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Ku PW, Steptoe A, Lai YJ, Yen YF, Ahmadi M, Inan-Eroglu E, Wang SF, Chen LJ, Stamatakis E. Are associations of leisure-time physical activity with mortality attenuated by high levels of chronic ambient fine particulate matter (PM 2.5) in older adults? A prospective cohort study. Exp Gerontol 2023; 175:112148. [PMID: 36931451 DOI: 10.1016/j.exger.2023.112148] [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: 01/09/2023] [Revised: 03/10/2023] [Accepted: 03/14/2023] [Indexed: 03/19/2023]
Abstract
BACKGROUND AND PURPOSE Although leisure-time physical activity (PA) has established health benefits in older adults, it is equivocal if exercising in environments with high levels of PM2.5 concentrations is equally beneficial for them. To explore the independent and joint associations of ambient PM2.5 and PA with all-cause mortality among adults aged 60 or older and to assess the modifying effect of age (60-74 years vs. 75+ years) on the joint associations. METHODS A prospective cohort study based on the MJ Cohort repeat examinations (2005-2016) and the Taiwan Air Quality Monitoring Network and death registry linkages (2005-2022). We included MJ Cohort participants aged 60 or more at baseline who attended the health check-ups at least twice (n = 21,760). Metabolic equivalent hours per week (MET-h/week) of leisure-time PA were computed. Multivariable adjusted associations were examined using time-varying Cox proportional hazard models. RESULTS There were 3539 all-cause deaths over a mean follow-up of 12.81 (SD = 3.67) years. Ambient PM2.5 and physical inactivity are both independently associated with all-cause mortality. The joint associations of PA and PM2.5 concentrations with all-cause mortality differed in the young-old (60-74 years) and the older-old (75+ years) (P for interaction = 0.01); Higher levels of long-term PM2.5 exposures (≥25 μg/m3) had little influence on the associations between PA and mortality in the young-old (HR = 0.68 (0.56-0.83) and HR = 0.72 (0.59-0.88) for participants with 7.5-<15 and 15+ MET-h/week respectively) but eliminated associations between exposure and outcome in the older-old (HR = 0.91 (0.69-01.21) and HR = 1.02 (0.76-1.38) for participants with 7.5-<15 and 15+ MET-h/week). CONCLUSION Long-term exposures to higher PM2.5 concentrations may eliminate the beneficial associations of PA with all-cause mortality among adults aged 75 and over.
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Affiliation(s)
- Po-Wen Ku
- Graduate Institute of Sports and Health Management, National Chung Hsing University, 402 Taichung, Taiwan; Department of Behavioural Science and Health, University College London, London WC1E 6BT, UK; Department of Kinesiology, National Tsing Hua University, Hsinchu City 402, Taiwan.
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London WC1E 6BT, UK.
| | - Yun-Ju Lai
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Puli Branch of Taichung Veterans General Hospital, Nantou 545, Taiwan; School of Medicine, National Yang-Ming Chiao Tung University, 112, Taiwan
| | - Yung-Feng Yen
- Section of Infectious Diseases, Taipei City Hospital, Taipei City Government, Taipei 111, Taiwan; Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Matthew Ahmadi
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia.
| | - Elif Inan-Eroglu
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia; Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Germany.
| | - Su-Fen Wang
- Department of Geography, National Changhua University of Education, Changhua City 500, Taiwan.
| | - Li-Jung Chen
- Department of Exercise Health Science, National Taiwan University of Sport, 404, Taiwan; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 16 De Crespigny Park, London SE5 8AF, UK.
| | - Emmanuel Stamatakis
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia.
