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Global Trends in the Relationship Between Chronic Air Pollution Exposure, Physical Activity and Lung Function in Youth Aged 5–18 Years With and Without Asthma: A Systematic Review

Samanta Gudziunaite, Kelly Mackintosh Orcid Logo, Gwyneth Davies Orcid Logo, KATHRYN JORDAN, Paul Lewis, Chris J. Griffiths, Alex Swain, Melitta McNarry Orcid Logo

Sports Medicine - Open, Volume: 11, Start page: 57

Swansea University Authors: Samanta Gudziunaite, Kelly Mackintosh Orcid Logo, Gwyneth Davies Orcid Logo, KATHRYN JORDAN, Paul Lewis, Alex Swain, Melitta McNarry Orcid Logo

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DOI (Published version): 10.1186/s40798-025-00856-3

Abstract

Background: Children are more susceptible to air pollution due, at least in part, to their less-developed respiratory systems and higher respiratory rates. Although the health benefits associated with physical activity are indisputable, there is considerable debate regarding whether increased exposu...

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Published in: Sports Medicine - Open
ISSN: 2198-9761
Published: Springer Nature 2025
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URI: https://cronfa.swan.ac.uk/Record/cronfa69320
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Although the health benefits associated with physical activity are indisputable, there is considerable debate regarding whether increased exposure to, and deeper inhalation of, air pollution while being physically active negates such health benefits. Objectives: The aim was to explore the relationship between air pollution and lung function and the influence of asthma status and physical activity in children and adolescents. Methods: Six databases were searched following PRISMA guidelines with no date restrictions: PubMed, Web of Science, MEDLINE, EMBASE, SPORTDiscus, and Cochrane Central Register of Controlled Trials (CENTRAL). Studies were included if they: i) studied children and adolescents (5&#x2013;18 years); ii) were peer-reviewed; iii) were available in the English language; and iv) reported data using previously validated tools. Results: From 12,161 original records, 16 studies were included in this review. The most widely examined pollutants were particulate matter PM2.5&#x2013;PM10, ozone (O3), nitrogen dioxide (NO2), nitrogen oxide (NOX), carbon monoxide (CO), and sulphur dioxide (SO2). Increased exposure to various air pollutants, particularly during outdoor physical activity, resulted in lung function deficits. This was especially evident in children and adolescents with asthma, dependent on the specific air pollutant. There was a consensus that forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) decreased as air pollution concentrations increased. Notably, there was a reduction in FEV1 at both three- and four-days post-exposure to CO, PM10, and NO2. Conclusions: There is a pressing need to reduce the impact of air pollution on lung function to improve health and realise the full benefits of physical activity. Given the potent and potentially long-term effects of air pollution, governments and local authorities must continue to reduce air pollution concentrations to improve the current and future health of populations globally. Key Points: &#x2022; Increased exposure to air pollutants results in impairments of children&#x2019;s and adolescents&#x2019; lung function, with the most pronounced effects observed three-to-four days post-exposure. This delayed impact suggests a prolonged risk of respiratory impairment following exposure, but further work is required to fully elucidate the timeline and associated dose-response relationship. &#x2022; The limited evidence available suggests that physical activity levels may be lower during periods with high air pollution concentrations, particularly in those living in urban areas or near roads. This is especially concerning for children with asthma, who are at a greater risk of experiencing poorer lung function due to the combined effects of reduced physical activity and increased pollutant concentrations. &#x2022; Physical activity during periods of high air pollution concentrations is tentatively suggested to deleteriously influence lung function in children and adolescents.