Department of Medicine, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul 03080, South Korea.
Department of Biomedical Sciences, Seoul National University Graduate School, 101, Daehak-ro, Jongno-gu, Seoul 03080, South Korea.
Eur Heart J. 2021 Jul 1;42(25):2487-2497. doi: 10.1093/eurheartj/ehab139.
Little is known about the trade-off between the health benefits of physical activity (PA) and the potential harmful effects of increased exposure to air pollution during outdoor PA. We examined the association of the combined effects of air pollution and changes in PA with cardiovascular disease (CVD) in young adults.
This nationwide cohort study included 1 469 972 young adults aged 20-39 years. Air pollution exposure was estimated by the annual average cumulative level of particulate matter (PM). PA was calculated as minutes of metabolic equivalent tasks per week (MET-min/week) based on two consecutive health examinations from 2009 to 2012. Compared with the participants exposed to low-to-moderate levels of PM2.5 or PM10 who continuously engaged in ≥1000 MET-min/week of PA, those who decreased their PA from ≥1000 MET-min/week to 1-499 MET-min/week [PM10 adjusted hazard ratio (aHR) 1.22; 95% confidence interval (CI) 1.00-1.48] and to 0 MET-min/week (physically inactive; PM10 aHR 1.38; 95% CI 1.07-1.78) had an increased risk of CVD (P for trend <0.01). Among participants exposed to high levels of PM2.5 or PM10, the risk of CVD was elevated with an increase in PA above 1000 MET-min/week.
Reducing PA may lead to subsequent elevation of CVD risk in young adults exposed to low-to-moderate levels of PM2.5 or PM10, whereas a large increase in PA in a high-pollution environment may adversely affect cardiovascular health.
人们对于体力活动（PA）带来的健康益处与户外活动中增加的空气污染暴露潜在有害影响之间的权衡关系知之甚少。我们研究了空气污染和 PA 变化的综合效应与年轻人心血管疾病（CVD）的相关性。
这项全国性队列研究纳入了 1469972 名 20-39 岁的年轻人。空气污染暴露通过每年平均累积颗粒物（PM）水平来估算。PA 根据 2009 年至 2012 年两次连续健康检查计算为每周代谢当量任务分钟数（MET-min/周）。与持续进行≥1000 MET-min/周 PA 且暴露于 PM2.5 或 PM10 低-中水平的参与者相比，那些从≥1000 MET-min/周减少到 1-499 MET-min/周的参与者（PM10 调整后的危险比[aHR]为 1.22；95%置信区间[CI]为 1.00-1.48）和减少到 0 MET-min/周（不活动；PM10 aHR 为 1.38；95% CI 为 1.07-1.78）发生 CVD 的风险增加（趋势 P<0.01）。在暴露于高水平 PM2.5 或 PM10 的参与者中，PA 增加超过 1000 MET-min/周时，CVD 风险升高。
在暴露于低-中水平 PM2.5 或 PM10 的年轻人中，减少 PA 可能导致 CVD 风险随后升高，而在高污染环境中 PA 大幅增加可能对心血管健康产生不利影响。