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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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Zhan B, Wang Q, Zhou Z, Li X, Yu H, Li B, Liao M. Association between Air Pollution and Physical Activity and Sedentary Behavior among Adults Aged 60 Years or Older in China: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2352. [PMID: 36767716 PMCID: PMC9915560 DOI: 10.3390/ijerph20032352] [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: 11/29/2022] [Revised: 01/21/2023] [Accepted: 01/22/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Exposure to air pollution is associated with an increased risk of all-cause mortality in older adults. Promoting physical activity (PA) and avoiding sedentary behavior (SB) serve as key strategies to maintain and improve human health. However, ambient air pollution can adversely affect PA and SB, increasing the risks of health problems. This study aimed to visualize national spatial patterns of average AQI concentration, PA, and SB distributions and to examine the associations between air pollution and PA and SB in a national sample of Chinese older adults aged 60 years or older. METHODS We analyzed the data of the China Longitudinal Aging Social Survey 2020 (CLASS 2020), which sampled 11,399 older men and women from 30 cities in China. Moderate, vigorous, and light PA and SB were measured using the Chinese version of the International Physical Activity Questionnaire-Short Form (IPAQ-C). The environmental measures included the average hourly air quality index (AQI), PM2.5, PM10, and NO2 (µg/m3). The data were analyzed using multivariable linear regression. RESULTS Increases in the standard deviations (±SD) of AQI, PM2.5, PM10, and NO2 concentrations were associated with decreases in MVPA per week of -2.34 (95%CI = -3.36, -1.32), -2.58 (95%CI = -3.61, -1.55), -1.96 (95%CI = -3.05, -0.08), and -1.19 (95%CI = -2.06, -0.31) and decreases in LPA per week of -6.06 (95%CI = -7.15, -4.97), -4.86 (95%CI = -5.88, -3.85), -4.78 (95%CI = -5.89, -3.68), and -4.59 (95%CI = -5.57, -3.61) h/week, respectively. Increases in one SD of AQI, PM2.5, PM10, and NO2 were associated with increases in SB per week of 1.32 (95%CI = 0.77, 1.88), 0.62 (95%CI = 0.09, 1.14), 1.03 (95%CI = 0.48, 1.59), and 0.98 (95%CI = 0.46, 1.49) h/week, respectively. CONCLUSIONS The spatial distributions of the average AQI concentration, MVPA, LPA, and SB are useful and allow environmental and health policymakers to identify the areas with the highest priority air pollution environmental equality concerns. AQI was positively associated with MVPA and LPA, and it was negatively associated with SB among older adults. AQI, PM2.5, PM10, and NO2 were hardly associated with women's average time spent engaged in MVPA. Region-specific and multi-level health policy options are needed to reduce ambient air pollution by taking different types of pollutants into account in order to avoid changes in PA and SB in this population, especially in locations with high air pollution concentrations.
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Affiliation(s)
- Bing Zhan
- School of Sport Management and Communication, Capital University of Physical Education and Sports, Beijing 100091, China
| | - Qiurui Wang
- Institute of Artificial Intelligence in Sports, Capital University of Physical Education and Sports, Beijing 100091, China
| | - Zhixiong Zhou
- School of Physical Education and Coaching Science, Capital University of Physical Education and Sports, Beijing 100091, China
| | - Xiaotian Li
- School of Recreation and Community Sport, Capital University of Physical Education and Sports, Beijing 100091, China
| | - Hongjun Yu
- Department of Physical Education, Tsinghua University, Beijing 100084, China
| | - Bingzhao Li
- Department of Mathematics and Statistics, Beijing Institute of Technology, Beijing 100081, China
| | - Mingxia Liao
- Institute of Artificial Intelligence in Sports, Capital University of Physical Education and Sports, Beijing 100091, China
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Chen SF, Chien YH, Chen PC. The association between long-term ambient fine particulate exposure and the mortality among adult patients initiating dialysis: A retrospective population-based cohort study in Taiwan. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 316:120606. [PMID: 36368554 DOI: 10.1016/j.envpol.2022.120606] [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: 07/03/2022] [Revised: 10/27/2022] [Accepted: 11/03/2022] [Indexed: 06/16/2023]
Abstract
