ADVANCEMENT OF THE SCIENCE
Abstract People with asthma, particularly young children, are more adversely affected by traffic emissions—and regular exercise reduces asthma symptoms and improves lung function. We studied the relationship between air pollution and objectively measured physical activity in children with asthma who were attending a school near a freeway. We continuously monitored air pollutants—PM 2.5 , PM 10 , nitrogen dioxide (NO 2 ), and ozone (O 3 )—at the school for 10 weeks and measured physical activity levels via accelerometry in children ( n = 12, ages 6–12 years). Concentrations of PM 2.5 , PM 10 , and NO 2 were negatively associated with moderate to vigorous physi- cal activity (PM 2.5 and PM 10 : p < .001; NO 2 : p = .04) and positively associated with sedentary activity (PM 2.5 and PM 10 : p < .001; NO 2 : p = .02). Physical activity is decreased and sedentary behavior is increased in children with asthma when air pollutants are higher. Strategies are available to mitigate air pollutant impact on beneficial physical activity during the school day. Decreased Moderate to Vigorous Physical Activity Levels in Children With Asthma Are Associated With Increased Traffic-Related Air Pollutants
Children attending elementary school spend 6–8 hr/day in school microenvironments that commonly also include outdoor activities. In many countries, severe conditions of air pollution frequently require the cancellation of physical or sport activities in elementary schools, which could lead to an increase in sedentary behavior (Giles & Koehle, 2014). This occurrence is particularly relevant for schools located near busy traffic intersec- tions or freeways where children might be exposed to higher levels of air pollution from traffic. Coarse particulate matter (PM 10 or particles <10 µm in aerodynamic diameter), fine particulate matter (PM 2.5 or particles <2.5 µm in aerodynamic diameter), nitrogen dioxide (NO 2 ), and ozone (O 3 ) are some of the traffic-related air pollutants to which children of roadside communities are com- monly exposed. Center for Community Health Impact, University of Texas Health Science Center School of Public Health Juan Aguilera, MPH, MD, PhD Center for Community Health Impact, University of Texas Health Science Center School of Public Health Soyoung Jeon, PhD Department of Economics, Applied Statistics, and International Business, New Mexico State University Amit U. Raysoni, MPH, PhD School of Earth, Environmental, and Marine Sciences, The University of Texas Rio Grande Valley Wen-Whai Li, PhD Department of Civil Engineering, The University of Texas at El Paso Leah D. Whigham, PhD, FTOS
Introduction
& Koehle, 2014). In controlled studies, the exposure to air pollutants during exercise has led to a reduction in performance (Rundell et al., 2008) and inhalation of airborne particles during exercise has been associated with a reduction in lung function (Cutrufello et al., 2012). Increased levels of air pollutants have also been associated with self-reported inac- tivity (Roberts et al., 2014; Wen et al., 2009). For these reasons, exposure to an environ- ment with an increased level of air pollution might lead to adverse health effects due to airway exposure to airborne pollutants from increased respiratory intake and also lack of physical activity.
Exposure to Air Pollutants and Physical Activity
Physical activity is essential for overall health (Janssen & LeBlanc, 2010). Regular outdoor activities, such as walking or jogging, can lead to a significantly lower risk of cardio- vascular disease and metabolic syndrome (Chen et al., 2013). Outdoor physical activ- ity, however, also exposes people to air pollut- ants that can lead to adverse health problems such as cardiovascular diseases (Le Tertre et al., 2002; Sharman et al., 2004), respiratory diseases (Pope et al., 2009; Shah et al., 2013), diabetes (Bowe et al., 2018), and obesity (An et al., 2018). During physical activity, a higher deposi- tion of air pollutants in the lungs can occur due to increased respiratory intake (Giles
Physical Activity in People With Asthma
People with asthma might engage in fewer aerobic activities and less physical activity overall due to concerns of triggering asthma symptoms (Garfinkel et al., 1992; Mälkiä & Impivaara, 1998). Given that asthma affects children at a young age when they are likely to establish their health habits, it is impor- tant to emphasize physical activity with pediatric asthma patients (Mancuso et al., 2006). National management guidelines for asthma state that most people’s symptoms
Air Pollutants in the School Environment
Spending time in an environment near heavy traffic is particularly harmful to children.
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Volume 85 • Number 8
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