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. 2021 Feb;147:105954. doi: 10.1016/j.envint.2020.105954

Table 3.

Summary of the long-term epidemiological studies that have combined health effects of air pollution and physical activity.

Author Year Study Population Location Physical Activity (PA) Air Pollutants Outcome Main findings
McConell et al. 2002 3,535 children age 9–16 years Southern California Number of team sports played (0,1,2, ≥3) PM10PM2.5
NO2
O3
Asthma incidence, parent reported Increased risk of asthma when playing ≥ 3 sports (compared to 0 sports) in high O3 communities (OR:3.3; 95%CI: 1.9–5.8), and not in low O3 communities (OR:0.8; 95%CI: 0.4–1.6); no difference in PM
Yu et al. 2004 821 children
age 8–12 years
Hong Kong Habitual exercise (sports, free play, running, ball games, cycling) SO2
NO2
PM10
Maximum oxygen intake (VO2 max) Children who exercised in high pollution area had lower VO2 max than children who exercised in low pollution areas (27.9 vs. 29.8 mL.kg(-1).min(-1))
Andersen et al. 2015 57,000 adults, age 50–65 years Denmark, Diet, Cancer and Health Cohort Sport
Cycling
Walking
Gardening
NO2 Mortality, CVD, respiratory, cancer, diabetes Benefits of cycling, participating in sport, and gardening on all-cause and cause specific mortality similar in both, low and high NO2 areas
Fisher et al. 2016 57,000 adults, age 50–65 years, Denmark, Diet, Cancer and Health Cohort Sport
Cycling
Walking
Gardening
NO2 Asthma, COPD Benefits of cycling, participating in sport, and gardening on asthma and COPD incidence seen in both, low and high NO2 areas
Kubesch et al. 2018 57,000 adults, age 50–65 years, Denmark, Diet, Cancer and Health Cohort Sport
Cycling
Walking
Gardening
NO2 Myocardial infarction (MI) Benefits of cycling, participating in sport, and gardening on MI incidence seen in both, low and high NO2 areas
Fuertes et al. 2018 2,228 adults, age 27–67 years Multi-centre ECRHS study, 14 countries Leisure-time vigorous PA PM10
PM2.5
NO2
Lung function (FEV1, FVC) PA positively associated with FEV1/FVC in smokers, irrespective of air pollution; in never-smokers association negative in areas with high PM10
Zhang and An (2018) 2018 359,067 adults, age ≥ 18 years Taiwan Habitual PA (inactive, low, moderate, high) PM2.5
Systemic inflammation, white blood cell (WBC) Inverse association between PA and WBC; positive association between PM2.5 and WBC; no interaction between PA and PM2.5
Sun et al. 2019 66,820 adults, age ≥ 18 years Hong Kong, Elderly Health Service Cohort Habitual PA (walking, stretching, TCE, aerobic) PM2.5
Mortality, CVD, respiratory No interaction between PA and PM2.5; the beneficial effects of habitual PA outweighed the detrimental effects of long-term exposure to PM2.5 on mortality

ECRHS - European Community Respiratory Health Survey; TCE - traditional Chinese exercise; CVD - cardiovascular disease; FEV1 – forced expiratory volume in 1 s, FVC – forced vital capacity.