Fine particulate matter (PM2.5) has been reported to be associated with increased risk of chronic kidney disease (CKD) and progression to end-stage renal disease (ESRD). However, studies on whether long-term exposure to PM2.5 negatively impacts the survival of patients with ESRD are very limited. To conduct this study, we linked Taiwan Air Quality-Monitoring Database (TAQMD) and the National Health Insurance Research Database (NHIRD) by zip-code. A retrospective population-based cohort of 34,088 adult patients initiating dialysis over six months was formed. Cox proportional regression models were used to estimate the risk of mortality in dialysis patients per 10-μg/m3 increase of PM2.5 and by PM2.5 levels divided into quintiles. Restricted cubic spline analysis was performed to delineate the concentration-response relationship between PM2.5 and mortality. The adjusted hazard ratio (aHR) per 10-μg/m3 increase of PM2.5 for mortality was 1.11 (95% confidence interval [CI] = 1.08-1.13). When analyzing PM2.5 exposure divided into quintiles, patients with mean PM2.5 exposure over 29.33 μg/m3, including level III (aHR 1.00, 95% CI = 0.94-1.07), level IV (aHR 1.09; 95% CI = 1.03-1.16), and level V (HR 1.11; 95% CI = 1.05-1.19), were at stepwise higher risks of mortality compared with level I. Spline analysis showed a non-linear concentration-response function between PM2.5 and mortality, with the lowest mortality aHR identified at a mean PM2.5 of 26 μg/m3, followed by a concentration interval with a gradual increase of aHR, and finally a steep rise of mortality risk when mean PM2.5 exceeded 37 μg/m3. Individuals with older age, those were male, with selected comorbidities, and with low socioeconomic status (SES) were at higher mortality risk. Male and non-diabetics participants were more sensitive to the effect of a 10-μg/m3 of PM2.5 increase on mortality than their counterparts. In conclusion, long-term exposure to PM2.5 exceeding a threshold was observed to be associated with increased risk of mortality among dialysis patients.
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Affiliation(s)
- Shih-Feng Chen
- Nephrology Department, New Taipei City Hospital, New Taipei City, Taiwan; Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, Taipei, Taiwan
| | - Yu-Hui Chien
- Nephrology Department, New Taipei City Hospital, New Taipei City, Taiwan
| | - Pau-Chung Chen
- Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, Taipei, Taiwan; Department of Public Health, National Taiwan University College of Public Health, Taiwan; Department of Environmental and Occupational Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taiwan; National Institute of Environmental Health Sciences, National Health Research Institutes, Taiwan.
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Kim YB, McCurdy AP, Lamboglia CG, Hakimi S, Kuzik N, Lee EY, Lindeman C, Sivak A, Spence JC. Ambient air pollution and movement behaviours: A scoping review. Health Place 2021; 72:102676. [PMID: 34700061 DOI: 10.1016/j.healthplace.2021.102676] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 08/15/2021] [Accepted: 09/20/2021] [Indexed: 11/19/2022]
Abstract
This scoping review summarizes the literature about how ambient (outdoor) air pollution impacts movement behaviours (i.e., physical activity, sedentary behaviour, and sleep), or beliefs about movement behaviours. Of 6552 potential documents, 58 documents and 218 findings were included in the final synthesis. Most studies were from the United States and China, involved cross-sectional designs, and included mixed age groups. Overall, unfavourable changes/associations (i.e., decreased/lower physical activity, increased/higher sedentary-related behaviour, and decreased/lower sleep duration and quality) or no change/association in movement behaviours in relation to ambient air pollution were identified. Our findings suggest that more attention should be given to understanding the impact of ambient air pollution on movement behaviours in general and in diverse countries and vulnerable populations such as children or older adults.
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Affiliation(s)
- Yeong-Bae Kim
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, T6G 2H9, Canada
| | - Ashley P McCurdy
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, T6G 2H9, Canada
| | - Carminda G Lamboglia
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, T6G 2H9, Canada
| | - Shawn Hakimi
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - Nicholas Kuzik
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, T6G 2H9, Canada
| | - Eun-Young Lee
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, K7L 3N6, Canada
| | - Cliff Lindeman
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, T6G 2H9, Canada
| | - Allison Sivak
- H.T. Coutts Library, University of Alberta, Edmonton, Alberta, T6G 2G5, Canada
| | - John C Spence
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, T6G 2H9, Canada.
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