The Health Effects of Exercising in Air Pollution

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REVIEW ARTICLE

The Health Effects of Exercising in Air Pollution Luisa V. Giles • Michael S. Koehle

 Springer International Publishing Switzerland 2013

Abstract The health benefits of exercise are well known. Many of the most accessible forms of exercise, such as walking, cycling, and running often occur outdoors. This means that exercising outdoors may increase exposure to urban air pollution. Regular exercise plays a key role in improving some of the physiologic mechanisms and health outcomes that air pollution exposure may exacerbate. This problem presents an interesting challenge of balancing the beneficial effects of exercise along with the detrimental effects of air pollution upon health. This article summarizes the pulmonary, cardiovascular, cognitive, and systemic health effects of exposure to particulate matter, ozone, and carbon monoxide during exercise. It also summarizes how air pollution exposure affects maximal oxygen consumption and exercise performance. This article highlights ways in which exercisers could mitigate the adverse health effects of air pollution exposure during exercise and draws attention to the potential importance of land use planning in selecting exercise facilities.

1 Introduction Physical inactivity poses a significant health risk to individuals as it increases the likelihood of developing heart disease, type 2 diabetes mellitus, cancer, and stroke [1, 2]. It is estimated that physical inactivity is the fourth most L. V. Giles (&)  M. S. Koehle School of Kinesiology, University of British Columbia, 210-6081 University Blvd, Vancouver, BC V6T 1Z1, Canada e-mail: [email protected] M. S. Koehle Division of Sports Medicine, University of British Columbia, Vancouver, Canada

common cause of mortality and contributes to 3.2 million deaths annually [3]. Many of the most accessible forms of exercise, such as walking, cycling, and running often occur outdoors. Globally, 52 % of people live in urban centers, and in the developed world this figure approaches 78 % [4]. This means that exercising outdoors may increase exposure to urban air pollution. Therefore, the purpose of this review is to summarize the health effects of exercising in air pollution, with a focus on particulate matter (PM), ozone, and carbon monoxide, as these pollutants are likely to cause adverse health effects in urban exercisers. A literature search using PubMed, Google Scholar, and EMBASE was performed. Text word searches of article titles and abstracts were conducted using search terms relevant to exercise and air pollution. Combinations of the following primary key words were used in the searches: ozone, particulate matter, particulate, diesel exhaust, gasoline, carbon monoxide, exercise, physical activity, and exertion. The use of ‘wild cards’ where appropriate captured variants on terms (e.g., exerci* to capture exercise, exercising). The literature search was last performed in April 2013. There was no restriction of searches to specific time/date ranges. Studies that directly examined the interactive eff