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Lee EY, Park S, Kim YB, Lee M, Lim H, Ross-White A, Janssen I, Spence JC, Tremblay MS. Exploring the Interplay Between Climate Change, 24-Hour Movement Behavior, and Health: A Systematic Review. J Phys Act Health 2024:1-19. [PMID: 39187251 DOI: 10.1123/jpah.2023-0637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 07/03/2024] [Accepted: 07/03/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND Given the emergence of climate change and health risks, this review examined potential relationships between varying indicators of climate change, movement behaviors (ie, physical activity [PA], sedentary behavior, and sleep), and health. METHODS Seven databases were searched in March 2020, April 2023, and April 2024. To be included, studies must have examined indicators of climate change and at least one of the movement behaviors as either an exposure or a third variable (ie, mediator/moderator), and a measure of health as outcome. Evidence was summarized by the role (mediator/moderator) that either climate change or movement behavior(s) has with health measures. Relationships and directionality of each association, as well as the strength and certainty of evidence were synthesized. RESULTS A total of 79 studies were eligible, representing 6,671,791 participants and 3137 counties from 25 countries (40% low- and middle-income countries). Of 98 observations from 17 studies that examined PA as a mediator, 34.7% indicated that PA mediated the relationship between climate change and health measure such that indicators of adverse climate change were associated with lower PA, and worse health outcome. Of 274 observations made from 46 studies, 28% showed that PA favorably modified the negative association between climate change and health outcome. Evidence was largely lacking and inconclusive for sedentary behavior and sleep, as well as climate change indicators as an intermediatory variable. CONCLUSIONS PA may mitigate the adverse impact of climate change on health. Further evidence is needed to integrate PA into climate change mitigation, adaptation, and resilience strategies.
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Affiliation(s)
- Eun-Young Lee
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
- Department of Gender Studies, Queen's University, Kingston, ON, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa,ON, Canada
- Institute of Sport Science, Seoul National University, Seoul, South Korea
| | - Seiyeong Park
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
- Institute of Sport Science, Seoul National University, Seoul, South Korea
| | - Yeong-Bae Kim
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Mikyung Lee
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | - Heejun Lim
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | - Amanda Ross-White
- Bracken Health Sciences Library, Queen's University, Kingston, ON, Canada
| | - Ian Janssen
- School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
- Department of Health Sciences, Queen's University, Kingston, ON, Canada
| | - John C Spence
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Mark S Tremblay
- Children's Hospital of Eastern Ontario Research Institute, Ottawa,ON, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada
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Song J, Wang BH, Gao Y, Chen Y, Sun X, Zhang Z, Wu IXY, Dai W. Interaction of physical activity and low-level air pollution on cardiovascular disease: a prospective cohort study in UK Biobank. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2024; 46:188. [PMID: 38696021 DOI: 10.1007/s10653-024-01922-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 02/19/2024] [Indexed: 06/17/2024]
Abstract
To investigate the associations of physical activity (PA), low-level air pollution, and interaction on cardiovascular diseases (CVD) incidence based on the UK Biobank. PA was measured by the International Physical Activity Questionnaire and five air pollutants were estimated using Land Use Regression. All association estimates were based on Cox regression. Dose-response relationship was explored by restricted cubic spline, while multiplicative and additive interaction were examined by Pinteraction and relative excess risk due to interaction (RERI). As deviating proportional hazards assumption, we analyzed data as follow-up < 4 years and ≥ 4 years, separately. PA with 1000-4000 Metabolic Equivalent Task (MET) min/week showed the strongest protective impact on CVD incidence, while only low-level nitrogen dioxides (NO2) showed negative impact among five air pollutants and was considered for further analysis. Multiplicative interaction between PA and NO2 was observed during ≥ 4 years follow-up (Pinteraction = 0.049) while not during < 4 years (Pinteraction = 0.290). Positive additive interactions were found for high PA and low NO2 (< 20 μg/m3) group (RERI: 0.07, 95% confidence intervals: 0.02-0.11) during < 4 years, and for moderate PA with NO2 at 40- μg/m3 (0.07, 0.02-0.13) and < 20 μg/m3 (0.07, 0.02-0.12), while high PA showed similar results with NO2 at 40-, 20- and < 20 μg/m3 during ≥ 4 years. PA about 1000-4000 METs min/week showed the lowest CVD risk. Possibility of interaction with PA and NO2 is more likely to present with the increase in follow-up duration. We call for the optimal thresholds of PA, and exploring interaction thoroughly by considering types of PA.
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Affiliation(s)
- Jinlu Song
- Xiangya School of Public Health, Central South University, 4/F, Xiangya School of Public Health, No.172, Tongzipo Road, Yuelu District, Changsha, Hunan, China
| | - Betty H Wang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, New Territories, Hong Kong
| | - Yinyan Gao
- Xiangya School of Public Health, Central South University, 4/F, Xiangya School of Public Health, No.172, Tongzipo Road, Yuelu District, Changsha, Hunan, China
| | - Yancong Chen
- Xiangya School of Public Health, Central South University, 4/F, Xiangya School of Public Health, No.172, Tongzipo Road, Yuelu District, Changsha, Hunan, China
- Changsha Center for Disease Control and Prevention, Changsha, Hunan, China
| | - Xuemei Sun
- Xiangya School of Public Health, Central South University, 4/F, Xiangya School of Public Health, No.172, Tongzipo Road, Yuelu District, Changsha, Hunan, China
| | - Zixuan Zhang
- Xiangya School of Public Health, Central South University, 4/F, Xiangya School of Public Health, No.172, Tongzipo Road, Yuelu District, Changsha, Hunan, China
- Changsha Center for Disease Control and Prevention, Changsha, Hunan, China
| | - Irene X Y Wu
- Xiangya School of Public Health, Central South University, 4/F, Xiangya School of Public Health, No.172, Tongzipo Road, Yuelu District, Changsha, Hunan, China.
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Central South University, Changsha, Hunan, China.
| | - Wenjie Dai
- Xiangya School of Public Health, Central South University, 4/F, Xiangya School of Public Health, No.172, Tongzipo Road, Yuelu District, Changsha, Hunan, China.
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Oja P, Memon AR, Titze S, Jurakic D, Chen ST, Shrestha N, Em S, Matolic T, Vasankari T, Heinonen A, Grgic J, Koski P, Kokko S, Kelly P, Foster C, Podnar H, Pedisic Z. Health Benefits of Different Sports: a Systematic Review and Meta-Analysis of Longitudinal and Intervention Studies Including 2.6 Million Adult Participants. SPORTS MEDICINE - OPEN 2024; 10:46. [PMID: 38658416 PMCID: PMC11043276 DOI: 10.1186/s40798-024-00692-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 02/28/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Several reviews have examined the health benefits of participation in specific sports, such as baseball, cricket, cross-country skiing, cycling, downhill skiing, football, golf, judo, rugby, running and swimming. However, new primary studies on the topic have recently been published, and the respective meta-analytic evidence needs to be updated. OBJECTIVES To systematically review, summarise and appraise evidence on physical health benefits of participation in different recreational sports. METHODS Searches for journal articles were conducted in PubMed/MEDLINE, Scopus, SpoLit, SPORTDiscus, Sports Medicine & Education Index and Web of Science. We included longitudinal and intervention studies investigating physical health outcomes associated with participation in a given sport among generally healthy adults without disability. RESULTS A total of 136 papers from 76 studies conducted among 2.6 million participants were included in the review. Our meta-analyses of available evidence found that: (1) cycling reduces the risk of coronary heart disease by 16% (pooled hazard ratio [HR] = 0.84; 95% confidence interval [CI]: 0.80, 0.89), all-cause mortality by 21% (HR = 0.79; 95% CI: 0.73, 0.84), cancer mortality by 10% (HR = 0.90; 95% CI: 0.85, 0.96) and cardiovascular mortality by 20% (HR = 0.80; 95% CI: 0.74, 0.86); (2) football has favourable effects on body composition, blood lipids, fasting blood glucose, blood pressure, cardiovascular function at rest, cardiorespiratory fitness and bone strength (p < 0.050); (3) handball has favourable effects on body composition and cardiorespiratory fitness (p < 0.050); (4) running reduces the risk of all-cause mortality by 23% (HR = 0.77; 95% CI: 0.70, 0.85), cancer mortality by 20% (HR = 0.80; 95% CI: 0.72, 0.89) and cardiovascular mortality by 27% (HR = 0.73; 95% CI: 0.57, 0.94) and improves body composition, cardiovascular function at rest and cardiorespiratory fitness (p < 0.010); and (5) swimming reduces the risk of all-cause mortality by 24% (HR = 0.76; 95% CI: 0.63, 0.92) and improves body composition and blood lipids (p < 0.010). CONCLUSIONS A range of physical health benefits are associated with participation in recreational cycling, football, handball, running and swimming. More studies are needed to enable meta-analyses of health benefits of participation in other sports. PROSPERO registration number CRD42021234839.
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Affiliation(s)
- Pekka Oja
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Aamir Raoof Memon
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Sylvia Titze
- Institute of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
| | - Danijel Jurakic
- Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
| | - Si-Tong Chen
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Nipun Shrestha
- NHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia
| | - Sowannry Em
- Institute of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
| | - Tena Matolic
- Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
| | - Tommi Vasankari
- UKK Institute for Health Promotion Research, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Ari Heinonen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jozo Grgic
- Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Pasi Koski
- Department of Teacher Education, University of Turku, Rauma, Finland
| | - Sami Kokko
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Paul Kelly
- Institute for Sport, Physical Education and Health Sciences, University of Edinburgh, Edinburgh, UK
| | - Charlie Foster
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Hrvoje Podnar
- Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
| | - Zeljko Pedisic
- Institute for Health and Sport, Victoria University, Melbourne, Australia.
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Ghaddar F, Zeidan RK, Salameh P, Maupas-Schwalm F. Physical activity and odds of coronary heart disease among Lebanese women. BMC Public Health 2024; 24:516. [PMID: 38373923 PMCID: PMC10875797 DOI: 10.1186/s12889-024-18042-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 02/07/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND It is known that physical activity (PA) is protective against cardiovascular morbidity and mortality. However, few studies have examined the association between PA, sedentary lifestyle and coronary heart disease (CHD) in women. This case-control study investigates the relationship between PA and sedentary behavior on CHD odds in Lebanese women over forty. METHODS One thousand five hundred selected Lebanese women (300 cases and 1200 controls) were included between 2018-2019. Cases were hospitalized women newly diagnosed with CHD, whereas the control groups were free of any heart diseases. Data on socio-demographic, lifestyle, cardiovascular factors, PA and sedentary lifestyle were collected. Multivariate logistic regressions, adjusted for covariates, were performed to investigate the association of PA domains and sedentary behavior with CHD. RESULTS A sedentary lifestyle combined with low activity levels increased the odds of CHD. Among cases, 46.7% participated in moderate or vigorous PA against almost 60.3% of controls. 36.3% of coronary patients had more than 10 h/day of sedentary time, with a positive correlation with CHD (adjusted OR: 1.533, 95%CI: 1.046-2.247). Conversely, moderate and high levels (respectively 600-3000 and ≥ 3000 metabolic equivalents [MET]-minutes/week) of domestic/garden PA revealed lower CHD odds (OR: 0.566, 95%CI: 0.396-0.808 and 0.193, 0.065-0.578 respectively). The detrimental influence of sedentary lifestyle appeared to be significantly reversed by weekly moderate PA, especially as weekly sedentary time was less (OR: 0.616, 95%CI: 0.427-0.888/ 6 to10h of sedentary time and OR: 0.537, 95% CI: 0.37-0.779/ ≤ 6 h), and except sedentary time exceeding 10 h daily. Two PA patterns revealed lower CHD odds: transport-related and domestic/garden PA, as early as low amount, even after adjustment for possible confounders. CONCLUSION The current study highlights the importance of combating sedentary behaviors and engaging in regular, easily accessible PA to reduce the odds of coronary disease among aging women. Therefore, better information regarding the benefits of physical activities such as transportation-related activities or gardening would be helpful in enhancing the prevention of CHD in aging women.
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Affiliation(s)
- Fatima Ghaddar
- Faculty of Public Health II, Lebanese University, Fanar, Lebanon.
| | - Rouba K Zeidan
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, UAE
- INSPECT-LB, National Institute of Public Health, Clinical Epidemiology and Toxicology, Beirut, Lebanon
- CERIPH, Center for Research in Public Health, Faculty of Public Health, Lebanese University, Mount-Lebanon, Lebanon
| | - Pascale Salameh
- INSPECT-LB, National Institute of Public Health, Clinical Epidemiology and Toxicology, Beirut, Lebanon
- Department of Research, Faculty of Pharmacy, Lebanese University, Hadath, Lebanon
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
- School of Medicine, Lebanese American University, Byblos, Lebanon
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Li Y, Guo B, Meng Q, Yin L, Chen L, Wang X, Jiang Y, Wei J, Wang J, Xia J, Wang Z, Duoji Z, Li X, Nima Q, Zhao X. Associations of long-term exposure to air pollution and physical activity with the risk of systemic inflammation-induced multimorbidity in Chinese adults: results from the China multi-ethnic cohort study (CMEC). BMC Public Health 2023; 23:2556. [PMID: 38129832 PMCID: PMC10734128 DOI: 10.1186/s12889-023-17518-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 12/18/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVE Previous studies proved the effect of long-term exposure to air pollution or physical activity (PA) on the risk of systemic inflammation-induced multimorbidity (SIIM), while the evidence regarding their joint effects was rare, especially in low- and middle-income countries. Therefore, we aimed to examine the extent of interaction or joint relations of PA and air pollution with SIIM. METHODS This study included 72,172 participants from China Multi-Ethnic Cohort.The average concentrations of ambient particulate matter pollutants (PM1, PM2.5, and PM10) were estimated using satellite-based random forest models. Self-reported information on a range of physical activities related to occupation, housework, commuting, and leisure activities was collected by an interviewer-administered questionnaire. A total of 11 chronic inflammatory systemic diseases were assessed based on self-reported lifetime diagnosis or medical examinations. SIIM was defined as having ≥ 2 chronic diseases related to systemic inflammation. Logistic regression models were used to assess the complex associations of air pollution particulate matter and PA with SIIM. RESULTS We found positive associations between long-term air pollution particulates exposure and SIIM, with odds ratios (95%CI) of 1.07 (1.03 to 1.11), 1.18 (1.13 to 1.24), and 1.08 (1.05 to 1.12) per 10 µg/m3 increase in PM1, PM2.5, and PM10. No significant multiplicative interaction was found between ambient air pollutant exposure and PA on SIIM, whereas negative additive interaction was observed between long-term exposure to PM2.5 and PA on SIIM. The positive associations between low volume PA and SIIM were stronger among those exposed to high-level air pollution particulates. Compared with individuals engaged in high volume PA and exposed to low-level ambient air pollutants, those engaged in low volume PA and exposed to high-level ambient air pollutants had a higher risk of SIIM (OR = 1.49 in PM1 exposure, OR = 1.84 in PM2.5 exposure, OR = 1.19 in PM10 exposure). CONCLUSIONS Long-term (3 years average) exposure to PM1, PM2.5, and PM10 was associated with an increased risk of SIIM. The associations were modified by PA, highlighting PA's importance in reducing SIIM for all people, especially those living in high-level air pollution regions.
