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Does physical activity modify the association between air pollution and recurrence of cardiovascular disease?
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
2021 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 18, no 5, p. 1-11, article id 2631Article in journal (Refereed) Published
Abstract [en]

We aimed to assess a possible interaction effect between physical activity and particulate air pollution exposure on recurrence of ischemic heart disease (IHD) and stroke. We followed 2221 adult participants comprising first time IHD (1403) and stroke (818) cases from the Västerbotten Intervention Program between 1 January 1990 to 31 December 2013. During mean follow-up times of 5.5 years, 428 and 156 participants developed IHD and stroke recurrence, respectively. PM2.5 concentrations above the median (5.48 µg/m3) were associated with increased risk of IHD and stroke recurrence by 13% (95% CI −17–45%) and 21% (95% CI −19–80%), respectively. These risk increases were however only observed among those that exercised at most once a week at 21% (95% CI −5– 50%) and 25% (95% CI −19–90%) for IHD and stroke recurrence, respectively. Higher frequency of exercise at recruitment was positively associated with IHD and stroke recurrence but only the association with IHD recurrence among participants with low residential PM2.5 was statistically significant (96% increased risk (95%-CI 22–215%)). However, no interaction effect between physical activity and PM2.5 exposure was found. Our findings suggest that physical activity may reduce the air pollution exposure associated risk for recurrent cardiovascular disease, likely by reducing the inflammatory response.

Place, publisher, year, edition, pages
MDPI, 2021. Vol. 18, no 5, p. 1-11, article id 2631
Keywords [en]
Active commuting, Cardiovascular disease prevention, Exercise, Interaction, PM2.5
National Category
Cardiac and Cardiovascular Systems Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-181583DOI: 10.3390/ijerph18052631ISI: 000628170200001Scopus ID: 2-s2.0-85101960141OAI: oai:DiVA.org:umu-181583DiVA, id: diva2:1538582
Available from: 2021-03-19 Created: 2021-03-19 Last updated: 2023-09-05Bibliographically approved
In thesis
1. Impacts of Active Transport on Health: with a focus on physical activity, air pollution, and cardiovascular disease
Open this publication in new window or tab >>Impacts of Active Transport on Health: with a focus on physical activity, air pollution, and cardiovascular disease
2021 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: There are increasing number of health impact assessment studies investigating the health effects by transferring trips made by motorised transport to active commuting; however, air pollution exposure during active commuting and its impact on health has been less thoroughly assessed. It is furthermore uncertain whether there is any interaction effect between air pollution and physical activity for the risk of cardiovascular diseases. The overall aim of the thesis was to improve the knowledge base for assessments of the total impact on health of a mode shift resulting in both increased physical activity and increased air pollution exposure, especially regarding combined effects on cardiovascular risks.

Methods: The thesis is based on four studies. In Study I, methodological issues related to the assessment of air pollution in previous studies on the health impact of changes in transport mode were critically reviewed. In Study II, the effect of leisure time and active commuting physical activity, on chronic diseases was quantified by conducting a random-effect meta-analysis. In two prospective cohort studies, participants of the Västerbotten Intervention Programme living in the Umeå region were studied to assess the impact as well as interaction effect of physical activity and air pollution on the incidence (Study III) and recurrence (Study IV) of cardiovascular diseases.

Results: In previous studies on the health impact of changes in transport mode, there was a large methodological discrepancy between studies due to different assumptions for air pollution exposure assessments in general populations and commuters as well as methods for estimation of impacts. Randomeffect meta-analyses showed a beneficial effect of leisure time physical activity and active commuting on morbidity among individuals performing these activities at the minimum level of physical activity recommended by WHO, equivalent to 11.25 MET-hours per week. Beneficial effects of exercise on firstincident ischemic heart disease (IHD) were observed among individuals with high residential PM10/PM2.5 concentrations, but not among individuals with low concentrations. Adverse effects associated with high residential PM10 and PM2.5 concentrations were only observed among the individuals whom less frequently exercised. A statistically significant interaction effect was found between air pollution and exercise in training clothes for first-incident IHD but not for recurrence of IHD/stroke.

Conclusions: The results in this thesis strengthen the public health message that physical activity is beneficial for cardiovascular health, even in areas with air pollution. Therefore, public health and transport policies should be designed to improve population health through promotion of active transport and mitigation of air pollution.

Place, publisher, year, edition, pages
Umeå: Umeå University, 2021. p. 86
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 2132
Keywords
Health impact assessment, Air pollution, Active commuting, Exercise, Interaction. Cardiovascular diseases, Ischemic heart diseases, Stroke
National Category
Public Health, Global Health, Social Medicine and Epidemiology Occupational Health and Environmental Health
Research subject
Public health; Occupational and Environmental Medicine
Identifiers
urn:nbn:se:umu:diva-183309 (URN)978-91-7855-533-8 (ISBN)978-91-7855-532-1 (ISBN)
Public defence
2021-06-15, Triple Helix, Universitetsledningshuset/Zoom, Umeå, 13:00 (English)
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Supervisors
Note

Zoom: https://umu.zoom.us/j/62645020569

Passcode: 223344

Available from: 2021-05-25 Created: 2021-05-21 Last updated: 2021-06-22Bibliographically approved

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Raza, WasifKrachler, BennoForsberg, BertilSommar, Johan Nilsson
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