</abstract><type>Journal Article</type><journal>Sports Medicine - Open</journal><volume>11</volume><journalNumber/><paginationStart>57</paginationStart><paginationEnd/><publisher>Springer Nature</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic>2198-9761</issnElectronic><keywords>Air quality; Health outcomes; Paediatrics; Children; Adolescents; Environmental exposures</keywords><publishedDay>21</publishedDay><publishedMonth>5</publishedMonth><publishedYear>2025</publishedYear><publishedDate>2025-05-21</publishedDate><doi>10.1186/s40798-025-00856-3</doi><url/><notes>Systematic Review</notes><college>COLLEGE NANME</college><CollegeCode>COLLEGE CODE</CollegeCode><institution>Swansea University</institution><apcterm>Other</apcterm><funders>This work was funded by Asthma&#x2009;+&#x2009;Lung UK through the Asthma UK Centre for Applied Research [AUK-AC-2012-01 and AUK-AC-2018-01].</funders><projectreference/><lastEdited>2025-05-23T10:44:54.6921951</lastEdited><Created>2025-04-23T10:33:21.8149223</Created><path><level id="1">Faculty of Science and Engineering</level><level id="2">School of Engineering and Applied Sciences - Sport and Exercise Sciences</level></path><authors><author><firstname>Samanta</firstname><surname>Gudziunaite</surname><order>1</order></author><author><firstname>Kelly</firstname><surname>Mackintosh</surname><orcid>0000-0003-0355-6357</orcid><order>2</order></author><author><firstname>Gwyneth</firstname><surname>Davies</surname><orcid>0000-0003-1218-1008</orcid><order>3</order></author><author><firstname>KATHRYN</firstname><surname>JORDAN</surname><order>4</order></author><author><firstname>Paul</firstname><surname>Lewis</surname><order>5</order></author><author><firstname>Chris J.</firstname><surname>Griffiths</surname><order>6</order></author><author><firstname>Alex</firstname><surname>Swain</surname><order>7</order></author><author><firstname>Melitta</firstname><surname>McNarry</surname><orcid>0000-0003-0813-7477</orcid><order>8</order></author></authors><documents><document><filename>69320__34340__6d15f6e1cd1b4ea08d32048f02c298f6.pdf</filename><originalFilename>69320.VOR.pdf</originalFilename><uploaded>2025-05-23T10:36:21.0034796</uploaded><type>Output</type><contentLength>1775011</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>&#xA9; The Author(s) 2025. 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spelling 2025-05-23T10:44:54.6921951 v2 69320 2025-04-23 Global Trends in the Relationship Between Chronic Air Pollution Exposure, Physical Activity and Lung Function in Youth Aged 5–18 Years With and Without Asthma: A Systematic Review 426b23cacaf61078bcd97d3718628877 Samanta Gudziunaite Samanta Gudziunaite true false bdb20e3f31bcccf95c7bc116070c4214 0000-0003-0355-6357 Kelly Mackintosh Kelly Mackintosh true false 92d69cf8519a334ced3f55142c811d95 0000-0003-1218-1008 Gwyneth Davies Gwyneth Davies true false 847249e83a9c9163e1cbfec5f0faeb39 KATHRYN JORDAN KATHRYN JORDAN true false 46dfc22d7468f247c390ba0c6cd8fba6 Paul Lewis Paul Lewis true false e58af411e7a9cdf4197ff81cad1eb321 Alex Swain Alex Swain true false 062f5697ff59f004bc8c713955988398 0000-0003-0813-7477 Melitta McNarry Melitta McNarry true false 2025-04-23 Background: Children are more susceptible to air pollution due, at least in part, to their less-developed respiratory systems and higher respiratory rates. Although the health benefits associated with physical activity are indisputable, there is considerable debate regarding whether increased exposure to, and deeper inhalation of, air pollution while being physically active negates such health benefits. Objectives: The aim was to explore the relationship between air pollution and lung function and the influence of asthma status and physical activity in children and adolescents. Methods: Six databases were searched following PRISMA guidelines with no date restrictions: PubMed, Web of Science, MEDLINE, EMBASE, SPORTDiscus, and Cochrane Central Register of Controlled Trials (CENTRAL). Studies were included if they: i) studied children and adolescents (5–18 years); ii) were peer-reviewed; iii) were available in the English language; and iv) reported data using previously validated tools. Results: From 12,161 original records, 16 studies were included in this review. The most widely examined pollutants were particulate matter PM2.5–PM10, ozone (O3), nitrogen dioxide (NO2), nitrogen oxide (NOX), carbon monoxide (CO), and sulphur dioxide (SO2). Increased exposure to various air pollutants, particularly during outdoor physical activity, resulted in lung function deficits. This