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Affiliation(s)
- Yajie Li
- Tibet Center for Disease Control and Prevention, 21 North linkuo Road, Lhasa, Tibet, China
| | - Bing Guo
- West China School of Public Health and West China Fourth Hospital, Sichuan University, 610041, Chengdu, China
| | - Qiong Meng
- School of Public Health, Kunming Medical University, Kunming, China
| | - Li Yin
- Meteorological Medical Research Center, Panzhihua Central Hospital, 617067, Panzhihua, China
- Clinical Medical Research Center, Panzhihua Central Hospital, Panzhihua, China
- Dali University, Dali, China
| | - Lin Chen
- West China School of Public Health and West China Fourth Hospital, Sichuan University, 610041, Chengdu, China
| | - Xing Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, 610041, Chengdu, China
| | - Ye Jiang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, 610041, Chengdu, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, USA
| | - Junhua Wang
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Jinjie Xia
- Chengdu Center for Disease Control and Prevention, Chengdu, China
| | - Zihao Wang
- Chongqing Center for disease Control and prevention, Chongqing, China
| | | | - Xianzhi Li
- Meteorological Medical Research Center, Panzhihua Central Hospital, 617067, Panzhihua, China.
- Clinical Medical Research Center, Panzhihua Central Hospital, Panzhihua, China.
- Dali University, Dali, China.
| | - Qucuo Nima
- Tibet Center for Disease Control and Prevention, 21 North linkuo Road, Lhasa, Tibet, China.
| | - Xing Zhao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, 610041, Chengdu, China.
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Logan G, Somers C, Baker G, Connell H, Gray S, Kelly P, McIntosh E, Welsh P, Gray CM, Gill JMR. Benefits, risks, barriers, and facilitators to cycling: a narrative review. Front Sports Act Living 2023; 5:1168357. [PMID: 37795314 PMCID: PMC10546027 DOI: 10.3389/fspor.2023.1168357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 09/05/2023] [Indexed: 10/06/2023] Open
Abstract
There is large potential to increase cycling participation worldwide. Participation in cycling is associated with lower risk of mortality from any cause, and incidence of cardiovascular disease and type 2 diabetes, as well as positive mental health and well-being. The largest potential for health gains likely to come from increasing participation amongst those who do not currently cycle regularly, rather than encouraging those who already cycle regularly to cycle more. Replacing car journeys with cycling can lead to reductions in air pollution emissions and lower pollutant exposure to the general population. Important gaps and uncertainties in the existing evidence base include: the extent to which the health benefits associated with cycling participation are fully causal due to the observational nature of much of the existing evidence base; the real-world economic cost-benefits of pragmatic interventions to increase cycling participation; and the most effective (combination of) approaches to increase cycling participation. To address these uncertainties, large-scale, long-term randomised controlled trials are needed to: evaluate the effectiveness, and cost-effectiveness, of (combinations of) intervention approaches to induce sustained long-term increases in cycling participation in terms of increases in numbers of people cycling regularly and number of cycling journeys undertaken, across a range of population demographic groups; establish the effects of such interventions on relevant outcomes related to health and wellbeing, economic productivity and wider societal impacts; and provide more robust quantification of potential harms of increasing cycling participation, such as collision risks.
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Affiliation(s)
- Greig Logan
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Camilla Somers
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Graham Baker
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, United Kingdom
| | - Hayley Connell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Stuart Gray
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Paul Kelly
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, United Kingdom
| | - Emma McIntosh
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Paul Welsh
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
| | - Cindy M. Gray
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Jason M. R. Gill
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom
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Zhao Y, Guo Q, Zhao J, Bian M, Qian L, Shao J, Wang Q, Duan X. Long-term exposure to fine particulate matter modifies the association between physical activity and the risk of hypertension. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:43690-43701. [PMID: 36658317 DOI: 10.1007/s11356-023-25256-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 01/07/2023] [Indexed: 06/17/2023]
Abstract
The trade-off between the potentially detrimental effects of fine particulate matter (PM2.5) and the benefits of physical activity (PA) is unclear. We aimed to explore the independent and interaction effects between long-term PM2.5 exposure and PA on blood pressure (BP) and hypertension. A total of 8704 adults (≥45 years) without hypertension at baseline in a nationwide cohort of the China Health and Retirement Longitudinal Study (CHARLS) were followed from 2011 to 2015. The participants were selected using a four-stage, stratified, and cluster sampling procedure. The annual PM2.5 concentrations at the residential address were estimated from a two-stage machine learning model with a 10 km × 10 km resolution. A standard questionnaire collected information on PA and potential confounders, and metabolic equivalents (MET·h/wk), which combined frequency, intensity, and duration information, were used to assess PA levels. We adopted mixed-effects regression models to explore the independent and interaction effects between long-term PM2.5 exposure and PA on BP and risk of hypertension. Systolic blood pressure (SBP) decreased by -0.84 mmHg (95% CI: -1.34, -0.34) per an IQR (interquartile range, 175.5 MET·h/wk) increase in PA, and diastolic blood pressure (DBP) decreased by -0.42 mmHg (95% CI: -0.76, -0.07). Each IQR (36.1 μg/m3) increment in PM2.5 was associated with 0.48 mmHg (95% CI: -0.24, 1.20) in SBP and -0.02 mmHg (95% CI: -0.44, 0.39) in DBP. PM2.5 showed an elevated effect with risks of hypertension (odds ratio, OR = 1.01; 95% CI: 1.00, 1.03), while PA showed the inverse result (OR = 0.98; 95% CI: 0.97, 0.99). Interaction analyses indicated PA maintained the beneficial effects on BP, but the negative association was attenuated, accompanied by the increase of PM2.5. PA decreased the BP and hypertension risks, while PM2.5 showed the opposite results. PM2.5 attenuated the beneficial effects of PA on BP and modified the association between PA and the risk of hypertension.
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Affiliation(s)
- Yuchen Zhao
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Qian Guo
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Jiahao Zhao
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Mengyao Bian
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Liqianxin Qian
- School of Civil and Resource Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Jing Shao
- National Institute of Sports Medicine, General Administration of Sport of China, Beijing, 100029, China
| | - Qirong Wang
- National Institute of Sports Medicine, General Administration of Sport of China, Beijing, 100029, China
| | - Xiaoli Duan
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, 100083, China.
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Andrade A, D’Oliveira A, De Souza LC, Bastos ACRDF, Dominski FH, Stabile L, Buonanno G. Effects of Air Pollution on the Health of Older Adults during Physical Activities: Mapping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3506. [PMID: 36834200 PMCID: PMC9960154 DOI: 10.3390/ijerph20043506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/12/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
Atmospheric pollutants present environmental threats to health and have been investigated in different environments, such as highways, squares, parks, and gyms. These environments are frequented by older adults, who are considered fragile to the harmful impacts of pollution present in the air. The aim was to analyze the state of the art on the effects of air pollution on the health of older adults during physical activities (PAs) through a mapping review. The search was performed in PubMed, Web of Science, Scopus, and Cinahl databases until June 2022. Of the 10,109 studies initially identified, 58 met the inclusion criteria. The most investigated health outcome was cardiovascular disease, followed by respiratory outcomes. Particulate matter (PM2.5 and PM10), nitrogen dioxide (NO2), and ozone (O3) were the most investigated pollutants. Of the 75 health outcomes investigated, in 29, air pollution had harmful effects on the health of the older adults during the practice of PA, more frequently in cardiovascular diseases. In 25 outcomes, the beneficial effects of PA to the health of the older adults remained, despite exposure to high and low concentrations of pollutants, most often in terms of mental disorders. We conclude that poor air quality is a harmful factor for the health of older adults during the practice of PAs, more frequently in cardiovascular and respiratory diseases. On the other hand, for mental-health-related outcomes (depression and cognition), in most studies, the beneficial effects of PA in older adults were maintained, even after exposure to pollutants.
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Affiliation(s)
- Alexandro Andrade
- Health and Sports Science Center, Department of Physical Education, CEFID, Santa Catarina State University, Florianópolis 88035-901, Brazil
| | - Anderson D’Oliveira
- Health and Sports Science Center, Department of Physical Education, CEFID, Santa Catarina State University, Florianópolis 88035-901, Brazil
| | - Loiane Cristina De Souza
- Health and Sports Science Center, Department of Physical Education, CEFID, Santa Catarina State University, Florianópolis 88035-901, Brazil
| | | | - Fábio Hech Dominski
- Department of Physical Education, Univille University, Joinville 89219-710, Brazil
| | - Luca Stabile
- Department of Civil and Mechanical Engineering, University of Cassino and Southern Lazio, Via Di Biasio 43, 03043 Cassino, Italy
| | - Giorgio Buonanno
- Department of Civil and Mechanical Engineering, University of Cassino and Southern Lazio, Via Di Biasio 43, 03043 Cassino, Italy
- International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane 4001, Australia
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9
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Hung A, Koch S, Bougault V, Gee CM, Bertuzzi R, Elmore M, McCluskey P, Hidalgo L, Garcia-Aymerich J, Koehle MS. Personal strategies to mitigate the effects of air pollution exposure during sport and exercise: a narrative review and position statement by the Canadian Academy of Sport and Exercise Medicine and the Canadian Society for Exercise Physiology. Br J Sports Med 2023; 57:193-202. [PMID: 36623867 DOI: 10.1136/bjsports-2022-106161] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2022] [Indexed: 01/11/2023]
Abstract
Air pollution is among the leading environmental threats to health around the world today, particularly in the context of sports and exercise. With the effects of air pollution, pollution episodes (eg, wildfire conflagrations) and climate change becoming increasingly apparent to the general population, so have their impacts on sport and exercise. As such, there has been growing interest in the sporting community (ie, athletes, coaches, and sports science and medicine team members) in practical personal-level actions to reduce the exposure to and risk of air pollution. Limited evidence suggests the following strategies may be employed: minimising all exposures by time and distance, monitoring air pollution conditions for locations of interest, limiting outdoor exercise, using acclimation protocols, wearing N95 face masks and using antioxidant supplementation. The overarching purpose of this position statement by the Canadian Academy of Sport and Exercise Medicine and the Canadian Society for Exercise Physiology is to detail the current state of evidence and provide recommendations on implementing these personal strategies in preventing and mitigating the adverse health and performance effects of air pollution exposure during exercise while recognising the limited evidence base.
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Affiliation(s)
- Andy Hung
- School of Kinesiology, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Sarah Koch
- Barcelona Institute for Global Health, Barcelona, Catalonia, Spain.,Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
| | - Valerie Bougault
- Laboratoire Motricité Humaine Expertise Sport Santé, Université Côte d'Azur, Nice, France
| | - Cameron Marshall Gee
- International Collaboration on Repair Discoveries, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada.,Athletics Canada, Ottawa, Ontario, Canada
| | - Romulo Bertuzzi
- Endurance Performance Research Group, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | | | - Paddy McCluskey
- Athletics Canada, Ottawa, Ontario, Canada.,Canadian Sport Institute - Pacific, Victoria, British Columbia, Canada
| | - Laura Hidalgo
- Barcelona Institute for Global Health, Barcelona, Catalonia, Spain.,Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
| | - Judith Garcia-Aymerich
- Barcelona Institute for Global Health, Barcelona, Catalonia, Spain.,Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
| | - Michael Stephen Koehle
- School of Kinesiology, The University of British Columbia, Vancouver, British Columbia, Canada .,Division of Sport & Exercise Medicine, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
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10
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Bo YC, Yu T, Guo C, Lin CC, Yang HT, Chang LYY, Thomas GN, Tam T, Lau AKH, Lao XQ. Cardiovascular Mortality, Habitual Exercise, and Particulate Matter 2.5 Exposure: A Longitudinal Cohort Study. Am J Prev Med 2023; 64:250-258. [PMID: 36272861 DOI: 10.1016/j.amepre.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 08/27/2022] [Accepted: 09/01/2022] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Habitual exercise may amplify the respiratory uptake of air pollutants in the lung, exacerbating the adverse effects of air pollution. However, it is unclear whether this can reduce the health benefits of habitual exercise (referred to as leisure-time exercise). Thus, the combined effects of habitual exercise and chronic exposure to ambient fine particulate matter 2.5 on cardiovascular mortality were examined among adults in Taiwan. METHODS A total of 384,128 adults were recruited between 2001 and 2016 and followed up to May 31, 2019. Participants' vital status was obtained by matching their unique identification numbers with records of cardiovascular death in the National Death Registry of Taiwan. A time-varying Cox regression model was used to analyze the data. Analyses were conducted in 2021. RESULTS Cardiovascular death risks were inversely associated with habitual exercise and positively associated with chronic exposure to particulate matter 2.5. The beneficial effects of habitual exercise on cardiovascular mortality were not modified by chronic exposure to particulate matter 2.5. Inactive participants with high particulate matter 2.5 exposure exhibited a 123% higher risk of cardiovascular death than high-exercise-group participants exposed to low levels of particulate matter 2.5 (95% CI=89, 163). CONCLUSIONS High level of habitual exercise combined with low exposure level of ambient particulate matter 2.5 is associated with the lowest risk of cardiovascular death. A higher level of habitual exercise is associated with a lower risk of cardiovascular death at all levels of particulate matter 2.5 exposure studied. The results indicate that habitual exercise is a safe health promotion strategy even for people residing in relatively polluted regions.
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Affiliation(s)
- Yacong C Bo
- School of Public Health, Zhengzhou University, Zhenghzou, China
| | - Tsung Yu
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Cui Guo
- Department of Urban Planning and Design, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Changqing C Lin
- Division of Environment and Sustainability, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong
| | - Hsiao Ting Yang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Central Ave, Hong Kong
| | | | - G N Thomas
- Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham, United Kingdom
| | - Tony Tam
- Department of Sociology, The Chinese University of Hong Kong, Central Ave, Hong Kong
| | - Alexis K H Lau
- Division of Environment and Sustainability, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong; Department of Civil and Environmental Engineering, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong
| | - Xiang Qian Lao
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Central Ave, Hong Kong; Department of Biomedical Sciences, City University of Hong Kong, Kowloon Tong, Hong Kong.
