Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/26726
Title: Cardiorespiratory effects of physical activity and urban air pollution in Europe
Authors: LAEREMANS, Michelle 
Advisors: INT PANIS, Luc
DE BOEVER, Patrick
JANSSENS, Davy
Issue Date: 2018
Abstract: Each year, five million premature deaths are due to a lack of physical activity. Active mobility (i.e. walking and cycling as a means of transport) has been introduced as an accessible solution to increase daily physical activity levels because it may be easier to integrate into daily routines compared to sports and exercise. The PASTA project (Physical Activity through Sustainable Transport Approaches) studied the benefits and risks of active mobility based on data from seven European cities (Antwerp, Barcelona, London, Örebro, Rome, Vienna and Zurich). Active mobility or physical activity in urban outdoor settings may put individuals at higher risk of air pollution exposure. Moreover, higher ventilation rates during physical activity may exacerbate the adverse effects on health. Worldwide, air pollution accounts for over four million annual deaths. Therefore, it has become an important public concern whether the health benefits of physical activity in an urban environment outweigh the risks. Various health impact assessments reported that the health benefits of physical activity on mortality and morbidity outweigh the risks of air pollution exposure on a population level. Less is known about the long- and short-term interaction on a subclinical, individual level. These physiological responses may impact the built-up of physical activity health benefits and the development of chronic conditions. Clearly, this is important information for the successful implementation of active mobility and urban physical activity programs. Therefore, the aim was to estimate the subclinical cardiorespiratory responses to real-world physical activity, air pollution and their interaction in healthy adults. We designed a study within the PASTA project to obtain a comprehensive view on the cardiorespiratory responses to physical activity and air pollution (chapter 1). A set of non-invasive outcomes was selected and related to continuous information on real-world physical activity and air pollution (cardiorespiratory outcomes: heart rate variability (HRV), retinal vessel diameters, fractional exhaled nitric oxide (FeNO), lung function). We monitored 122 individuals in three European cities (Antwerp: 41; Barcelona: 41; London: 40) during one week which was repeated in three different seasons. This allowed to approximate their long-term lifestyle to estimate the subchronic cardiorespiratory effects. Both physical activity and air pollution were measured on a personal level with wearable sensors to limit exposure misclassification. Black carbon (BC) was used as a proxy to study the health effects of air pollution and was assessed with the microAeth. Daily physical activity patterns were monitored with the SenseWear armband. However, no standard of good practice is available to assess physical activity, so we compared the results of two frequently used measurement techniques: the SenseWear, a wearable sensor, and the GPAQ (Global Physical Activity Questionnaire), a questionnaire. Table 1 contains the main results, conclusions and perspectives summarized per chapter and compared to the state of the art. Overall, we found statistically significant acute and long-term responses to habitual physical activity and air pollution exposure in healthy individuals in an urban environment. 1) Assessment of free-living physical activity (chapter 2): GPAQ estimates were lower compared to the SenseWear, yet they were significantly correlated. Estimates of vigorous-intensity physical activity specifically were highly similar. The differences between all variables were reproducible across repeated measurements. 2) Long-term respiratory effects (chapter 3): Weekly physical activity improves lung function (FEV1, FEV1/FVC and FEF25-75) at low BC concentrations. The beneficial effect decreased with increasing yearly, average BC levels. 3) Short-term cardiorespiratory effects (chapter 4): Sympathetic tone dominated with both acute physical activity (increased LF/HF) and BC (decreased SDNN, rMSSD and HF). No responses of the retinal microvasculature were observed. Regarding respiratory effects, physical activity acted as bronchodilator (FEV1 and FEV1/FVC), while lung function decreased with BC (PEF). The interaction suggested counteracting of the adverse BC effect by physical activity (FEV1 and FVC). This is the first study simultaneously executed in multiple European cities that integrated effects of air pollution and physical activity to assess both the long-and short-term independent and combined impact on subclinical, cardiorespiratory markers. Based on the results, we propose caution for respiratory health with physical activity in polluted areas. Regarding short-term cardiorespiratory effects, no clear harmful effects were observed in healthy individuals. This is the first study simultaneously executed in multiple European cities that integrated effects of air pollution and physical activity to assess both the long-and short-term independent and combined impact on subclinical, cardiorespiratory markers. Based on the results, we propose caution for respiratory health with physical activity in polluted areas. Regarding short-term cardiorespiratory effects, no clear harmful effects were observed in healthy individuals. We recommend for further research to expand on our research design and focus on time- and location-specific responses to environmental and lifestyle triggers. This will aid the urban design process to improve public health. It is also recommended to further characterize the cardiorespiratory responses to physical activity and air pollution to enhance the physiological interpretation.
Document URI: http://hdl.handle.net/1942/26726
Category: T1
Type: Theses and Dissertations
Appears in Collections:PhD theses
Research publications

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