sciences, Beijing, China.
Xiang ZhangDepartment of Geography, McGill University, Montreal, Quebec, Canada.
Ellison CarterDepartment of Civil and Environmental Engineering, Colorado State University, Fort Collins, CO, United States.
Brian RobinsonDepartment of Geography, McGill University, Montreal, Quebec, Canada.
Yuanxun ZhangCollege of Resources and Environment, University of Chinese Academy of Sciences, Beijing, China.

Funding

CIHR 148697CIHR 159477Health Effects InstituteNational Key R&D Program of China 2022YFE0209500U.S. Environmental Protection Agency R-82811201
6 · The paper itself

Abstract

rationaleNorthern China's Clean Heating Policy (CHP) aimed to reduce wintertime coal burning in rural homes by restricting coal use and providing subsidies for clean heating. The policy's health impacts on respiratory outcomes have not been empirically evaluated.

objectivesTo estimate the impact of the CHP on respiratory symptoms and airway inflammation using a difference-in-differences design leveraging the policy's staggered rollout across rural Beijing villages.

methodsWe enrolled 1003 adults aged ≥40 years from 50 rural villages reliant on coal heating at baseline (2018-2019). Over 4 winters (2018-2022), 20 villages were enrolled in the CHP. During up to 3 winter waves of data collection, we measured respiratory symptoms by questionnaire and, in a subsample, measured fractional exhaled nitric oxide (FeNO). We estimated the policy's effects using extended 2-way fixed effects models, accounting for village-level clustering and potential time-varying confounders. MEASUREMENTS AND MAIN

resultsExposure to the CHP was associated with a 7.5 percentage point reduction (95% confidence interval (CI): -12.8, -2.3) in the prevalence of any respiratory symptom, primarily driven by reductions in reported difficulty breathing (-3.3 pp, 95% CI: -8.0, 1.3), shortness of breath (-3.5 pp, 95% CI: -9.3, 2.3), and cough (-2.8 pp, 95% CI: -7.3, 1.6). We observed no evidence of an effect of the CHP on FeNO (0.3 ppb, 95% CI: -2.2, 2.8).

conclusionsThe CHP led to reductions in reported respiratory symptoms among Beijing adults. This study contributes to the limited empirical evidence that clean energy policies can yield health benefits.

Indexed as

Air Pollution, IndoorCoalHeatingRespiratory Tract DiseasesAdultAgedBeijingChinaFemaleHumansMaleMiddle AgedNitric OxideRural PopulationCoalNitric OxideChinadifference-in-differencesFeNOhousehold energy transitionrespiratory health

Identifiers

PMID42085295
PMCPMC13519311

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.