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11
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Zou H, Cai M, Qian ZM, Zhang Z, Vaughn MG, Wang X, Li H, Lin H. The effects of ambient fine particulate matter exposure and physical activity on heart failure: A risk-benefit analysis of a prospective cohort study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 853:158366. [PMID: 36049682 DOI: 10.1016/j.scitotenv.2022.158366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 08/11/2022] [Accepted: 08/24/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Evidence supporting the adverse effects of air pollution and the benefits of physical activity (PA) on heart failure (HF) has continued to grow. However, their joint effects remain largely unknown. METHODS Our investigation included a total of 321,672 participants free of HF at baseline from the UK Biobank. Participants were followed up till March 2021. Information on participants' PA levels and additional covariates was collected by questionnaire. The annual fine particulate matter (PM2.5) concentration was estimated using a Land Use Regression (LUR) model. Cox proportional hazards models were used to assess the associations of PA and PM2.5 exposure with incident HF, as well as their interaction on both additive and multiplicative scales. RESULTS During a median follow-up of 12.0 years, 8212 cases of HF were uncovered. Compared with participants with low PA, the hazard ratios (HRs) were 0.69 (95 % CI: 0.65, 0.73) and 0.61 (95 % CI: 0.58, 0.65) for those with moderate and high PA, respectively. PM2.5 was associated with an elevated risk of incident HF with an HR of 1.11 (95 % CI: 1.08, 1.14) per interquartile range (IQR) increment. The synergistic additive interaction between low PA and high PM2.5 exposure on HF was observed. Compared with participants with high PA and low PM2.5 exposure, those with low PA and high PM2.5 exposure had the highest risk of HF [HR (95 % CI): 1.90 (1.76, 2.06)]. CONCLUSIONS Our findings indicate that PA might still be an appropriate strategy to prevent HF for those living in areas with relatively high air pollution. Individuals with low PA may pay more attention to air pollution.
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Affiliation(s)
- Hongtao Zou
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Miao Cai
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Zhengmin Min Qian
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, Saint Louis, MO 63104, USA
| | - Zilong Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Michael G Vaughn
- School of Social Work, College for Public Health & Social Justice, Saint Louis University, Saint Louis, MO 63103, USA
| | - Xiaojie Wang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Haitao Li
- Department of Social Medicine and Health Service Management, Health Science Center, Shenzhen University, Shenzhen 518055, China
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
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12
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Chandia-Poblete D, Cole-Hunter T, Haswell M, Heesch KC. The influence of air pollution exposure on the short- and long-term health benefits associated with active mobility: A systematic review. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 850:157978. [PMID: 35964755 DOI: 10.1016/j.scitotenv.2022.157978] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 08/08/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
Active mobility (AM), defined as walking and cycling for transportation, can improve health through increasing regular physical activity. However, these health improvements could be outweighed by harm from inhaling traffic-related air pollutants during AM participation. The interaction of AM and air pollutants on health is complex physiologically, manifesting as acute changes in health indicators that may lead to poor long-term health consequences. The aim of this study was to systematically review the current evidence of effect modification by air pollution (AP) on associations between AM and health indicators. Studies were included if they examined associations between AM and health indicators being modified by AP or, conversely, associations between AP and health indicators being modified by AM. Thirty-three studies met eligibility criteria. The main AP indicators studied were particulate matter, ultrafine particles, and nitrogen oxides. Most health indicators studied were grouped into cardiovascular and respiratory indicators. There is evidence of a reduction by AP, mainly ultrafine particles and PM2.5, in the short-term health benefits of AM. Multiple studies suggest that long-term health benefits of AM are not negatively associated with levels of the single traffic-related pollutant NO2. However, other studies reveal reduced long-term health benefits of AM in areas affected by high levels of pollutant mixtures. We recommend that future studies adopt consistent and rigorous study designs and include reporting of interaction testing, to advance understanding of the complex relationships between AM, AP, and health indicators.
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Affiliation(s)
- Damian Chandia-Poblete
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Queensland 4059, Australia.
| | - Thomas Cole-Hunter
- Section of Environmental Health, Department of Public Health, Faculty of Health and Medical Science, University of Copenhagen, Øster Farimagsgade 5, 1353 Copenhagen, Denmark.
| | - Melissa Haswell
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Queensland 4059, Australia; Office of the Deputy Vice Chancellor (Indigenous Strategy and Services) and School of Geosciences, Faculty of Science, University of Sydney, Australia.
| | - Kristiann C Heesch
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Queensland 4059, Australia.
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13
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Li ZH, Zhong WF, Zhang XR, Chung VC, Song WQ, Chen Q, Wang XM, Huang QM, Shen D, Zhang PD, Liu D, Zhang YJ, Chen PL, Cheng X, Yang HL, Cai MC, Gao X, Kraus VB, Mao C. Association of physical activity and air pollution exposure with the risk of type 2 diabetes: a large population-based prospective cohort study. Environ Health 2022; 21:106. [PMID: 36336676 PMCID: PMC9639290 DOI: 10.1186/s12940-022-00922-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The interplay between physical activity (PA) and air pollution in relation to type 2 diabetes (T2D) remains largely unknown. Based on a large population-based cohort study, this study aimed to examine whether the benefits of PA with respect to the risk of T2D are moderated by exposure to air pollution. METHODS UK Biobank participants (n = 359,153) without diabetes at baseline were included. Information on PA was obtained using the International Physical Activity Questionnaire short form. Exposure to air pollution, including PM2.5, PMcoarse (PM2.5-10), PM10, and NO2, was estimated from land use regression models. Cox regression models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (95% CIs). RESULTS During a median of 8.9 years of follow-up, 13,706 T2D events were recorded. Compared with a low PA level, the HRs for the risk of T2D among individuals with moderate and high PA were 0.82 (95% CI, 0.79-0.86) and 0.73 (95% CI, 0.70-0.77), respectively. Compared with low levels of air pollution, the HRs for risk of T2D for high levels of air pollution (PM2.5, PMcoarse, PM10, and NO2) were 1.19 (1.14-1.24), 1.06 (1.02-1.11), 1.13 (1.08-1.18), and 1.19 (1.14-1.24), respectively. There was no effect modification of the associations between PA and T2D by air pollution (all P-interactions > 0.05). The inverse associations between PA and T2D in each air pollution stratum were generally consistent (all P for trend < 0.05). CONCLUSION A higher PA and lower air pollution level were independently associated with a lower risk of T2D. The beneficial effects of PA on T2D generally remained stable among participants exposed to different levels of air pollution. Further studies are needed to replicate our findings in moderately and severely polluted areas.
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Affiliation(s)
- Zhi-Hao Li
- Department of Epidemiology, School of Public Health, Southern Medical University, 510515, Guangzhou, Guangdong, China
- Microbiome Medicine Center, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Wen-Fang Zhong
- Department of Epidemiology, School of Public Health, Southern Medical University, 510515, Guangzhou, Guangdong, China
| | - Xi-Ru Zhang
- Department of Epidemiology, School of Public Health, Southern Medical University, 510515, Guangzhou, Guangdong, China
| | - Vincent Ch Chung
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Wei-Qi Song
- Department of Epidemiology, School of Public Health, Southern Medical University, 510515, Guangzhou, Guangdong, China
| | - Qing Chen
- Department of Epidemiology, School of Public Health, Southern Medical University, 510515, Guangzhou, Guangdong, China
| | - Xiao-Meng Wang
- Department of Epidemiology, School of Public Health, Southern Medical University, 510515, Guangzhou, Guangdong, China
| | - Qing-Mei Huang
- Department of Epidemiology, School of Public Health, Southern Medical University, 510515, Guangzhou, Guangdong, China
| | - Dong Shen
- Department of Epidemiology, School of Public Health, Southern Medical University, 510515, Guangzhou, Guangdong, China
| | - Pei-Dong Zhang
- Department of Epidemiology, School of Public Health, Southern Medical University, 510515, Guangzhou, Guangdong, China
| | - Dan Liu
- Department of Epidemiology, School of Public Health, Southern Medical University, 510515, Guangzhou, Guangdong, China
| | - Yu-Jie Zhang
- Department of Epidemiology, School of Public Health, Southern Medical University, 510515, Guangzhou, Guangdong, China
| | - Pei-Liang Chen
- Department of Epidemiology, School of Public Health, Southern Medical University, 510515, Guangzhou, Guangdong, China
| | - Xin Cheng
- Department of Epidemiology, School of Public Health, Southern Medical University, 510515, Guangzhou, Guangdong, China
| | - Hai-Lian Yang
- Department of Epidemiology, School of Public Health, Southern Medical University, 510515, Guangzhou, Guangdong, China
| | - Miao-Chun Cai
- Department of Epidemiology, School of Public Health, Southern Medical University, 510515, Guangzhou, Guangdong, China
| | - Xiang Gao
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, University Park, USA
| | - Virginia Byers Kraus
- Duke Molecular Physiology Institute, Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Chen Mao
- Department of Epidemiology, School of Public Health, Southern Medical University, 510515, Guangzhou, Guangdong, China.
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14
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Guo C, Yu T, Lin C, Chang LY, Bo Y, Wong MCS, Tam T, Lau AKH, Lao XQ. Habitual Exercise, Air Pollution, and Pneumonia Mortality: A Longitudinal Cohort Study of Approximately 0.4 Million Adults. Am J Epidemiol 2022; 191:1732-1741. [PMID: 35773998 DOI: 10.1093/aje/kwac113] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 06/15/2022] [Accepted: 06/23/2022] [Indexed: 01/29/2023] Open
Abstract
In this study, we aimed to examine the combined associations of particulate matter with an aerodynamic diameter less than or equal to 2.5 μm (PM2.5) and habitual exercise with pneumonia mortality. We included 384,130 persons aged ≥18 years from Taiwan, Republic of China, during 2001-2016. We followed participants until May 31, 2019, to obtain information on vital status. A time-dependent Cox regression model was used for statistical analysis. We found that risks of pneumonia mortality were reduced by 55% (hazard ratio (HR) = 0.45, 95% confidence interval (CI): 0.36, 0.55) and 36% (HR = 0.64, 95% CI: 0.52, 0.80) in participants who engaged in high and moderate levels of exercise, respectively, as compared with inactive persons. By contrast, each 10-μg/m3 increase in chronic PM2.5 exposure was associated with a 30% (HR = 1.30, 95% CI: 1.17, 1.45) higher risk of pneumonia mortality. Risk of pneumonia death was 72% lower (HR = 0.28, 95% CI: 0.20, 0.41) for persons with a high exercise level and a low PM2.5 level. Lower risk of pneumonia mortality was associated with both higher exercise and lower PM2.5 air pollution levels. For adults exposed to different levels of PM2.5, exercise benefits remained. Our findings suggest that engaging in exercise is a safe and effective strategy for alleviating the burden of pneumonia mortality, even for people who reside in a moderately polluted area.
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15
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Juneja Gandhi T, Garg PR, Kurian K, Bjurgert J, Sahariah SA, Mehra S, Vishwakarma G. Outdoor Physical Activity in an Air Polluted Environment and Its Effect on the Cardiovascular System-A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10547. [PMID: 36078268 PMCID: PMC9517891 DOI: 10.3390/ijerph191710547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/18/2022] [Accepted: 07/27/2022] [Indexed: 06/15/2023]
Abstract
Air pollution is a global public health threat. Evidence suggests that increased air pollution leads to increased cardiovascular morbidity and mortality. The aim of this review was to systematically review and synthesize scientific evidence to understand the effect of performing outdoor physical activity (PA) in a polluted environment on cardiovascular outcomes. This review was developed and reported in accordance with the PRISMA guidelines. Electronic searches in Embase, Web of Science, and PubMed were undertaken through March 2021 initially, and later updated through to 31st January 2022, for observational studies published in peer-reviewed journals that report cardiovascular mortality or morbidity due to outdoor PA in air polluted environment. These searches yielded 10,840 citations. Two reviewers independently reviewed each citation for its eligibility. Seven studies were found to be eligible. Of these, five were cohort studies and two were cross-sectional studies. Pollutants measured in the selected studies were Particulate Matter (PM)-PM10, PM2.5, nitrogen oxides (NOx), and ozone (O3). The most common study outcome was myocardial infarction, followed by cardiovascular mortality, hypertension and heart rate variability. Six studies emphasized that the PA has beneficial effects on cardiovascular outcomes, though air pollutants attenuate this effect to an extent. Two studies showed that walking, even in the polluted environment, significantly reduced the heart rate and heart rate variability indices. The beneficial effects of outdoor PA outweigh the harmful effects of air pollution on cardiovascular health, though the benefits reduce to an extent when PA is carried out in a polluted environment. Because a limited number of studies (n = 7) were eligible for inclusion, the review further emphasizes the critical need for more primary studies that differentiate between outdoor and indoor PA and its effect on cardiovascular health.
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Affiliation(s)
- Taruna Juneja Gandhi
- MAMTA Health Institute for Mother and Child, B-5, Greater Kailash Enclave II, New Delhi 110048, India
| | - Priyanka Rani Garg
- MAMTA Health Institute for Mother and Child, B-5, Greater Kailash Enclave II, New Delhi 110048, India
| | - Kauma Kurian
- MAMTA Health Institute for Mother and Child, B-5, Greater Kailash Enclave II, New Delhi 110048, India
| | | | - Sirazul Ameen Sahariah
- MAMTA Health Institute for Mother and Child, B-5, Greater Kailash Enclave II, New Delhi 110048, India
| | - Sunil Mehra
- MAMTA Health Institute for Mother and Child, B-5, Greater Kailash Enclave II, New Delhi 110048, India
| | - Gayatri Vishwakarma
- Indian Spinal Injuries Centre Sector-C, Vasant Kunj, New Delhi 110070, India
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16
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Raichlen DA, Furlong M, Klimentidis YC, Sayre MK, Parra KL, Bharadwaj PK, Wilcox RR, Alexander GE. Association of Physical Activity with Incidence of Dementia Is Attenuated by Air Pollution. Med Sci Sports Exerc 2022; 54:1131-1138. [PMID: 35704438 PMCID: PMC9204780 DOI: 10.1249/mss.0000000000002888] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Physical activity (PA) is recognized as one of the key lifestyle behaviors that reduces risk of developing dementia late in life. However, PA also leads to increased respiration, and in areas with high levels of air pollution, PA may increase exposure to pollutants linked with higher risk of developing dementia. Here, we investigate whether air pollution attenuates the association between PA and dementia risk. METHODS This prospective cohort study included 35,562 adults 60 yrs and older from the UK Biobank. Average acceleration magnitude (ACCave) from wrist-worn accelerometers was used to assess PA levels. Air pollution levels (NO, NO2, PM10, PM2.5, PM2.5-10, and PM2.5 absorbance) were estimated with land use regression methods. Incident all-cause dementia was derived from inpatient hospital records and death registry data. RESULTS In adjusted models, ACCave was associated with reduced risk of developing dementia (HR = 0.71, 95% confidence interval [CI] = 0.60-0.83), whereas air pollution variables were not associated with dementia risk. There were significant interactions between ACCave and PM2.5 (HRinteraction = 1.33, 95% CI = 1.13-1.57) and PM2.5 absorbance (HRinteraction = 1.24, 95% CI = 1.07-1.45) on incident dementia. At the lowest tertiles of pollution, ACCave was associated with reduced risk of incident dementia (HRPM 2.5 = 0.66, 95% CI = 0.49-0.91; HRPM 2.5 absorbance = 0.60, 95% CI = 0.44-0.81). At the highest tertiles of these pollutants, there was no significant association of ACCave with incident dementia (HRPM 2.5 = 0.88, 95% CI = 0.68-1.14; HRPM 2.5 absorbance = 0.79, 95% CI = 0.60-1.04). CONCLUSIONS PA is associated with reduced risk of developing all-cause dementia. However, exposure to even moderate levels of air pollution attenuates the benefits of PA on risk of dementia.