was especially evident in children and adolescents with asthma, dependent on the specific air pollutant. There was a consensus that forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) decreased as air pollution concentrations increased. Notably, there was a reduction in FEV1 at both three- and four-days post-exposure to CO, PM10, and NO2. Conclusions: There is a pressing need to reduce the impact of air pollution on lung function to improve health and realise the full benefits of physical activity. Given the potent and potentially long-term effects of air pollution, governments and local authorities must continue to reduce air pollution concentrations to improve the current and future health of populations globally. Key Points: • Increased exposure to air pollutants results in impairments of children’s and adolescents’ lung function, with the most pronounced effects observed three-to-four days post-exposure. This delayed impact suggests a prolonged risk of respiratory impairment following exposure, but further work is required to fully elucidate the timeline and associated dose-response relationship. • The limited evidence available suggests that physical activity levels may be lower during periods with high air pollution concentrations, particularly in those living in urban areas or near roads. This is especially concerning for children with asthma, who are at a greater risk of experiencing poorer lung function due to the combined effects of reduced physical activity and increased pollutant concentrations. • Physical activity during periods of high air pollution concentrations is tentatively suggested to deleteriously influence lung function in children and adolescents. Journal Article Sports Medicine - Open 11 57 Springer Nature 2198-9761 Air quality; Health outcomes; Paediatrics; Children; Adolescents; Environmental exposures 21 5 2025 2025-05-21 10.1186/s40798-025-00856-3 Systematic Review COLLEGE NANME COLLEGE CODE Swansea University Other This work was funded by Asthma + Lung UK through the Asthma UK Centre for Applied Research [AUK-AC-2012-01 and AUK-AC-2018-01]. 2025-05-23T10:44:54.6921951 2025-04-23T10:33:21.8149223 Faculty of Science and Engineering School of Engineering and Applied Sciences - Sport and Exercise Sciences Samanta Gudziunaite 1 Kelly Mackintosh 0000-0003-0355-6357 2 Gwyneth Davies 0000-0003-1218-1008 3 KATHRYN JORDAN 4 Paul Lewis 5 Chris J. Griffiths 6 Alex Swain 7 Melitta McNarry 0000-0003-0813-7477 8 69320__34340__6d15f6e1cd1b4ea08d32048f02c298f6.pdf 69320.VOR.pdf 2025-05-23T10:36:21.0034796 Output 1775011 application/pdf Version of Record true © The Author(s) 2025. This article is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). true eng http://creativecommons.org/licenses/by/4.0/
title Global Trends in the Relationship Between Chronic Air Pollution Exposure, Physical Activity and Lung Function in Youth Aged 5–18 Years With and Without Asthma: A Systematic Review
spellingShingle Global Trends in the Relationship Between Chronic Air Pollution Exposure, Physical Activity and Lung Function in Youth Aged 5–18 Years With and Without Asthma: A Systematic Review
Samanta Gudziunaite
Kelly Mackintosh
Gwyneth Davies
KATHRYN JORDAN
Paul Lewis
Alex Swain
Melitta McNarry
title_short Global Trends in the Relationship Between Chronic Air Pollution Exposure, Physical Activity and Lung Function in Youth Aged 5–18 Years With and Without Asthma: A Systematic Review
title_full Global Trends in the Relationship Between Chronic Air Pollution Exposure, Physical Activity and Lung Function in Youth Aged 5–18 Years With and Without Asthma: A Systematic Review
title_fullStr Global Trends in the Relationship Between Chronic Air Pollution Exposure, Physical Activity and Lung Function in Youth Aged 5–18 Years With and Without Asthma: A Systematic Review
title_full_unstemmed Global Trends in the Relationship Between Chronic Air Pollution Exposure, Physical Activity and Lung Function in Youth Aged 5–18 Years With and Without Asthma: A Systematic Review
title_sort Global Trends in the Relationship Between Chronic Air Pollution Exposure, Physical Activity and Lung Function in Youth Aged 5–18 Years With and Without Asthma: A Systematic Review
author_id_str_mv 426b23cacaf61078bcd97d3718628877
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author_id_fullname_str_mv 426b23cacaf61078bcd97d3718628877_***_Samanta Gudziunaite
bdb20e3f31bcccf95c7bc116070c4214_***_Kelly Mackintosh
