Exercising in Air Pollution: The Cleanest versus Dirtiest Cities Challenge

Kennedi DeRossett
KIN 256
Purpose
The purpose of this study was to estimate the inhaled dose of air pollutants during two
simulated exercise sessions held in the cleanest and dirtiest cities reported by the World Health
Organization (WHO). Ultimately, the goal was to compare the dose of coarse PM10 particles and
fine PM2.5 particles inhaled when completing the recommended 30 minutes of daily exercise at
the 10 cleanest and dirtiest cities related to the PM annual concentrations reported by WHO.

Methods
116 healthy male volunteers were recruited to participate in this study. To be included in
the study, the volunteers had to have been supplement free for at least three months prior to the
initiation of the experiment.
The individuals performed maximal running tests on a treadmill that were completed in
different increments. All participants were asked to avoid any exhaustive exercise for 48 hours
prior to the testing and instructed to wear standard running shoes for each test. All tests were
performed 2-3 hours after the individuals last meal, in a lab located in Sao Paulo, Brazil at the
same time of day in a temperature-controlled room. Participants completed 30 minute all out
treadmill trials that were used to simulate hypothetical conditions (rest and continuous moderate
exercise) and their correlating PM inhalation rates.
During the treadmill tests, the participants ventilation data was collected in order to
predict their total ventilation (VETOTAL) of both hypothetical scenarios (rest and moderate
exercise). From the VETOTAL for each of the scenarios, the individuals’ inhaled PM10 and PM2.5
were calculated for each of the included cities (WHO report of air pollution data 2016).
Maximal Running Test Protocol – Each participant completed a three-minute rest and a
three-minute warm up at eight km/hr. From there, the treadmill speed was increased by 1 km/hr
every minute until exhaustion. By utilizing a gas analyzer, the participants gas exchanges were
measured breath by breath at rest and during the exercise test. The data collected was averaged
over 30 second intervals for the duration of the test. Once the test was complete, VE data was
extracted and used to predict their VETOTAL for the two hypothetical 30-minute scenarios (rest and
65% of their VO2max. Their individual VETOTAL were then used to calculate the air pollutants
inhaled dose.
Air Pollutants Inhalation Dose Calculations – The participants VE data from the 30-
minute treadmill tests were used to calculate the total ventilation (VETOTAL) for the two given
scenarios (rest and continuous exercise at 65% VO2max). The intensity of the test was decided
based on the moderate intensity aerobic exercise recommendations from the ACSM. The VE
related to 65% of the participants VO2max was calculated using: VETOTAL (L) = VE (L·min-1) x 30
min. From the calculated VETOTAL values, the inhaled PM10 and PM2.5 amounts were determined.

Results
Data was assessed through the Shapiro-Wilk test. Using SPSS, a two-way ANOVA was
conducted to compare the scenarios (rest and exercise) and inhaled PM between cities (cleanest
and dirtiest). The levels of PM10 and PM2.5 in the dirtiest cities were ~47 times higher than in the
cleanest cities. As expected, the VE and VETOTAL were significantly higher in exercise compared
to rest. The inhaled PM10 and PM2.5 were significantly higher for rest and exercise at the dirtiest
cities compared to the cleanest.
Exercising in Air Pollution: The Cleanest versus Dirtiest Cities Challenge

Conclusions
The goal of this study was to compare the PM10 and PM2.5 amounts inhaled during a
simulated 30-minute daily exercise (as recommended by the ACSM to stay healthy) in cities with
distinct air pollution levels. The study found that exercise performed in the dirtiest cities could
lead to ~37-66 times higher inhaled pollutants than the cleanest cities. This factor could
ultimately suppress/eliminate the health benefits provided by aerobic exercise.
All of the cleanest cities air pollution levels fell below the WHO guidelines and in the
“ideal for health” category. Whereas the dirtiest cities pollution levels rose above the interim
target 1 (level responsible for ~5% increase in short-term mortality over the air quality
guidelines). The cleanest cities were found to be located in developed countries and are relatively
small, while most of the dirty cities are all located in underdeveloped countries (Chinese cities
are the exception).
For a healthy individual, 30 minutes of aerobic exercise daily is the recommendation
given by the ACSM. However, exercising in one of the dirtiest cities could lead to a higher risk
of mortality and have more health risks than benefits. Exercise benefits in the cleanest cities
continue to increase after 90 minutes of exercise. However, exercise benefits in the dirtiest cities
diminish after only 15 minutes of exercise. 15 minutes of exercise in the dirtiest cities has no
benefit and exercising longer than that (>75 minutes) could potentially lead to harmful health
effects due to air pollution exposure.

Strengths and Weaknesses

One strength of this study is that there are not many done like it and it helps play a part in
the growing knowledge of air pollutants on individual health. There was a large sample size of
116 individuals and the testing times/location were kept consistent throughout the experiment.
One weakness of this study is that only the ten cleanest and dirtiest cities of the WHO
database were analyzed, meaning that the data does not fully represent all cities around the
world. Since an average pollution concentration was used for each location, the large daily and
specific city variations were not accounted for. This study was not actually conducted within the
dirtiest and cleanest cities, which means all of the ventilation and pollution values are estimates.
Another weakness could be the target population included in this study; being all men and no
women. Testing and recording possible gender differences in reaction to air pollutants could be
beneficial to all of the citizens living in a certain area.

Practical Application
Future studies can build off of this experiment and incorporate different genders and the
reactions each experience depending on the level of inhaled particles. Another avenue to study is
at-risk populations, as this one was conducted with healthy individuals. Studying air pollutants
could help prevent a lot of lung related diseases by educating people on how to stay safe when
living in a highly polluted area.

Pasqua, L. A., Damasceno, M. V., Cruz, R., Matsuda, M., Martins, M. G., Silva, A. E.,
Marquezini, M., Saldiva, P. H., & Bertuzzi, R. (2018). Exercising in Air Pollution: The
Cleanest versus Dirtiest Cities Challenge. International Journal of Environmental
Research and Public Health, 15(7), 1-10. https://doi.org/gfc2cc