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Affiliation(s)
- David A Raichlen
- Human and Evolutionary Biology Section, Department of Biological Sciences, University of Southern California, CA
| | - Melissa Furlong
- Department of Community, Environment, and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ
| | | | - M Katherine Sayre
- Human and Evolutionary Biology Section, Department of Biological Sciences, University of Southern California, CA
| | - Kimberly L Parra
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ
| | | | - Rand R Wilcox
- Department of Psychology, University of Southern California, CA
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17
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Zeng YQ, Chan SHT, Guo C, Chang LY, Bo Y, Lin C, Yu Z, Lau AKH, Tam T, Lao XQ. Habitual exercise, chronic exposure to fine particulate matter and high-sensitivity C reactive protein in Asian adults. Occup Environ Med 2022; 79:557-565. [PMID: 35738890 DOI: 10.1136/oemed-2022-108328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 06/06/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Exercise may increase the inhaled amount of air pollutants and exacerbate the adverse health effects. We investigated the combined effects of chronic exposure to fine particulate matter with an aerodynamic diameter less than 2.5 µm (PM2.5) and habitual exercise on C reactive protein (CRP), a sensitive marker of inflammation. METHODS We selected 40 209 Taiwanese adults who joined a standard medical screening programme between 2001 and 2016. The PM2.5 exposure was estimated at each participant's address using a satellite-based spatiotemporal model. Information on habitual exercise was collected using a standard self-administered questionnaire. Mixed-effects linear regression models were used to investigate the associations of CRP with PM2.5 and exercise. An interaction term of PM2.5 and exercise was introduced in the models to test the modifying effects. RESULTS A greater amount of habitual exercise was associated with a decreased level of CRP, while a higher concentration of PM2.5 exposure was associated with an increased level of CRP. The inverse associations of habitual exercise with CRP were not modified by chronic exposure to PM2.5. The participants in the group with a low level of exercise and a high level of PM2.5 exposure exhibited a 19.1% higher level of CRP than those in the group with a high level of exercise and a low level of PM2.5 exposure (95% CI: 13.7% to 24.8%; p<0.001). The longitudinal and sensitivity analyses yielded similar results. CONCLUSIONS Increased levels of exercise and reduced exposure levels of PM2.5 are associated with a lower CRP level. Habitual exercise reduces CRP level regardless of the levels of chronic PM2.5 exposure. Our results support that habitual exercise is a safe approach for reducing systemic inflammation to improve cardiovascular health even for people residing in relatively polluted areas.
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Affiliation(s)
- Yi Qian Zeng
- Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Shin Heng Teresa Chan
- Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Cui Guo
- Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ly-Yun Chang
- Institute of Sociology, Academia Sinica, Taipei, Taiwan
| | - Yacong Bo
- Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Changqing Lin
- Division of Environment and Sustainability, the Hong Kong University of Science and Technology, Hong Kong SAR, China
| | - Zengli Yu
- Department of Nutrition and Food Hygiene, School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Alexis K H Lau
- Division of Environment and Sustainability, the Hong Kong University of Science and Technology, Hong Kong SAR, China.,Department of Civil and Environmental Engineering, the Hong Kong University of Science and Technology, Hong Kong SAR, China
| | - Tony Tam
- Department of Sociology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiang Qian Lao
- Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China .,Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, Guangdong, China
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Chronic fine particulate matter exposure, habitual exercise, and dyslipidemia: A longitudinal cohort study. Environ Epidemiol 2022; 6:e190. [PMID: 35169668 PMCID: PMC8835602 DOI: 10.1097/ee9.0000000000000190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 12/14/2021] [Indexed: 11/26/2022] Open
Abstract
Background: Physical activity may increase the intake of air pollutants due to a higher ventilation rate, which may exacerbate the adverse health effects. This study investigated the combined effects of habitual exercise and long-term exposure to fine particulate matter (PM2.5) on the incidence of dyslipidemia in a large longitudinal cohort in Taiwan. Methods: A total of 121,948 adults (≥18 years) who received at least two medical examinations from 2001 to 2016 were recruited, yielding 407,821 medical examination records. A satellite-based spatiotemporal model was used to estimate the 2-year average PM2.5 concentration (i.e., the year of and the year before the medical examination) at each participant’s address. Information on habitual exercise within 1 month before the medical examination was collected using a standard self-administered questionnaire. A Cox regression model with time-dependent covariates was used to investigate the combined effects. Results: Compared with inactivity, moderate and high levels of exercise were associated with a lower incidence of dyslipidemia, with hazard ratios (HRs) (95% confidence intervals [CIs]) of 0.91 (0.88, 0.94) and 0.73 (0.71, 0.75), respectively. Participants with a moderate (22.37–25.96 μg/m3) or high (>25.96 μg/m3) level of PM2.5 exposure had a higher incidence of dyslipidemia than those with a low level of PM2.5 exposure (≤22.37 μg/m3), with HRs (95% CIs) of 1.36 (1.32, 1.40), and 1.90 (1.81, 1.99), respectively. We observed a statistically significant, but minor, interaction effect of PM2.5 exposure and exercise on the development of dyslipidemia, with an overall hazard ratios (95% CI) of 1.08 (1.05, 1.10), indicating that an incremental increase in the level of exercise was associated with an 8% increase in the risk of dyslipidemia associated with every 10 μg/m3 increase in PM2.5 exposure. However, the negative association between habitual exercise and dyslipidemia remained, regardless of the level of PM2.5 exposure, suggesting that the benefits of increased habitual exercise outweighed the adverse effects of the increase in PM2.5 intake during exercise. Conclusions: Increased levels of exercise and reduced levels of PM2.5 exposures were associated with a lower incidence of dyslipidemia. Although an increase in habitual exercise slightly increased the risk of dyslipidemia associated with PM2.5 exposure, the benefits of the increased habitual exercise outweighed the risks. Our findings suggest that habitual exercise is an effective approach for dyslipidemia prevention, even for people residing in relatively polluted areas.
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Furlong MA, Alexander GE, Klimentidis YC, Raichlen DA. Association of Air Pollution and Physical Activity With Brain Volumes. Neurology 2022; 98:e416-e426. [PMID: 34880089 PMCID: PMC8793107 DOI: 10.1212/wnl.0000000000013031] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 10/22/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND AND OBJECTIVES In high-pollution areas, physical activity may have a paradoxical effect on brain health by increasing particulate deposition in the lungs. We examined whether physical activity modifies associations of air pollution (AP) with brain volumes in an epidemiologic framework. METHODS The UK Biobank enrolled >500,000 adult participants from 2006 to 2010. Wrist accelerometers, multimodal MRI with T1 images and T2 fluid-attenuated inversion recovery data, and land use regression were used to estimate vigorous physical activity (VigPA), structural brain volumes, and AP, respectively, in subsets of the full sample. We evaluated associations among AP interquartile ranges, VigPA, and brain structure volumes and assessed interactions between AP and VigPA. RESULTS Eight thousand six hundred participants were included, with an average age of 55.55 (SD 7.46) years. After correction for multiple testing, in overall models, VigPA was positively associated with gray matter volume (GMV) and negatively associated with white matter hyperintensity volume (WMHV), while NO2, PM2.5absorbance, and PM2.5 were negatively associated with GMV. NO2 and PM2.5absorbance interacted with VigPA on WMHV (false discovery rate-corrected interaction p = 0.037). Associations between these air pollutants and WMHVs were stronger among participants with high VigPA. Similarly, VigPA was negatively associated with WMHV for those in areas of low NO2 and PM2.5absorbance but was null among those living in areas of high NO2 and PM2.5absorbance. DISCUSSION: Physical activity is associated with beneficial brain outcomes, while AP is associated with detrimental brain outcomes. VigPA may exacerbate associations of AP with white matter hyperintensity lesions, and AP may attenuate the beneficial associations of physical activity with these lesions.
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Affiliation(s)
- Melissa A Furlong
- From the Department of Community, Environment, and Policy (M.A.F.), Mel and Enid Zuckerman College of Public Health, Departments of Psychology and Psychiatry (G.E.A.), Evelyn F. McKnight Brain Institute (G.E.A.), BIO5 Institute (G.E.A., Y.C.K.), Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs (G.E.A.), and Department of Epidemiology and Biostatistics (Y.C.K.), University of Arizona, Tucson; Arizona Alzheimer's Consortium (G.E.A.), Phoenix; and Human and Evolutionary Biology Section (D.A.R.), Department of Biological Sciences, University of Southern California, Los Angeles.
| | - Gene E Alexander
- From the Department of Community, Environment, and Policy (M.A.F.), Mel and Enid Zuckerman College of Public Health, Departments of Psychology and Psychiatry (G.E.A.), Evelyn F. McKnight Brain Institute (G.E.A.), BIO5 Institute (G.E.A., Y.C.K.), Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs (G.E.A.), and Department of Epidemiology and Biostatistics (Y.C.K.), University of Arizona, Tucson; Arizona Alzheimer's Consortium (G.E.A.), Phoenix; and Human and Evolutionary Biology Section (D.A.R.), Department of Biological Sciences, University of Southern California, Los Angeles
| | - Yann C Klimentidis
- From the Department of Community, Environment, and Policy (M.A.F.), Mel and Enid Zuckerman College of Public Health, Departments of Psychology and Psychiatry (G.E.A.), Evelyn F. McKnight Brain Institute (G.E.A.), BIO5 Institute (G.E.A., Y.C.K.), Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs (G.E.A.), and Department of Epidemiology and Biostatistics (Y.C.K.), University of Arizona, Tucson; Arizona Alzheimer's Consortium (G.E.A.), Phoenix; and Human and Evolutionary Biology Section (D.A.R.), Department of Biological Sciences, University of Southern California, Los Angeles
| | - David A Raichlen
- From the Department of Community, Environment, and Policy (M.A.F.), Mel and Enid Zuckerman College of Public Health, Departments of Psychology and Psychiatry (G.E.A.), Evelyn F. McKnight Brain Institute (G.E.A.), BIO5 Institute (G.E.A., Y.C.K.), Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs (G.E.A.), and Department of Epidemiology and Biostatistics (Y.C.K.), University of Arizona, Tucson; Arizona Alzheimer's Consortium (G.E.A.), Phoenix; and Human and Evolutionary Biology Section (D.A.R.), Department of Biological Sciences, University of Southern California, Los Angeles
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20
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Abstract
Unhealthy levels of air pollution are breathed by billions of people worldwide, and air pollution is the leading environmental cause of death and disability globally. Efforts to reduce air pollution at its many sources have had limited success, and in many areas of the world, poor air quality continues to worsen. Personal interventions to reduce exposure to air pollution include avoiding sources, staying indoors, filtering indoor air, using face masks, and limiting physical activity when and where air pollution levels are elevated. The effectiveness of these interventions varies widely with circumstances and conditions of use. Compared with upstream reduction or control of emissions, personal interventions place burdens and risk of adverse unintended consequences on individuals. We review evidence regarding the balance of benefits and potential harms of personal interventions for reducing exposure to outdoor air pollution, which merit careful consideration before making public health recommendations with regard to who should use personal interventions and where, when, and how they should be used. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Robert J Laumbach
- Rutgers School of Public Health, and Environmental and Occupational Health Sciences Institute, Piscataway, New Jersey, USA;
| | - Kevin R Cromar
- Marron Institute of Urban Management, New York University, New York, NY, USA.,Departments of Environmental Medicine and Population Health, Grossman School of Medicine, New York University, New York, NY, USA;
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21
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Peterman JE, Bassett DR, Finch WH, Harber MP, Whaley MH, Fleenor BS, Kaminsky LA. Associations Between Active Commuting and Cardiovascular Disease in the United States. J Phys Act Health 2021; 18:1525-1531. [PMID: 34689123 DOI: 10.1123/jpah.2021-0245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 08/06/2021] [Accepted: 08/20/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Active commuting is inversely related with cardiovascular disease (CVD) risk factors yet associations with CVD prevalence in the US population are unknown. METHODS Aggregate data from national surveys conducted in 2017 provided state-level percentages of adults who have/had coronary heart disease, myocardial infarction, and stroke, and who actively commuted to work. Associations between active commuting and CVD prevalence rates were assessed using Pearson correlations and generalized additive models controlling for covariates. RESULTS Significant correlations were observed between active commuting and all CVD rates (r range = -.31 to -.47; P < .05). The generalized additive model analyses for active commuting (walking, cycling, or public transport) in all adults found no relationships with CVD rates; however, a significant curvilinear association was observed for stroke within men. The generalized additive model curves when examining commuting via walking or cycling in all adults demonstrated nuanced, generally negative linear or curvilinear associations between coronary heart disease, myocardial infarction, and stroke. CONCLUSION Significant negative correlations were observed between active commuting and prevalence rates of coronary heart disease, myocardial infarction, and stroke. Controlling for covariates influenced these associations and highlights the need for future research to explore the potential of active commuting modes to reduce CVD in the United States.
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22
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Bo Y, Yu T, Chang LY, Guo C, Lin C, Zeng Y, Huang B, Tam T, Lau AKH, Wong SYS, Lao XQ. Combined effects of chronic PM2.5 exposure and habitual exercise on cancer mortality: a longitudinal cohort study. Int J Epidemiol 2021; 51:225-236. [PMID: 34632511 DOI: 10.1093/ije/dyab209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 09/20/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Exercise may increase the inhalation and deposition of air pollutants, which may counteract its beneficial effects. We thus examined the combined effects of chronic exposure to fine particulate matter (PM2.5) and habitual exercise on the risk of death from cancer in Taiwan. PATIENTS AND METHODS A total of 384 128 adults (≥18 years of age) were recruited for a medical screening programme between 2001 and 2016, yielding 842 384 medical-examination records. All participants were followed up until 31 May 2019. Vital data were obtained from the National Death Registry of Taiwan and the ambient PM2.5 exposure was estimated using a satellite-based spatiotemporal model. Information on habitual exercise was collected using a standard self-administered questionnaire. The time-dependent Cox-regression model was used to evaluate the combined effects. RESULTS A greater amount of habitual exercise was associated with lower risk of death from cancer, whilst a higher level of PM2.5 exposure was associated with a higher risk of death from cancer. The inverse associations of habitual exercise with death from cancer were not modified by chronic exposure to PM2.5. The participants in the group with a high level of exercise and a low level of PM2.5 exposure exhibited a 35% lower risk of death from cancer than those in the group with a low level of exercise and a high level of PM2.5 exposure (95% confidence interval: 28%, 42%). CONCLUSIONS Increased levels of exercise and reduced exposure levels of PM2.5 are associated with a lower risk of death from cancer. Habitual exercise reduces the risk of death from cancer regardless of the levels of chronic PM2.5 exposure. Our results indicate that habitual exercise is a suitable health-promotion strategy even for people who reside in moderately polluted regions.
