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Martin L, Nasir H, Bagheri R, Ugbolue UC, Laporte C, Baker JS, Gu Y, Zak M, Duclos M, Dutheil F. Physical Activity, Air Pollution, and Mortality: A Systematic Review and Meta-analysis. SPORTS MEDICINE - OPEN 2025; 11:35. [PMID: 40192932 PMCID: PMC11977067 DOI: 10.1186/s40798-025-00830-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 03/04/2025] [Indexed: 04/10/2025]
Abstract
BACKGROUND As whether the positive effects of physical activity on mortality outweigh the negative effects of exposure to pollution is still under debate, we conducted a systematic review and meta-analysis on the risk of mortality for combined exposure to physical activity and air pollution. METHODS PubMed, Cochrane, Embase and ScienceDirect databases were searched for studies assessing the risk of mortality for combined exposure to physical activity and air pollution. RESULTS We included eight studies for a total of 1,417,945 individuals (mean 57.7 years old, 39% men) - 54,131 died. We confirmed that air pollution increased the risk of mortality by 36% (OR 1.36, 95CI 1.05-1.52), whereas physical activity in a non-polluted environment decreased the risk of mortality by 31% (OR 0.69, 95CI 0.42-0.95). Our meta-analysis demonstrated that combined exposure to physical activity and air pollution decreased the risk of mortality by 26% (OR 0.74, 95CI 0.63-0.85). This risk decreased whatever the level of physical activity: by 19% (OR 0.81, 95CI 0.69-0.93) for low, by 32% (OR 0.68, 95CI 0.44-0.93) for moderate, and by 30% (OR 0.70, 95CI 0.49-0.91) for high physical activity in air pollution. CONCLUSION We confirmed that air pollution increased mortality by 36% in our meta-analysis. Despite the controversial benefit-risk, we demonstrated a reduction of mortality by 26% for combined exposure to physical activity and air pollution - nearly comparable to the reduction of mortality when practicing physical activity without air pollution (- 31%). However, the limited number of included studies precluded the demonstration of a dose-response relationship between levels of physical activity and air pollution, and reduction of mortality.
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Affiliation(s)
- Louise Martin
- General Medicine, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Hijrah Nasir
- Laboratory of the Metabolic Adaptations to Exercise Under Physiological and Pathological Conditions (AME2P), Chaire « Santé en Mouvement », Université Clermont Auvergne, Clermont-Ferrand, France
| | - Reza Bagheri
- Exercise Physiology Department, University of Isfahan, Isfahan, Iran
| | - Ukadike C Ugbolue
- Health and Life Sciences, Institute for Clinical Exercise & Health Science, University of the West of Scotland, University of Strathclyde, Glasgow, Scotland, UK
| | - Catherine Laporte
- Clermont Auvergne INP, CNRS, CHU Clermont-Ferrand, Institut Pascal, Université Clermont Auvergne, 63000, Clermont-Ferrand, France
| | - Julien S Baker
- Centre for Health and Exercise Science Research, Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo, Zhejiang, China
| | - Marek Zak
- Collegium Medicum, Institute of Health Sciences, The Jan Kochanowski University, Kielce, Poland
| | - Martine Duclos
- INRAe, CHU Clermont-Ferrand, Sport Medicine, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Frédéric Dutheil
- LaPSCo, Physiological and Psychosocial Stress, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, CNRS, Occupational and Environmental Medicine, Université Clermont Auvergne, WittyFit, 58 Rue Montalembert, 63000, Clermont-Ferrand, France.
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Wang Y, Du Z, Zhang W, Wang X, Lin X, Liu Y, Deng Y, Zhang D, Gu J, Xu L, Hao Y. Cohort Profile: The Pearl River Cohort Study. Int J Epidemiol 2024; 53:dyae112. [PMID: 39186943 DOI: 10.1093/ije/dyae112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 08/23/2024] [Indexed: 08/28/2024] Open
Affiliation(s)
- Ying Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- Research Center for Health Information & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Zhicheng Du
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- Research Center for Health Information & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Wangjian Zhang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- Research Center for Health Information & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Xiaowen Wang
- Peking University Center for Public Health and Epidemic Preparedness & Response, Peking University, Peking, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Peking, China
| | - Xiao Lin
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- Research Center for Health Information & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Yu Liu
- School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yu Deng
- Laboratory Animal Center, Sun Yat-sen University, Shenzhen, China
| | - Dingmei Zhang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jing Gu
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- Research Center for Health Information & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Lin Xu
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Yuantao Hao
- Peking University Center for Public Health and Epidemic Preparedness & Response, Peking University, Peking, China
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Peking, China
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Liu T, Liu Y, Su Y, Hao J, Liu S. Air pollution and upper respiratory diseases: an examination among medically insured populations in Wuhan, China. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024; 68:1123-1132. [PMID: 38507092 DOI: 10.1007/s00484-024-02651-3] [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: 09/14/2023] [Revised: 02/26/2024] [Accepted: 03/05/2024] [Indexed: 03/22/2024]
Abstract
Multiple evidence has supported that air pollution exposure has detrimental effects on the cardiovascular and respiratory systems. However, most investigations focus on the general population, with limited research conducted on medically insured populations. To address this gap, the current research was designed to examine the acute effects of inhalable particulate matter (PM2.5 and PM10), nitrogen dioxide (NO2), ground-level ozone (O3), and sulfur dioxide (SO2) on the incidence of upper respiratory tract infections (URTI), utilizing medical insurance data in Wuhan, China. Data on URTI were collected from the China Medical Insurance Basic Database for Wuhan covering the period from 2014 to 2018, while air pollutant data was gathered from ten national monitoring stations situated in Wuhan city. Statistical analysis was performed using generalized additive models for quasi-Poisson distribution with a log link function. The analysis indicated that except for ozone, higher exposure to four other pollutants (NO2, SO2, PM2.5, and PM10) were significantly linked to an elevated risk of URTI, particularly during the previous 0-3 days and previous 0-4 days. Additionally, NO2 and SO2 were found to be positively linked with laryngitis. Furthermore, the effects of air pollutants on the risk of URTI were more pronounced during cold seasons than hot seasons. Notably, females and the employed population were more susceptible to infection than males and non-employed individuals. Our findings gave solid proof of the link between ambient air pollution exposure and the risk of URTI in medically insured populations.
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Affiliation(s)
- Tianyu Liu
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Yuehua Liu
- Vanke School of Public Health, Tsinghua University, 30 Shuangqing Road, Haidian District, Beijing, China
| | - Yaqian Su
- School of Public Health, Shantou University, Shantou, 515063, Guangdong Province, China
| | - Jiayuan Hao
- Department of Population and Public Health Sciences, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - Suyang Liu
- School of Public Health, Shantou University, Shantou, 515063, Guangdong Province, China.
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