Air Pollution Exposure and Physical Activity in China: Current Knowledge, Public Health Implications, and Future Research Needs

Abstract

Deteriorating air quality in China has created global public health concerns in regard to health and health-related behaviors. Although emerging environmental regulations address ambient air pollution in China, the level of enforcement and long-term impact of these measures remain unknown. Exposure to air pollution has been shown to lead to multiple adverse health outcomes, including increased rates of heart disease and mortality. However, a lesser-known but increasingly significant concern is the relationship between air pollution and its effects on outdoor exercise. This is especially important in China, which has a culturally rooted lifestyle that encourages participation in outdoor physical activity. This article evaluates the intersection of air pollution and outdoor exercise and provides a discussion of issues related to its public health impact in China, where efforts to promote a healthy lifestyle may be adversely affected by the ambient air pollution that has accompanied rapid economic development and urbanization.

Ambient PM 2.5 and Stroke

“…3 Therefore, there is increasing concern about the trade-off between the health benefits of physical activity and potential health hazards from increased air pollution exposures. 26 We observed a greater association between PM 2.5 and stroke for high levels of physical activity. A few exposure studies also found reduced lung function associated with exercises in highly polluted areas.…”

Risk Reduction Behaviors Regarding PM2.5 Exposure among Outdoor Exercisers in the Nanjing Metropolitan Area, China

“…Outdoor physical activity is already a culturally rooted daily lifestyle for Chinese people [12]. Regular exercise has been shown to improve overall health and wellbeing, while physical inactivity is the fourth leading risk for global mortality, contributing to 3.2 million deaths annually [13,14,15].…”

One Health in China

“…Warmer temperatures and extreme weather events reduce agricultural production and also directly affect human health through various diseases, such as heat-related disorders, mental health problems, vector-borne diseases, food-borne and water-borne diseases, and respiratory and allergic disorders (12). Relevant environmental regulations and laws have not yet solved air pollution in China, and the long-term effects of these measures remain obscure (13). …”

“…According to the WHO, 16 of the 20 worst polluted cities worldwide are located in China. The negative impact of this serious pollution situation in China is the same or still worse than that of the SARS epidemic in 2003 (13), which in turn may increase the risk of health problems in the populace, including cardiovascular and cerebrovascular diseases (19, 20). …”

“…Data from the Global Burden of Disease Study showed that, in 2010, air pollution led to more than 1.3 million premature deaths in China (64), the highest among 15 countries (65). Also, cities, such as Beijing, have been described as ‘uninhabitable for human beings’ (13). …”