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Affiliation(s)
- Yacong Bo
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.,Department of Nutrition and Food Hygiene, School of Public Health, Zhengzhou University, China
| | - Tsung Yu
- Department of Public Health, College of Medicine, National Cheng Kung University, Taiwan
| | | | - Cui Guo
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Changqing Lin
- Division of Environment and Sustainability, the Hong Kong University of Science and Technology, Hong Kong, China
| | - Yiqian Zeng
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Bo Huang
- Department of Geography and Resource Management, the Chinese University of Hong Kong, Hong Kong, China
| | - Tony Tam
- Department of Sociology, the Chinese University of Hong Kong, Hong Kong, China
| | - Alexis K H Lau
- Division of Environment and Sustainability, the Hong Kong University of Science and Technology, Hong Kong, China.,Department of Civil and Environmental Engineering, the Hong Kong University of Science and Technology, Hong Kong, China
| | - Samuel Y S Wong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Xiang Qian Lao
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.,Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, China
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23
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Personal Interventions for Reducing Exposure and Risk for Outdoor Air Pollution: An Official American Thoracic Society Workshop Report. Ann Am Thorac Soc 2021; 18:1435-1443. [PMID: 34468284 PMCID: PMC8489863 DOI: 10.1513/annalsats.202104-421st] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Poor air quality affects the health and wellbeing of large populations around the globe. Although source controls are the most effective approaches for improving air quality and reducing health risks, individuals can also take actions to reduce their personal exposure by staying indoors, reducing physical activity, altering modes of transportation, filtering indoor air, and using respirators and other types of face masks. A synthesis of available evidence on the efficacy, effectiveness, and potential adverse effects or unintended consequences of personal interventions for air pollution is needed by clinicians to assist patients and the public in making informed decisions about use of these interventions. To address this need, the American Thoracic Society convened a workshop in May of 2018 to bring together a multidisciplinary group of international experts to review the current state of knowledge about personal interventions for air pollution and important considerations when helping patients and the general public to make decisions about how best to protect themselves. From these discussions, recommendations were made regarding when, where, how, and for whom to consider personal interventions. In addition to the efficacy and safety of the various interventions, the committee considered evidence regarding the identification of patients at greatest risk, the reliability of air quality indices, the communication challenges, and the ethical and equity considerations that arise when discussing personal interventions to reduce exposure and risk from outdoor air pollution.
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Ried-Larsen M, Rasmussen MG, Blond K, Overvad TF, Overvad K, Steindorf K, Katzke V, Andersen JLM, Petersen KEN, Aune D, Tsilidis KK, Heath AK, Papier K, Panico S, Masala G, Pala V, Weiderpass E, Freisling H, Bergmann MM, Verschuren WMM, Zamora-Ros R, Colorado-Yohar SM, Spijkerman AMW, Schulze MB, Ardanaz EMA, Andersen LB, Wareham N, Brage S, Grøntved A. Association of Cycling With All-Cause and Cardiovascular Disease Mortality Among Persons With Diabetes: The European Prospective Investigation Into Cancer and Nutrition (EPIC) Study. JAMA Intern Med 2021; 181:1196-1205. [PMID: 34279548 PMCID: PMC8290339 DOI: 10.1001/jamainternmed.2021.3836] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 05/15/2021] [Indexed: 12/23/2022]
Abstract
Importance Premature death from all causes and cardiovascular disease (CVD) causes is higher among persons with diabetes. Objective To investigate the association between time spent cycling and all-cause and CVD mortality among persons with diabetes, as well as to evaluate the association between change in time spent cycling and risk of all-cause and CVD mortality. Design, Setting, and Participants This prospective cohort study included 7459 adults with diabetes from the European Prospective Investigation into Cancer and Nutrition study. Questionnaires regarding medical history, sociodemographic, and lifestyle information were administered in 10 Western European countries from 1992 through 2000 (baseline examination) and at a second examination 5 years after baseline. A total of 5423 participants with diabetes completed both examinations. The final updated primary analysis was conducted on November 13, 2020. Exposures The primary exposure was self-reported time spent cycling per week at the baseline examination. The secondary exposure was change in cycling status from baseline to the second examination. Main Outcomes and Measures The primary and secondary outcomes were all-cause and CVD mortality, respectively, adjusted for other physical activity modalities, diabetes duration, and sociodemographic and lifestyle factors. Results Of the 7459 adults with diabetes included in the analysis, the mean (SD) age was 55.9 (7.7) years, and 3924 (52.6%) were female. During 110 944 person-years of follow-up, 1673 deaths from all causes were registered. Compared with the reference group of people who reported no cycling at baseline (0 min/wk), the multivariable-adjusted hazard ratios for all-cause mortality were 0.78 (95% CI, 0.61-0.99), 0.76 (95% CI, 0.65-0.88), 0.68 (95% CI, 0.57-0.82), and 0.76 (95% CI, 0.63-0.91) for cycling 1 to 59, 60 to 149, 150 to 299, and 300 or more min/wk, respectively. In an analysis of change in time spent cycling with 57 802 person-years of follow-up, a total of 975 deaths from all causes were recorded. Compared with people who reported no cycling at both examinations, the multivariable-adjusted hazard ratios for all-cause mortality were 0.90 (95% CI, 0.71-1.14) in those who cycled and then stopped, 0.65 (95% CI, 0.46-0.92) in initial noncyclists who started cycling, and 0.65 (95% CI, 0.53-0.80) for people who reported cycling at both examinations. Similar results were observed for CVD mortality. Conclusion and Relevance In this cohort study, cycling was associated with lower all-cause and CVD mortality risk among people with diabetes independent of practicing other types of physical activity. Participants who took up cycling between the baseline and second examination had a considerably lower risk of both all-cause and CVD mortality compared with consistent noncyclists.
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Affiliation(s)
- Mathias Ried-Larsen
- Centre for Physical Activity Research, Rigshospitalet, Copenhagen, Denmark
- University of Southern Denmark, Odense, Denmark
| | | | - Kim Blond
- Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - Thure F. Overvad
- Aalborg Thrombosis Research Unit, Aalborg University, Aalborg, Denmark
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - Kim Overvad
- Aalborg Thrombosis Research Unit, Aalborg University, Aalborg, Denmark
- Aarhus University, Aarhus, Denmark
| | | | - Verena Katzke
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | | | - Dagfinn Aune
- Imperial College London, London, England, United Kingdom
| | - Kostas K. Tsilidis
- Imperial College London, London, England, United Kingdom
- University of Ioannina School of Medicine, Ioannina, Greece
| | | | - Keren Papier
- University of Oxford, Oxford, England, United Kingdom
| | | | | | - Valeria Pala
- Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy
| | | | | | | | - W. M. Monique Verschuren
- National Institute for Public Health and the Environment, Utrecht, the Netherlands
- Utrecht University, Utrecht, the Netherlands
| | - Raul Zamora-Ros
- Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Sandra M. Colorado-Yohar
- Biomedical Research Institute of Murcia(IMIB-Arrixaca), Murcia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- University of Antioquia, Medellín, Colombia
| | | | - Matthias B. Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
| | - Eva M. A. Ardanaz
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Public Health Institute of Navarra, Navarra, Spain
- Navarra Institute for Health Research, Navarra, Spain
| | | | - Nick Wareham
- University of Cambridge, Cambridge, England, United Kingdom
| | - Søren Brage
- University of Cambridge, Cambridge, England, United Kingdom
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25
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Lin Y, Yang X, Liang F, Huang K, Liu F, Li J, Xiao Q, Chen J, Liu X, Cao J, Chen S, Shen C, Yu L, Lu F, Wu X, Zhao L, Wu X, Li Y, Hu D, Huang J, Lu X, Liu Y, Gu D. Benefits of active commuting on cardiovascular health modified by ambient fine particulate matter in China: A prospective cohort study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 224:112641. [PMID: 34461320 PMCID: PMC9188394 DOI: 10.1016/j.ecoenv.2021.112641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/09/2021] [Accepted: 08/11/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Active commuting as a contributor to daily physical activity is beneficial for cardiovascular health, but leads to more chances of exposure to ambient air pollution. This study aimed to investigate associations between active commuting to work with cardiovascular disease (CVD), mortality and life expectancy among general Chinese adults, and to further evaluate the modification effect of fine particulate matter (PM2.5) exposure on these associations. METHODS We included 76,176 Chinese adults without CVD from three large cohorts of the Prediction for Atherosclerotic Cardiovascular Disease Risk in China project. Information about commuting mode and physical activity were collected by unified questionnaire. Satellite-based PM2.5 concentrations at 1-km spatial resolution was used for estimating PM2.5 exposure of participants. Hazard ratios (HRs) and 95% confidence intervals (CIs) for CVD incidence, mortality and all-cause mortality were estimated using Cox proportional hazards regression models. Multiplicative interaction term of commuting mode and PM2.5 level was tested to investigate potential effect modification. RESULTS During 448,499 person-years of follow-up, 2230 CVD events and 2777 all-cause deaths were recorded. Compared with the non-active commuters, the multivariable-adjusted HRs (95% CIs) of CVD incidence and all-cause mortality were 0.95(0.85-1.05) and 0.79(0.72-0.87) for walking commuters, respectively. Corresponding HRs (95% CIs) for cycling commuters were 0.71(0.62-0.82) and 0.67(0.59-0.76). Active commuters over 45 years old were estimated to have more CVD-free years and life expectancy than non-active commuters under lower PM2.5 concentration. However, these beneficial effects of active commuting were alleviated or counteracted by long-term exposure to high PM2.5 concentration. Significant multiplicative interaction of commuting mode and PM2.5 level was showed in all-cause mortality, with the lowest risk observed in cycling participants exposed to lower level of PM2.5. CONCLUSIONS Active commuting was associated with lower risk of CVD, all-cause mortality, and longer life expectancy among Chinese adults under ambient settings with lower PM2.5 level. It will be valuable to encourage active commuting among adults and develop stringent strategies on ambient PM2.5 pollution control for prevention of CVD and prolongation of life expectancy.
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Affiliation(s)
- Yuan Lin
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Xueli Yang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Fengchao Liang
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen 518055, China
| | - Keyong Huang
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Fangchao Liu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Jianxin Li
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Qingyang Xiao
- School of Environment, Tsinghua University, Beijing 100084, China
| | - Jichun Chen
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Xiaoqing Liu
- Division of Epidemiology, Guangdong Provincial People's Hospital and Cardiovascular Institute, Guangzhou 510080, China
| | - Jie Cao
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Shufeng Chen
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Chong Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Ling Yu
- Department of Cardiology, Fujian Provincial Hospital, Fuzhou 350014, China
| | - Fanghong Lu
- Cardio-Cerebrovascular Control and Research Center, Institute of Basic Medicine, Shandong Academy of Medical Sciences, Jinan 250062, China
| | - Xianping Wu
- Center for Chronic and Noncommunicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu 610041, China
| | - Liancheng Zhao
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Xigui Wu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Ying Li
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Dongsheng Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen 518071, China
| | - Jianfeng Huang
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Xiangfeng Lu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Yang Liu
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Dongfeng Gu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China; School of Medicine, Southern University of Science and Technology, Shenzhen 518055, China.
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26
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Guo C, Yu T, Chang LY, Lin C, Yang HT, Bo Y, Zeng Y, Tam T, Lau AKH, Lao XQ. Effects of air pollution and habitual exercise on the risk of death: a longitudinal cohort study. CMAJ 2021; 193:E1240-E1249. [PMID: 34400482 PMCID: PMC8386491 DOI: 10.1503/cmaj.202729] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2021] [Indexed: 01/15/2023] Open
Abstract
Background: Exercise may exacerbate the adverse health effects of air pollution by increasing the inhalation of air pollutants. We investigated the combined effects of long-term exposure to fine particle matter (PM2.5) and habitual exercise on deaths from natural causes in Taiwan. Methods: We recruited 384 130 adults (aged ≥ 18 yr) with 842 394 medical examination records between 2001 and 2016, and followed all participants until May 31, 2019. We obtained vital data from the National Death Registry of Taiwan. We estimated PM2.5 exposure using a satellite-based spatiotemporal model, and collected information on exercise habits using a standard self-administered questionnaire. We analyzed the data using a Cox regression model with time-dependent covariates. Results: A higher level of habitual exercise was associated with a lower risk of death from natural causes, compared with inactivity (hazard ratio [HR] 0.84, 95% confidence interval [CI] 0.80–0.88 for the moderate exercise group; HR 0.65, 95% CI 0.62–0.68 for the high exercise groups), whereas a higher PM2.5 exposure was associated with a higher risk of death from natural causes compared with lower exposure (HR 1.02, 95% CI 0.98–1.07, and HR 1.15, 95% CI 1.10–1.20, for the moderate and high PM2.5 exposure groups, respectively). Compared with inactive adults with high PM2.5 exposure, adults with high levels of habitual exercise and low PM2.5 exposure had a substantially lower risk of death from natural causes. We found a minor, but statistically significant, interaction effect between exercise and PM2.5 exposure on risk of death (HR 1.03 95% CI 1.01–1.06). Subgroup analyses, stratified by PM2.5 categories, suggested that moderate and high levels of exercise were associated with a lower risk of death in each PM2.5 stratum, compared with inactivity. Interpretation: Increased levels of exercise and reduced PM2.5 exposure are associated with a lower risk of death from natural causes. Habitual exercise can reduce risk regardless of the levels of PM2.5 exposure. Our results suggest that exercise is a safe health improvement strategy, even for people residing in relatively polluted regions.
