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Outdoor Physical Activity in an Air Polluted Environment and Its Effect on the Cardiovascular System—A Systematic Review

Author

Listed:
  • Taruna Juneja Gandhi

    (MAMTA Health Institute for Mother and Child, B-5, Greater Kailash Enclave II, New Delhi 110048, India
    These authors contributed equally to this work.)

  • Priyanka Rani Garg

    (MAMTA Health Institute for Mother and Child, B-5, Greater Kailash Enclave II, New Delhi 110048, India
    These authors contributed equally to this work.)

  • Kauma Kurian

    (MAMTA Health Institute for Mother and Child, B-5, Greater Kailash Enclave II, New Delhi 110048, India)

  • Jonas Bjurgert

    (Lund University, Box 117, SE-221 00 Lund, Sweden)

  • Sirazul Ameen Sahariah

    (MAMTA Health Institute for Mother and Child, B-5, Greater Kailash Enclave II, New Delhi 110048, India)

  • Sunil Mehra

    (MAMTA Health Institute for Mother and Child, B-5, Greater Kailash Enclave II, New Delhi 110048, India)

  • Gayatri Vishwakarma

    (Indian Spinal Injuries Centre Sector-C, Vasant Kunj, New Delhi 110070, India)

Abstract

Air pollution is a global public health threat. Evidence suggests that increased air pollution leads to increased cardiovascular morbidity and mortality. The aim of this review was to systematically review and synthesize scientific evidence to understand the effect of performing outdoor physical activity (PA) in a polluted environment on cardiovascular outcomes. This review was developed and reported in accordance with the PRISMA guidelines. Electronic searches in Embase, Web of Science, and PubMed were undertaken through March 2021 initially, and later updated through to 31st January 2022, for observational studies published in peer-reviewed journals that report cardiovascular mortality or morbidity due to outdoor PA in air polluted environment. These searches yielded 10,840 citations. Two reviewers independently reviewed each citation for its eligibility. Seven studies were found to be eligible. Of these, five were cohort studies and two were cross-sectional studies. Pollutants measured in the selected studies were Particulate Matter (PM)—PM10, PM2.5, nitrogen oxides (NO x ), and ozone (O 3 ). The most common study outcome was myocardial infarction, followed by cardiovascular mortality, hypertension and heart rate variability. Six studies emphasized that the PA has beneficial effects on cardiovascular outcomes, though air pollutants attenuate this effect to an extent. Two studies showed that walking, even in the polluted environment, significantly reduced the heart rate and heart rate variability indices. The beneficial effects of outdoor PA outweigh the harmful effects of air pollution on cardiovascular health, though the benefits reduce to an extent when PA is carried out in a polluted environment. Because a limited number of studies ( n = 7) were eligible for inclusion, the review further emphasizes the critical need for more primary studies that differentiate between outdoor and indoor PA and its effect on cardiovascular health.

Suggested Citation

  • Taruna Juneja Gandhi & Priyanka Rani Garg & Kauma Kurian & Jonas Bjurgert & Sirazul Ameen Sahariah & Sunil Mehra & Gayatri Vishwakarma, 2022. "Outdoor Physical Activity in an Air Polluted Environment and Its Effect on the Cardiovascular System—A Systematic Review," IJERPH, MDPI, vol. 19(17), pages 1-24, August.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:17:p:10547-:d:896483
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    References listed on IDEAS

    as
    1. Zhuanlan Sun & Demi Zhu, 2019. "Exposure to outdoor air pollution and its human health outcomes: A scoping review," PLOS ONE, Public Library of Science, vol. 14(5), pages 1-18, May.
    2. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
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