92d69cf8519a334ced3f55142c811d95_***_Gwyneth Davies
847249e83a9c9163e1cbfec5f0faeb39_***_KATHRYN JORDAN
46dfc22d7468f247c390ba0c6cd8fba6_***_Paul Lewis
e58af411e7a9cdf4197ff81cad1eb321_***_Alex Swain
062f5697ff59f004bc8c713955988398_***_Melitta McNarry
author Samanta Gudziunaite
Kelly Mackintosh
Gwyneth Davies
KATHRYN JORDAN
Paul Lewis
Alex Swain
Melitta McNarry
author2 Samanta Gudziunaite
Kelly Mackintosh
Gwyneth Davies
KATHRYN JORDAN
Paul Lewis
Chris J. Griffiths
Alex Swain
Melitta McNarry
format Journal article
container_title Sports Medicine - Open
container_volume 11
container_start_page 57
publishDate 2025
institution Swansea University
issn 2198-9761
doi_str_mv 10.1186/s40798-025-00856-3
publisher Springer Nature
college_str Faculty of Science and Engineering
hierarchytype
hierarchy_top_id facultyofscienceandengineering
hierarchy_top_title Faculty of Science and Engineering
hierarchy_parent_id facultyofscienceandengineering
hierarchy_parent_title Faculty of Science and Engineering
department_str School of Engineering and Applied Sciences - Sport and Exercise Sciences{{{_:::_}}}Faculty of Science and Engineering{{{_:::_}}}School of Engineering and Applied Sciences - Sport and Exercise Sciences
document_store_str 1
active_str 0
description Background: Children are more susceptible to air pollution due, at least in part, to their less-developed respiratory systems and higher respiratory rates. Although the health benefits associated with physical activity are indisputable, there is considerable debate regarding whether increased exposure to, and deeper inhalation of, air pollution while being physically active negates such health benefits. Objectives: The aim was to explore the relationship between air pollution and lung function and the influence of asthma status and physical activity in children and adolescents. Methods: Six databases were searched following PRISMA guidelines with no date restrictions: PubMed, Web of Science, MEDLINE, EMBASE, SPORTDiscus, and Cochrane Central Register of Controlled Trials (CENTRAL). Studies were included if they: i) studied children and adolescents (5–18 years); ii) were peer-reviewed; iii) were available in the English language; and iv) reported data using previously validated tools. Results: From 12,161 original records, 16 studies were included in this review. The most widely examined pollutants were particulate matter PM2.5–PM10, ozone (O3), nitrogen dioxide (NO2), nitrogen oxide (NOX), carbon monoxide (CO), and sulphur dioxide (SO2). Increased exposure to various air pollutants, particularly during outdoor physical activity, resulted in lung function deficits. This was especially evident in children and adolescents with asthma, dependent on the specific air pollutant. There was a consensus that forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) decreased as air pollution concentrations increased. Notably, there was a reduction in FEV1 at both three- and four-days post-exposure to CO, PM10, and NO2. Conclusions: There is a pressing need to reduce the impact of air pollution on lung function to improve health and realise the full benefits of physical activity. Given the potent and potentially long-term effects of air pollution, governments and local authorities must continue to reduce air pollution concentrations to improve the current and future health of populations globally. Key Points: • Increased exposure to air pollutants results in impairments of children’s and adolescents’ lung function, with the most pronounced effects observed three-to-four days post-exposure. This delayed impact suggests a prolonged risk of respiratory impairment following exposure, but further work is required to fully elucidate the timeline and associated dose-response relationship. • The limited evidence available suggests that physical activity levels may be lower during periods with high air pollution concentrations, particularly in those living in urban areas or near roads. This is especially concerning for children with asthma, who are at a greater risk of experiencing poorer lung function due to the combined effects of reduced physical activity and increased pollutant concentrations. • Physical activity during periods of high air pollution concentrations is tentatively suggested to deleteriously influence lung function in children and adolescents.
published_date 2025-05-21T05:26:37Z
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