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Affiliation(s)
- Cui Guo
- Jockey Club School of Public Health and Primary Care (Guo, Yang, Bo, Zeng, Lao), the Chinese University of Hong Kong, Hong Kong SAR, China; Department of Public Health (Yu), National Cheng Kung University, Tainan, Taiwan; Institute of Sociology (Chang), Academia Sinica, Taipei, Taiwan; Division of Environment and Sustainability (Lin, Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Civil and Environmental Engineering (Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Nutrition and Food Hygiene (Bo), School of Public Health, Zhengzhou University, China; Department of Sociology (Tam), the Chinese University of Hong Kong, Hong Kong SAR, China; Shenzhen Research Institute of the Chinese University of Hong Kong (Lao), Shenzhen, China
| | - Tsung Yu
- Jockey Club School of Public Health and Primary Care (Guo, Yang, Bo, Zeng, Lao), the Chinese University of Hong Kong, Hong Kong SAR, China; Department of Public Health (Yu), National Cheng Kung University, Tainan, Taiwan; Institute of Sociology (Chang), Academia Sinica, Taipei, Taiwan; Division of Environment and Sustainability (Lin, Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Civil and Environmental Engineering (Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Nutrition and Food Hygiene (Bo), School of Public Health, Zhengzhou University, China; Department of Sociology (Tam), the Chinese University of Hong Kong, Hong Kong SAR, China; Shenzhen Research Institute of the Chinese University of Hong Kong (Lao), Shenzhen, China
| | - Ly-Yun Chang
- Jockey Club School of Public Health and Primary Care (Guo, Yang, Bo, Zeng, Lao), the Chinese University of Hong Kong, Hong Kong SAR, China; Department of Public Health (Yu), National Cheng Kung University, Tainan, Taiwan; Institute of Sociology (Chang), Academia Sinica, Taipei, Taiwan; Division of Environment and Sustainability (Lin, Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Civil and Environmental Engineering (Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Nutrition and Food Hygiene (Bo), School of Public Health, Zhengzhou University, China; Department of Sociology (Tam), the Chinese University of Hong Kong, Hong Kong SAR, China; Shenzhen Research Institute of the Chinese University of Hong Kong (Lao), Shenzhen, China
| | - Changqing Lin
- Jockey Club School of Public Health and Primary Care (Guo, Yang, Bo, Zeng, Lao), the Chinese University of Hong Kong, Hong Kong SAR, China; Department of Public Health (Yu), National Cheng Kung University, Tainan, Taiwan; Institute of Sociology (Chang), Academia Sinica, Taipei, Taiwan; Division of Environment and Sustainability (Lin, Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Civil and Environmental Engineering (Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Nutrition and Food Hygiene (Bo), School of Public Health, Zhengzhou University, China; Department of Sociology (Tam), the Chinese University of Hong Kong, Hong Kong SAR, China; Shenzhen Research Institute of the Chinese University of Hong Kong (Lao), Shenzhen, China
| | - Hsiao Ting Yang
- Jockey Club School of Public Health and Primary Care (Guo, Yang, Bo, Zeng, Lao), the Chinese University of Hong Kong, Hong Kong SAR, China; Department of Public Health (Yu), National Cheng Kung University, Tainan, Taiwan; Institute of Sociology (Chang), Academia Sinica, Taipei, Taiwan; Division of Environment and Sustainability (Lin, Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Civil and Environmental Engineering (Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Nutrition and Food Hygiene (Bo), School of Public Health, Zhengzhou University, China; Department of Sociology (Tam), the Chinese University of Hong Kong, Hong Kong SAR, China; Shenzhen Research Institute of the Chinese University of Hong Kong (Lao), Shenzhen, China
| | - Yacong Bo
- Jockey Club School of Public Health and Primary Care (Guo, Yang, Bo, Zeng, Lao), the Chinese University of Hong Kong, Hong Kong SAR, China; Department of Public Health (Yu), National Cheng Kung University, Tainan, Taiwan; Institute of Sociology (Chang), Academia Sinica, Taipei, Taiwan; Division of Environment and Sustainability (Lin, Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Civil and Environmental Engineering (Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Nutrition and Food Hygiene (Bo), School of Public Health, Zhengzhou University, China; Department of Sociology (Tam), the Chinese University of Hong Kong, Hong Kong SAR, China; Shenzhen Research Institute of the Chinese University of Hong Kong (Lao), Shenzhen, China
| | - Yiqian Zeng
- Jockey Club School of Public Health and Primary Care (Guo, Yang, Bo, Zeng, Lao), the Chinese University of Hong Kong, Hong Kong SAR, China; Department of Public Health (Yu), National Cheng Kung University, Tainan, Taiwan; Institute of Sociology (Chang), Academia Sinica, Taipei, Taiwan; Division of Environment and Sustainability (Lin, Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Civil and Environmental Engineering (Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Nutrition and Food Hygiene (Bo), School of Public Health, Zhengzhou University, China; Department of Sociology (Tam), the Chinese University of Hong Kong, Hong Kong SAR, China; Shenzhen Research Institute of the Chinese University of Hong Kong (Lao), Shenzhen, China
| | - Tony Tam
- Jockey Club School of Public Health and Primary Care (Guo, Yang, Bo, Zeng, Lao), the Chinese University of Hong Kong, Hong Kong SAR, China; Department of Public Health (Yu), National Cheng Kung University, Tainan, Taiwan; Institute of Sociology (Chang), Academia Sinica, Taipei, Taiwan; Division of Environment and Sustainability (Lin, Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Civil and Environmental Engineering (Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Nutrition and Food Hygiene (Bo), School of Public Health, Zhengzhou University, China; Department of Sociology (Tam), the Chinese University of Hong Kong, Hong Kong SAR, China; Shenzhen Research Institute of the Chinese University of Hong Kong (Lao), Shenzhen, China
| | - Alexis K H Lau
- Jockey Club School of Public Health and Primary Care (Guo, Yang, Bo, Zeng, Lao), the Chinese University of Hong Kong, Hong Kong SAR, China; Department of Public Health (Yu), National Cheng Kung University, Tainan, Taiwan; Institute of Sociology (Chang), Academia Sinica, Taipei, Taiwan; Division of Environment and Sustainability (Lin, Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Civil and Environmental Engineering (Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Nutrition and Food Hygiene (Bo), School of Public Health, Zhengzhou University, China; Department of Sociology (Tam), the Chinese University of Hong Kong, Hong Kong SAR, China; Shenzhen Research Institute of the Chinese University of Hong Kong (Lao), Shenzhen, China
| | - Xiang Qian Lao
- Jockey Club School of Public Health and Primary Care (Guo, Yang, Bo, Zeng, Lao), the Chinese University of Hong Kong, Hong Kong SAR, China; Department of Public Health (Yu), National Cheng Kung University, Tainan, Taiwan; Institute of Sociology (Chang), Academia Sinica, Taipei, Taiwan; Division of Environment and Sustainability (Lin, Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Civil and Environmental Engineering (Lau), the Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Nutrition and Food Hygiene (Bo), School of Public Health, Zhengzhou University, China; Department of Sociology (Tam), the Chinese University of Hong Kong, Hong Kong SAR, China; Shenzhen Research Institute of the Chinese University of Hong Kong (Lao), Shenzhen, China.
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Zeng Y, Lin C, Guo C, Bo Y, Chang LY, Lau AKH, Tam T, Yu Z, Lao XQ. Combined effects of chronic PM 2.5 exposure and habitual exercise on renal function and chronic kidney disease: A longitudinal cohort study. Int J Hyg Environ Health 2021; 236:113791. [PMID: 34147785 DOI: 10.1016/j.ijheh.2021.113791] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 05/19/2021] [Accepted: 06/07/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND We investigated the combined effects of chronic PM2.5 exposure and habitual exercise on the decline of renal function and the incidence of chronic kidney disease (CKD) in a large cohort in Taiwan. METHODS The present data analysis included a total of 108,615 participants aged 18 years or above who were recruited between 2001 and 2016. All participants underwent at least two medical examinations. Estimated glomerular filtration rate (eGFR) was calculated using the Modification of Diet in Renal Disease (MDRD) equation. The incident of eGFR decline ≥30% was defined as a decline in eGFR of ≥30% during the study period, while the incident CKD was defined as an eGFR <60 mL/min/1.73 m2 or a newly self-reported physician-diagnosed CKD in the subsequent visits. The satellite-based spatiotemporal model was used to estimate PM2.5 exposure at each participant's address. Information on habitual exercise was collected using a standard self-administered questionnaire. The Cox regression model with time-dependent covariates was used for data analyses. RESULTS Higher habitual exercise was associated with lower risks of renal function decline and CKD development, whereas higher PM2.5 exposure was associated with higher risks of renal function decline and CKD development. We found no significant interaction effect between PM2.5 and habitual exercise, with an HR (95% CI) of 1.02 (0.97, 1.07) for incident eGFR decline ≥30% and 1.00 (0.95, 1.05) for CKD development. Compared to participants with inactive-exercise and high-PM2.5, participants with high-exercise and low-PM2.5 had 74% and 61% lower risks of renal function decline and CKD development, respectively. CONCLUSION Increased habitual exercise and reduced PM2.5 exposures are associated with lower risks of renal function decline and CKD development. Habitual exercise reduces risks of renal function decline and CKD development regardless of the levels of chronic PM2.5 exposure. Our study suggests that habitual exercise is a safe approach for kidney health improvement even for people residing in relatively polluted areas and should be promoted.
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Affiliation(s)
- Yiqian Zeng
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Changqing Lin
- Division of Environment and Sustainability, The Hong Kong University of Science and Technology, Hong Kong SAR, China
| | - Cui Guo
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yacong Bo
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ly-Yun Chang
- Institute of Sociology, Academia Sinica, Taipei, Taiwan
| | - Alexis K H Lau
- Division of Environment and Sustainability, The Hong Kong University of Science and Technology, Hong Kong SAR, China; Department of Civil and Environmental Engineering, The Hong Kong University of Science and Technology, Hong Kong SAR, China
| | - Tony Tam
- Department of Sociology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Zengli Yu
- Department of Nutrition and Food Hygiene, School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Xiang Qian Lao
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China; Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, Guangdong, China.
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Urban Environment and Health: A Cross-Sectional Study of the Influence of Environmental Quality and Physical Activity on Blood Pressure. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116126. [PMID: 34204097 PMCID: PMC8201128 DOI: 10.3390/ijerph18116126] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/01/2021] [Accepted: 06/04/2021] [Indexed: 12/29/2022]
Abstract
Few studies have examined the relation between urban built environment and the prevalence of hypertension. This cross-sectional study aimed at assessing the relationship between the environmental quality, physical activity, and stress on hypertension among citizens of Kaunas city, Lithuania. We conducted a survey of 1086 citizens residing in 11 districts to determine their perceptions of environmental quality, health behavior, and health indices. The independent variables included residential traffic flows, access to public transportation and green spaces. Dependent variables included physician-diagnosed hypertension, systolic and diastolic blood pressure, and stress level. We used multivariable logistic regression to assess the associations as odds ratios (OR). The environmental factors beneficially associated with meeting the physical activity recommendations were opportunities for walking to reach the city's green spaces and available relaxation areas. Residents of high noise level districts aged 45-64 years had a significantly higher OR of stress and a higher prevalence of hypertension when age, sex, education status, family status, and smoking were accounted for. However, meeting the physical activity recommendations had a beneficial effect on the risk of hypertension. This study provided evidence that improvement of the district-level built environment supporting citizens' physical activity might reduce the risk of hypertension.
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Wang F, Wang X. Associations between PM2.5 exposure duration and physical activity intensity on the health of hypertension in urban residents of Beijing. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:29742-29754. [PMID: 33569688 DOI: 10.1007/s11356-021-12698-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 01/25/2021] [Indexed: 06/12/2023]
Abstract
Hypertension is reported to be associated with air pollution and physical activity (PA), and they have different or even conflicting effects on blood pressure (BP). The study evaluated the combined effects of PM2.5 exposure duration and physical activity intensity on systolic blood pressure (SBP) and diastolic blood pressure (DBP) of hypertension. A total of 2613 patients (≥18-year-olds) at baseline who attended surveys from the China Health and Nutrition Survey (2011-2015) in Beijing were selected, as well as the PM2.5 data collected in the same period. The mixed linear effects model and multivariate analysis of variance (MANOVA) were used to explore the multiple effects of PM2.5 exposure duration and PA intensity on SBP and DBP, respectively. The correlation results indicated PM2.5 exposure duration (>15 days) occurred more significant correlations with DBP and longer PM2.5 exposures duration (>60 day) with SBP. The mixed linear effects model showed the important random terms of gender, PA levels, and BMI classification for both SBP and DBP. It also indicated the significant fixed effect from age for both SBP and DBP, and the significant fixed effects from PM2.5 and weight, as well as the interaction in DBP. The random effects of PA levels put effects on different weight people for SBP and on different age people for DBP, while the person of SBP exposed to PM2.5 environments may tend to be affected by BMI classification. The model's main effects showed PA and the interaction with gender could put significant effects on BP. The gender effects and the PA level effects were also improved by the MANOVA results. We concluded that the more PM2.5 exposure duration may lead to more significant correlation with higher BP values. The PA levels could lead to the different effects on the health showing the variations in age, gender, and BMI classification. For SBP of people who are exposed to PM2.5 environments, it may tend to be affected by BMI classification, which also may influence the DBP through weight adjusting first and then cause hypertension. The gender difference of BP may be affected by PA showing the higher PA level and the more gender difference.
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Affiliation(s)
- Fei Wang
- Sports Science Institute, Shanxi University, Taiyuan, 030006, Shanxi, China.
- School of Physical Education, Shanxi University, No. 92 Wucheng Road, Taiyuan, 030006, Shanxi, China.
| | - Xinyu Wang
- School of Physical Education, Shanxi University, No. 92 Wucheng Road, Taiyuan, 030006, Shanxi, China
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Guo C, Yang HT, Chang LY, Bo Y, Lin C, Zeng Y, Tam T, Lau AKH, Hoek G, Lao XQ. Habitual exercise is associated with reduced risk of diabetes regardless of air pollution: a longitudinal cohort study. Diabetologia 2021; 64:1298-1308. [PMID: 33660006 DOI: 10.1007/s00125-021-05408-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 12/21/2020] [Indexed: 12/14/2022]
Abstract
AIMS/HYPOTHESIS Physical activity may increase a person's inhalation of air pollutants and exacerbate the adverse health effects. This study aimed to investigate the combined associations of chronic exposure to particulate matter with an aerodynamic diameter less than 2.5 μm (PM2.5) and habitual physical activity with the incidence of type 2 diabetes in Taiwan. METHODS We selected 156,314 non-diabetic adults (≥18 years old) who joined an ongoing longitudinal cohort between 2001 and 2016. Incident type 2 diabetes was identified at the follow-up medical examinations. Two-year mean PM2.5 exposure was estimated at each participant's address using a satellite-based spatiotemporal model. Information on physical activity and a wide range of covariates was collected using a standard self-administered questionnaire. We analysed the data using a Cox regression model with time-varying covariates. An interaction term between PM2.5 and physical activity was included to examine the overall interaction effects. RESULTS Compared with high physical activity, moderate and inactive/low physical activity were associated with a higher risk of diabetes (HR [95% CI] 1.31 [1.22, 1.41] and 1.56 [1.46, 1.68], respectively). Participants with moderate/high PM2.5 had a higher risk of type 2 diabetes than the participants exposed to low PM2.5 (HR 1.31 [1.22, 1.40] and 1.94 [1.76, 2.14], respectively). The participants with high physical activity and low PM2.5 had a 64% lower risk of type 2 diabetes than those with inactive/low physical activity and high PM2.5. CONCLUSIONS/INTERPRETATION Higher physical activity and lower PM2.5 exposure are associated with lower risk of type 2 diabetes. Habitual physical activity can reduce the risk of diabetes regardless of the levels of PM2.5 exposure. Our results indicate that habitual physical activity is a safe diabetes prevention strategy for people residing in relatively polluted regions.
