Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
Department of Social Medicine and Health Service Management, Shenzhen University General Hospital, Shenzhen, 518055, China.
BMC Med. 2022 Feb 28;20(1):70. doi: 10.1186/s12916-022-02274-8.
The combined health impact of physical activity (PA) and air pollution on chronic obstructive pulmonary disease (COPD) remains unclear. We investigated the joint effects of habitual PA and long-term fine particulate matter (PM) exposure on COPD incidence in a prospective population-based cohort.
A prospective cohort study was conducted using data from the UK Biobank. Incidence of COPD was ascertained through linkage to the UK National Health Services register. Annual mean PM concentration was obtained using land use regression model. PA was measured by questionnaire and wrist-worn accelerometer. Cox proportional hazard models were applied to examine the associations between PM, PA, and COPD. Additive and multiplicative interactions were examined.
A total of 266,280 participants free of COPD at baseline were included in data analysis with an average follow-up of 10.64 years, contributing to around 2.8 million person-years. Compared with participants with low level of PA, those with higher PA levels had lower risks of COPD incidence [hazard ratio (HR): 0.769, 95% CI: 0.720, 0.820 for moderate level; HR: 0.726, 95% CI: 0.679, 0.776 for high level]. By contrast, PM was associated with increased risk of COPD (HR per interquartile range increment: 1.065, 95% CI: 1.032, 1.099). Limited evidence of interaction between habitual PA and PM exposure was found. Similar results were found for accelerometer-measured PA.
Our study suggests that habitual PA could reduce risk of COPD incidence, and such protective effects were not affected by ambient PM pollution exposure.
体力活动（PA）和空气污染对慢性阻塞性肺疾病（COPD）的综合健康影响仍不清楚。我们在一项前瞻性基于人群的队列研究中调查了习惯性 PA 和长期细颗粒物（PM）暴露对 COPD 发病率的联合影响。
使用来自英国生物库的数据进行前瞻性队列研究。通过与英国国家卫生服务登记处的链接确定 COPD 的发病率。使用土地利用回归模型获得年平均 PM 浓度。PA 通过问卷和腕戴加速度计进行测量。应用 Cox 比例风险模型来检查 PM、PA 和 COPD 之间的关联。检查了相加和相乘交互作用。
在数据分析中，共纳入了 266,280 名在基线时无 COPD 的参与者，平均随访时间为 10.64 年，约为 280 万人年。与低 PA 水平的参与者相比，高 PA 水平的参与者患 COPD 的风险较低[风险比（HR）：0.769，95%CI：0.720，0.820 为中水平；HR：0.726，95%CI：0.679，0.776 为高水平]。相比之下，PM 与 COPD 风险增加相关（每四分位间距增加的 HR：1.065，95%CI：1.032，1.099）。发现习惯性 PA 和 PM 暴露之间的相互作用证据有限。使用加速度计测量的 PA 也得到了类似的结果。
我们的研究表明，习惯性 PA 可以降低 COPD 发病率的风险，并且这种保护作用不受环境 PM 污染暴露的影响。