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Affiliation(s)
- Cui Guo
- Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Hsiao Ting Yang
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Ly-Yun Chang
- Institute of Sociology, Academia Sinica, Taipei, Taiwan
| | - Yacong Bo
- Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, SAR, China
- School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Changqing Lin
- Division of Environment and Sustainability, the Hong Kong University of Science and Technology, Hong Kong, SAR, China
- Department of Civil and Environmental Engineering, the Hong Kong University of Science and Technology, Hong Kong, SAR, China
| | - Yiqian Zeng
- Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Tony Tam
- Department of Sociology, the Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Alexis K H Lau
- Division of Environment and Sustainability, the Hong Kong University of Science and Technology, Hong Kong, SAR, China
- Department of Civil and Environmental Engineering, the Hong Kong University of Science and Technology, Hong Kong, SAR, China
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Xiang Qian Lao
- Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, SAR, China.
- Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, Guangdong, China.
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The joint association of physical activity and fine particulate matter exposure with incident dementia in elderly Hong Kong residents. ENVIRONMENT INTERNATIONAL 2021; 156:106645. [PMID: 34015665 DOI: 10.1016/j.envint.2021.106645] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 04/13/2021] [Accepted: 05/12/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The evidence for the beneficial effects of physical activity (PA) and potentially detrimental effects of long-term exposure to fine particulate matter (PM2.5) on neurodegeneration diseases is accumulating. However, their joint effects remain unclear. We evaluated joint associations of habitual PA and PM2.5 exposure with incident dementia in a longitudinal elderly cohort in Hong Kong. METHODS A total of 57,775 elderly participants (≥65 years) without dementia were enrolled during 1998-2001 and followed up till 2011. Their information on PA and other relevant covariates were collected at baseline (1998-2001) by a standard self-administered questionnaire, including PA volumes (high, moderate, low, and inactive) and types (aerobic exercise, traditional Chinese exercise, stretching exercise, walking slowly, and no exercise). Their annual mean PM2.5 exposures at the residential address were estimated using a satellite-based spatiotemporal model. We then adopted the Cox proportional hazards model to examine the joint associations with the incidence of all-cause dementia, Alzheimer's diseases, and vascular dementia on additive and multiplicative scales. RESULTS During the follow-up period, we identified 1,157 incident cases of dementia, including 642 cases of Alzheimer's disease and 324 cases of vascular dementia. A higher PA level was associated with a lower risk of incident all-cause dementia (hazard ratio (HR) for the high-PA volume was 0.59 (95% CI, 0.47, 0.75), as compared with the inactive-PA), whereas a high level of PM2.5 was related to the higher risk with an HR of 1.15 (95%CI: 1.00, 1.33) compared with the low-level of PM2.5. No clear evidence was observed of interaction between habitual PA (volume and type) and PM2.5 inhalation to incident dementia on either additive or multiplicative scale. CONCLUSION Habitual PA and long-term PM2.5 exposure were oppositely related to incident dementia in the Hong Kong aged population. The benefits of PA remain in people irrespective of exposure to air pollution.
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Raza W, Krachler B, Forsberg B, Sommar JN. Air pollution, physical activity and ischaemic heart disease: a prospective cohort study of interaction effects. BMJ Open 2021; 11:e040912. [PMID: 33849846 PMCID: PMC8051414 DOI: 10.1136/bmjopen-2020-040912] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 03/21/2021] [Accepted: 03/28/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To assess a possible interaction effect between physical activity and air pollution on first incidence of ischaemic heart disease (IHD). DESIGN Prospective cohort study. SETTING Umeå, Northern Sweden. PARTICIPANTS We studied 34 748 adult participants of Västerbotten Intervention Programme cohort from 1990 to January 2014. Annual particulate matter concentrations (PM2.5 and PM10) at the participants' residential addresses were modelled and a questionnaire on frequency of exercise and active commuting was completed at baseline. Cox proportional hazards modelling was used to estimate (1) association with physical activity at different levels of air pollution and (2) the association with particulate matter at different levels of physical activity. OUTCOME First incidence of IHD. RESULTS Over a mean follow-up of 12.4 years, there were 1148 IHD cases. Overall, we observed an increased risk of IHD among individuals with higher concentrations of particles at their home address. Exercise at least twice a week was associated with a lower risk of IHD among participants with high residential PM2.5 (hazard ratio (HR) 0.60; 95% CI: 0.44 to 0.82) and PM10 (HR 0.55; 95% CI: 0.4 to 0.76). The same beneficial effect was not observed with low residential PM2.5 (HR 0.94; 95% CI: 0.72 to 1.22) and PM10 (HR 0.99; 95% CI: 0.76 to 1.29). An increased risk associated with higher long-term exposure to particles was only observed among participants that exercised in training clothes at most one a week and among those not performing any active commuting. However, only the interaction effect on HRs for exercise was statistically significant. CONCLUSION Exercise was associated with a lower risk of first incidence of IHD among individuals with higher residential particle concentrations. An air pollution-associated risk was only observed among those who exercised less. The findings support the promotion of physical activity and a mitigation of air pollution.
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Affiliation(s)
- Wasif Raza
- Public Health and Clinical Medicine, Sustainable Health, Umeå University, Umea, Sweden
| | - Benno Krachler
- Public Health and Clinical Medicine, Sustainable Health, Umeå University, Umea, Sweden
| | - Bertil Forsberg
- Public Health and Clinical Medicine, Sustainable Health, Umeå University, Umea, Sweden
| | - Johan Nilsson Sommar
- Public Health and Clinical Medicine, Sustainable Health, Umeå University, Umea, Sweden
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Does Physical Activity Modify the Association between Air Pollution and Recurrence of Cardiovascular Disease? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052631. [PMID: 33807925 PMCID: PMC7967368 DOI: 10.3390/ijerph18052631] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/02/2021] [Accepted: 03/02/2021] [Indexed: 01/02/2023]
Abstract
We aimed to assess a possible interaction effect between physical activity and particulate air pollution exposure on recurrence of ischemic heart disease (IHD) and stroke. We followed 2221 adult participants comprising first time IHD (1403) and stroke (818) cases from the Västerbotten Intervention Program between 1 January 1990 to 31 December 2013. During mean follow-up times of 5.5 years, 428 and 156 participants developed IHD and stroke recurrence, respectively. PM2.5 concentrations above the median (5.48 µg/m3) were associated with increased risk of IHD and stroke recurrence by 13% (95% CI −17–45%) and 21% (95% CI −19–80%), respectively. These risk increases were however only observed among those that exercised at most once a week at 21% (95% CI −5–50%) and 25% (95% CI −19–90%) for IHD and stroke recurrence, respectively. Higher frequency of exercise at recruitment was positively associated with IHD and stroke recurrence but only the association with IHD recurrence among participants with low residential PM2.5 was statistically significant (96% increased risk (95%-CI 22–215%)). However, no interaction effect between physical activity and PM2.5 exposure was found. Our findings suggest that physical activity may reduce the air pollution exposure associated risk for recurrent cardiovascular disease, likely by reducing the inflammatory response.
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Tainio M, Jovanovic Andersen Z, Nieuwenhuijsen MJ, Hu L, de Nazelle A, An R, Garcia LMT, Goenka S, Zapata-Diomedi B, Bull F, Sá THD. Air pollution, physical activity and health: A mapping review of the evidence. ENVIRONMENT INTERNATIONAL 2021; 147:105954. [PMID: 33352412 PMCID: PMC7816214 DOI: 10.1016/j.envint.2020.105954] [Citation(s) in RCA: 127] [Impact Index Per Article: 42.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 06/30/2020] [Accepted: 07/03/2020] [Indexed: 05/19/2023]
Abstract
BACKGROUND Exposure to air pollution and physical inactivity are both significant risk factors for non-communicable diseases (NCDs). These risk factors are also linked so that the change in exposure in one will impact risks and benefits of the other. These links are well captured in the active transport (walking, cycling) health impact models, in which the increases in active transport leading to increased inhaled dose of air pollution. However, these links are more complex and go beyond the active transport research field. Hence, in this study, we aimed to summarize the empirical evidence on the links between air pollution and physical activity, and their combined effect on individual and population health. OBJECTIVES AND METHODS We conducted a non-systematic mapping review of empirical and modelling evidence of the possible links between exposure to air pollution and physical activity published until Autumn 2019. We reviewed empirical evidence for the (i) impact of exposure to air pollution on physical activity behaviour, (ii) exposure to air pollution while engaged in physical activity and (iii) the short-term and (iv) long-term health effects of air pollution exposure on people engaged in physical activity. In addition, we reviewed (v) public health modelling studies that have quantified the combined effect of air pollution and physical activity. These broad research areas were identified through expert discussions, including two public events performed in health-related conferences. RESULTS AND DISCUSSION The current literature suggests that air pollution may decrease physical activity levels during high air pollution episodes or may prevent people from engaging in physical activity overall in highly polluted environments. Several studies have estimated fine particulate matter (PM2.5) exposure in active transport environment in Europe and North-America, but the concentration in other regions, places for physical activity and for other air pollutants are poorly understood. Observational epidemiological studies provide some evidence for a possible interaction between air pollution and physical activity for acute health outcomes, while results for long-term effects are mixed with several studies suggesting small diminishing health gains from physical activity due to exposure to air pollution for long-term outcomes. Public health modelling studies have estimated that in most situations benefits of physical activity outweigh the risks of air pollution, at least in the active transport environment. However, overall evidence on all examined links is weak for low- and middle-income countries, for sensitive subpopulations (children, elderly, pregnant women, people with pre-existing conditions), and for indoor air pollution. CONCLUSIONS Physical activity and air pollution are linked through multiple mechanisms, and these relations could have important implications for public health, especially in locations with high air pollution concentrations. Overall, this review calls for international collaboration between air pollution and physical activity research fields to strengthen the evidence base on the links between both and on how policy options could potentially reduce risks and maximise health benefits.
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Affiliation(s)
- Marko Tainio
- Sustainable Urbanisation Programme, Finnish Environment Institute SYKE, Helsinki, Finland; Systems Research Institute, Polish Academy of Sciences, Warsaw, Poland
| | | | - Mark J Nieuwenhuijsen
- ISGlobal - Barcelona Institute for Global Health, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Madrid, Spain
| | - Liang Hu
- Department of Sport Science, Zhejiang University, Hangzhou, China
| | - Audrey de Nazelle
- Centre for Environmental Policy, Imperial College London, London, UK
| | - Ruopeng An
- Brown School, Washington University in St. Louis, St. Louis, US
| | | | - Shifalika Goenka
- Centre for Chronic Disease Control and Public Health Foundation of India, New Delhi, India
| | | | - Fiona Bull
- Department of Health Promotion, World Health Organization, Geneva, Switzerland
| | - Thiago Herick de Sá
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
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Rajagopalan S, Brauer M, Bhatnagar A, Bhatt DL, Brook JR, Huang W, Münzel T, Newby D, Siegel J, Brook RD. Personal-Level Protective Actions Against Particulate Matter Air Pollution Exposure: A Scientific Statement From the American Heart Association. Circulation 2020; 142:e411-e431. [PMID: 33150789 DOI: 10.1161/cir.0000000000000931] [Citation(s) in RCA: 115] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Since the publication of the last American Heart Association scientific statement on air pollution and cardiovascular disease in 2010, unequivocal evidence of the causal role of fine particulate matter air pollution (PM2.5, or particulate matter ≤2.5 μm in diameter) in cardiovascular disease has emerged. There is a compelling case to provide the public with practical personalized approaches to reduce the health effects of PM2.5. Such interventions would be applicable not only to individuals in heavily polluted countries, high-risk or susceptible individuals living in cleaner environments, and microenvironments with higher pollution exposures, but also to those traveling to locations with high levels of PM2.5. The overarching motivation for this document is to summarize the current evidence supporting personal-level strategies to prevent the adverse cardiovascular effects of PM2.5, guide the use of the most proven/viable approaches, obviate the use of ineffective measures, and avoid unwarranted interventions. The significance of this statement relates not only to the global importance of PM2.5, but also to its focus on the most tested interventions and viable approaches directed at particulate matter air pollution. The writing group sought to provide expert consensus opinions on personal-level measures recognizing the current uncertainty and limited evidence base for many interventions. In doing so, the writing group acknowledges that its intent is to assist other agencies charged with protecting public health, without minimizing the personal choice considerations of an individual who may decide to use these interventions in the face of ongoing air pollution exposure.
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Elliott EG, Laden F, James P, Rimm EB, Rexrode KM, Hart JE. Interaction between Long-Term Exposure to Fine Particulate Matter and Physical Activity, and Risk of Cardiovascular Disease and Overall Mortality in U.S. Women. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:127012. [PMID: 33356515 PMCID: PMC7757788 DOI: 10.1289/ehp7402] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 10/20/2020] [Accepted: 11/20/2020] [Indexed: 05/05/2023]
Abstract
BACKGROUND Increased respiration during physical activity may increase air pollution dose, which may attenuate the benefits of physical activity on cardiovascular disease (CVD) risk and overall mortality. OBJECTIVES We aimed to examine the multiplicative interaction between long-term ambient residential exposure to fine particulate matter < 2.5 microns (PM 2.5 ) and physical activity in the association with CVD risk and overall mortality. METHODS We followed 104,990 female participants of the U.S.-based prospective Nurses' Health Study from 1988 to 2008. We used Cox proportional hazards models to assess the independent associations of 24-months moving average residential PM 2.5 exposure and physical activity updated every 4 y and the multiplicative interaction of the two on CVD (myocardial infarction and stroke) risk and overall mortality, after adjusting for demographics and CVD risk factors. RESULTS During 20 years of follow-up, we documented 6,074 incident CVD cases and 9,827 deaths. In fully adjusted models, PM 2.5 exposure was associated with modest increased risks of CVD [hazard ratio (HR) for fifth quintile ≥ 16.5 μ g / m 3 compared to first quintile < 10.7 μ g / m 3 : 1.09, 95% confidence interval (CI): 0.99, 1.20; p trend = 0.05 ] and overall mortality (HR fifth compared to first quintile: 1.10, 95% CI: 1.02, 1.19; p trend = 0.07 ). Higher overall physical activity was associated with substantially lower risk of CVD [HR fourth quartile, which was ≥ 24.4 metabolic equivalent of task (MET)-h/wk, compared to first quartile (< 3.7 MET-h / wk ): 0.61, 95% CI: 0.57, 0.66; p t r e n d < 0.0001 ] and overall mortality (HR fourth compared to first quartile: 0.40, 95% CI: 0.37, 0.42; p t r e n d < 0.0001 ). We observed no statistically significant interactions between PM 2.5 exposure and physical activity (overall, walking, vigorous activity) in association with CVD risk and overall mortality. DISCUSSION In this study of U.S. women, we observed no multiplicative interaction between long-term PM 2.5 exposure and physical activity; higher physical activity was strongly associated with lower CVD risk and overall mortality at all levels of PM 2.5 exposure. https://doi.org/10.1289/EHP7402.
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Affiliation(s)
- Elise G. Elliott
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Francine Laden
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Peter James
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
| | - Eric B. Rimm
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Kathryn M. Rexrode
- Division of Women’s Health, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Jaime E. Hart
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
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Eguiluz‐Gracia I, Mathioudakis AG, Bartel S, Vijverberg SJH, Fuertes E, Comberiati P, Cai YS, Tomazic PV, Diamant Z, Vestbo J, Galan C, Hoffmann B. The need for clean air: The way air pollution and climate change affect allergic rhinitis and asthma. Allergy 2020; 75:2170-2184. [PMID: 31916265 DOI: 10.1111/all.14177] [Citation(s) in RCA: 182] [Impact Index Per Article: 45.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 12/20/2019] [Accepted: 12/27/2019] [Indexed: 02/06/2023]
Abstract
Air pollution and climate change have a significant impact on human health and well-being and contribute to the onset and aggravation of allergic rhinitis and asthma among other chronic respiratory diseases. In Westernized countries, households have experienced a process of increasing insulation and individuals tend to spend most of their time indoors. These sequelae implicate a high exposure to indoor allergens (house dust mites, pets, molds, etc), tobacco smoke, and other pollutants, which have an impact on respiratory health. Outdoor air pollution derived from traffic and other human activities not only has a direct negative effect on human health but also enhances the allergenicity of some plants and contributes to global warming. Climate change modifies the availability and distribution of plant- and fungal-derived allergens and increases the frequency of extreme climate events. This review summarizes the effects of indoor air pollution, outdoor air pollution, and subsequent climate change on asthma and allergic rhinitis in children and adults and addresses the policy adjustments and lifestyle changes required to mitigate their deleterious effects.
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Affiliation(s)
- Ibon Eguiluz‐Gracia
- Allergy Unit IBIMA‐Hospital Regional Universitario de Malaga‐UMA Malaga Spain
| | - Alexander G. Mathioudakis
- Division of Infection, Immunity and Respiratory Medicine School of Biological Sciences The University of Manchester Manchester Academic Health Science Centre UK
- North West Lung Centre Wythenshawe Hospital Manchester University NHS Foundation Trust Southmoor Road Manchester UK
| | - Sabine Bartel
- Early Life Origins of Chronic Lung Disease, Research Center Borstel Leibniz Lung Center Member of the German Research Center for Lung Research (DZL) Borstel Germany
- Department of Pathology and Medical Biology University Medical Center Groningen GRIAC Research Institute University of Groningen Groningen The Netherlands
| | - Susanne J. H. Vijverberg
- Department of Respiratory Medicine Amsterdam UMC University of Amsterdam Amsterdam The Netherlands
| | - Elaine Fuertes
- National Heart and Lung Institute Imperial College London London UK
| | - Pasquale Comberiati
- Section of Paediatrics Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
- Department of Clinical Immunology and Allergology Sechenov University Moscow Russia
| | - Yutong Samuel Cai
- Department of Epidemiology and Biostatistics MRC Centre for Environment and Health School of Public Health Imperial College London London UK
- The George Institute for Global Health University of Oxford Oxford UK
| | - Peter Valentin Tomazic
- Department of General ORL, Head and Neck Surgery Medical University of Graz Graz Austria
| | - Zuzana Diamant
- Department of Respiratory Medicine & Allergology Institute for Clinical Science Skane University Hospital Lund University Lund Sweden
- Department of Respiratory Medicine First Faculty of Medicine Charles University and Thomayer Hospital Prague Czech Republic
| | - Jørgen Vestbo
- Division of Infection, Immunity and Respiratory Medicine School of Biological Sciences The University of Manchester Manchester Academic Health Science Centre UK
- North West Lung Centre Wythenshawe Hospital Manchester University NHS Foundation Trust Southmoor Road Manchester UK
| | - Carmen Galan
- Department of Botany, Ecology and Plant Physiology International Campus of Excellence on Agrifood (ceiA3) University of Córdoba Córdoba Spain
| | - Barbara Hoffmann
- Institute for Occupational, Social and Environmental Medicine Medical Faculty University of Düsseldorf Düsseldorf Germany
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Guo C, Zeng Y, Chang LY, Yu Z, Bo Y, Lin C, Lau AK, Tam T, Lao XQ. Independent and Opposing Associations of Habitual Exercise and Chronic PM 2.5 Exposures on Hypertension Incidence. Circulation 2020; 142:645-656. [PMID: 32686482 DOI: 10.1161/circulationaha.120.045915] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND We investigated the joint associations of habitual physical activity (PA) and long-term exposure to fine particulate matter (PM2.5) with the development of hypertension in a longitudinal cohort in Taiwan. METHODS We selected 140 072 adults (≥18 years of age) without hypertension who joined a standard medical screening program with 360 905 medical examinations between 2001 and 2016. PM2.5 exposure was estimated at each participant's address using a satellite data-based spatiotemporal model with 1 km2 resolution. Information on habitual PA and a wide range of covariates was collected using a standard self-administered questionnaire. We used the Cox regression model with time-dependent covariates to examine the joint associations. RESULTS The mean age of all observations was 41.7 years, and 48.8% were male. The mean value for systolic and diastolic blood pressure was 112.5 and 68.7mm Hg, respectively. Approximately 34.2% of all observations were inactive (0 metabolic equivalence values-hours), 29.8% had moderate-PA (median [interquartile range]; 3.75 [3.38 to 4.38] metabolic equivalence values-hours), and 36.0% had high-PA (15.7 [10.3 to 24.8] metabolic equivalence values-hours). The mean±SD of PM2.5 was 26.1±7.3 μg/m3. The prevalence of cardiovascular disease, diabetes mellitus, and cancer was 2.1%, 2.9%, and 1.5%, respectively. After adjusting for a wide range of covariates (including a mutual adjustment for PA or PM2.5), a higher PA level was associated with a lower risk of hypertension (hazard ratio [HR] for the moderate- and high-PA was 0.93 [95% CI, 0.89-0.97] and 0.92 [95% CI, 0.88-0.96], respectively, as compared with the inactive-PA), whereas a higher level of PM2.5 was associated with a higher risk of hypertension (HR for the moderate- and high-PM2.5 was 1.37 [95% CI, 1.32-1.43] and 1.92 [95% CI, 1.81-2.04], respectively, as compared with the low-PM2.5 group]. No significant interaction was observed between PA and PM2.5 (HR 1.01 [95% CI, 1.00-1.02]). CONCLUSIONS A high-PA and low PM2.5 exposure were associated with a lower risk of hypertension. The negative association between PA and hypertension remained stable in people exposed to various levels of PM2.5, and the positive association between PM2.5 and hypertension was not modified by PA. Our results indicated that PA is a suitable hypertension prevention strategy for people residing in relatively polluted regions.
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Affiliation(s)
- Cui Guo
- Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, China (C.G., Y.Z., Y.B., X.Q.L.)
| | - Yiqian Zeng
- Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, China (C.G., Y.Z., Y.B., X.Q.L.)
| | - Ly-Yun Chang
- Institute of Sociology, Academia Sinica, Taipei, Taiwan (L.C.)
| | - Zengli Yu
- Department of Nutrition and Food Hygiene, School of Public Health, Zhengzhou University, Henan, China (Z.Y.)
| | - Yacong Bo
- Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, China (C.G., Y.Z., Y.B., X.Q.L.)
| | - Changqing Lin
- Division of Environment and Sustainability, the Hong Kong University of Science and Technology, China (C.L., A.K.H.L.)
| | - Alexis Kh Lau
- Division of Environment and Sustainability, the Hong Kong University of Science and Technology, China (C.L., A.K.H.L.)
| | - Tony Tam
- Department of Sociology, the Chinese University of Hong Kong, China (T.T.)
| | - Xiang Qian Lao
- Shenzhen Research Institute of the Chinese University of Hong Kong, Guangdong, China (X.Q.L.)
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Sun S, Cao W, Qiu H, Ran J, Lin H, Shen C, Siu-Yin Lee R, Tian L. Benefits of physical activity not affected by air pollution: a prospective cohort study. Int J Epidemiol 2020; 49:142-152. [PMID: 31504557 DOI: 10.1093/ije/dyz184] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 08/19/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Physical activity (PA) is beneficial to human health, whereas long-term exposure to air pollution is harmful. However, their combined effects remain unclear. We aimed to estimate the combined (interactive) mortality effects of PA and long-term exposure to fine particulate matter (PM2.5) among older adults in Hong Kong. METHODS Participants aged ≥65 years from the Elderly Health Service Cohort (n = 66 820) reported their habitual PA at baseline (1998-2001) and were followed up till 31 December 2011. We used a satellite-based spatiotemporal model to estimate PM2.5 concentration at the residential address for each participant. We used Cox proportional hazards regression to assess the interaction between habitual PA and long-term exposure to PM2.5 on cardiovascular and respiratory mortality. We tested for additive interaction by estimating relative excess risk due to interaction and multiplicative interaction employing P-value for the interaction term. RESULTS The death risks were inversely associated with a higher volume of PA and were positively associated with long-term exposure to PM2.5. The benefits of PA were more pronounced for participation in traditional Chinese exercise (e.g. Tai Chi) and aerobic exercise (e.g. cycling). We found little evidence of interaction between PA (volume and type) and long-term exposure to PM2.5 on either additive or multiplicative scales. CONCLUSIONS In this cohort of older Chinese adults, PA may decrease the risk of mortality, be it in areas of relatively good or bad air quality. The beneficial mortality effects of habitual PA outweighed the detrimental effects of long-term exposure to air pollution in Hong Kong.
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Affiliation(s)
- Shengzhi Sun
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China.,Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Wangnan Cao
- Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, RI, USA
| | - Hong Qiu
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| | - Jinjun Ran
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| | - Hualiang Lin
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Chen Shen
- UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Ruby Siu-Yin Lee
- Elderly Health Service, Department of Health, Hong Kong SAR, China
| | - Linwei Tian
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
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Grøntved A, Rasmussen MG, Blond K, Østergaard L, Andersen ZJ, Møller NC. Bicycling for Transportation and Recreation in Cardiovascular Disease Prevention. CURRENT CARDIOVASCULAR RISK REPORTS 2019. [DOI: 10.1007/s12170-019-0623-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Analysis of Self-Reported Walking for Transit in a Sprawling Urban Metropolitan Area in the Western U.S. SUSTAINABILITY 2019. [DOI: 10.3390/su11030852] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Walkability is associated with increased levels of physical activity and improved health and sustainability. The sprawling design of many metropolitan areas of the western U.S., such as Las Vegas, influences their walkability. The purpose of this study was to consider sprawl characteristics along with well-known correlates of walkability to determine what factors influence self-reported minutes of active transportation. Residents from four neighborhoods in the Las Vegas Metropolitan Area, targeted for their high and low walkability scores, were surveyed for their perceptions of street-connectivity, residential-density, land-use mix, and retail–floor-area ratio and sprawl characteristics including distance between crosswalks, single-entry-communities, high-speed streets, shade, and access to transit. A Poisson model provided the best estimates for minutes of active transportation and explained 11.28% of the variance. The model that included sprawl characteristics resulted in a better estimate of minutes of active transportation compared to the model without them. The results indicate that increasing walkability in urban areas such as Las Vegas requires an explicit consideration of its sprawl characteristics. Not taking such design characteristics into account may result in the underestimation of the influence of sprawl on active transportation and may result in a missed opportunity to increase walking. Understanding the correlates of walkability at the local level is important in successfully promoting walking as a means to increase active transportation and improve community health and sustainability.
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Zhan C, Shi M, Wu R, He H, Liu X, Shen B. MIRKB: a myocardial infarction risk knowledge base. DATABASE-THE JOURNAL OF BIOLOGICAL DATABASES AND CURATION 2019; 2019:5612251. [PMID: 31688939 PMCID: PMC6830040 DOI: 10.1093/database/baz125] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 06/08/2019] [Accepted: 09/15/2019] [Indexed: 02/05/2023]
Abstract
Myocardial infarction (MI) is a common cardiovascular disease and a leading cause of death worldwide. The etiology of MI is complicated and not completely understood. Many risk factors are reported important for the development of MI, including lifestyle factors, environmental factors, psychosocial factors, genetic factors, etc. Identifying individuals with an increased risk of MI is urgent and a major challenge for improving prevention. The MI risk knowledge base (MIRKB) is developed for facilitating MI research and prevention. The goal of MIRKB is to collect risk factors and models related to MI to increase the efficiency of systems biological level understanding of the disease. MIRKB contains 8436 entries collected from 4366 articles in PubMed before 5 July 2019 with 7902 entries for 1847 single factors, 195 entries for 157 combined factors and 339 entries for 174 risk models. The single factors are classified into the following five categories based on their characteristics: molecular factor (2356 entries, 649 factors), imaging (821 entries, 252 factors), physiological factor (1566 entries, 219 factors), clinical factor (2523 entries, 561 factors), environmental factor (46 entries, 26 factors), lifestyle factor (306 entries, 65 factors) and psychosocial factor (284 entries, 75 factors). MIRKB will be helpful to the future systems level unraveling of the complex mechanism of MI genesis and progression.
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Affiliation(s)
- Chaoying Zhan
- Centre for Systems Biology, Soochow University, Suzhou 215006, China
| | - Manhong Shi
- Centre for Systems Biology, Soochow University, Suzhou 215006, China.,College of Information and Network Engineering, Anhui Science and Technology University, Fengyang, Anhui 233100, China
| | - Rongrong Wu
- Centre for Systems Biology, Soochow University, Suzhou 215006, China
| | - Hongxin He
- Centre for Systems Biology, Soochow University, Suzhou 215006, China
| | - Xingyun Liu
- Centre for Systems Biology, Soochow University, Suzhou 215006, China.,Institutes for Systems Genetics, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Bairong Shen
- Institutes for Systems Genetics, West China Hospital, Sichuan University, Chengdu 610041, China
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