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Original article
Respiratory and inflammatory responses to short-term exposure to traffic-related air pollution with and without moderate physical activity
  1. Nadine Janet Kubesch1,2,3,
  2. Audrey de Nazelle1,2,3,4,
  3. Dane Westerdahl5,
  4. David Martinez1,2,3,
  5. Gloria Carrasco-Turigas1,2,3,
  6. Laura Bouso1,2,3,
  7. Stefano Guerra1,2,3,6,
  8. Mark J Nieuwenhuijsen1,2,3
  1. 1Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
  2. 2Universitat Pompeu Fabra (UPF), Barcelona, Spain
  3. 3Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
  4. 4Centre for Environmental Policy, Imperial College London, London, UK
  5. 5Department of Mechanical and Aerospace Engineering, Cornell University, Ithaca, New York, USA
  6. 6Arizona Respiratory Center, University of Arizona, Tucson, Arizona, USA
  1. Correspondence to Nadine Janet Kubesch, Centre for Research in Environmental Epidemiology (CREAL), C/Dr Aiguader 88, Barcelona 08003, Spain; nkubesch{at}


Objectives Exposure to traffic-related air pollution (TRAP) has been associated with adverse respiratory and systemic outcomes. Physical activity (PA) in polluted air may increase pollutant uptake and thereby health effects. The authors aimed to determine the short-term health effects of TRAP in healthy participants and any possible modifying effect of PA.

Methods Crossover real-world exposure study comparing in 28 healthy participants pulmonary and inflammatory responses to four different exposure scenarios: 2 h exposure in a high and low TRAP environment, each at rest and in combination with intermittent moderate PA, consisting of four 15 min rest and cycling intervals. Data were analysed using mixed effect models for repeated measures.

Results Intermittent PA compared to rest, irrespective of the TRAP exposure status, increased statistically significant (p≤0.05) pulmonary function (forced expiratory volume in 1 s (34 mL), forced vital capacity (29 mL), forced expiratory flow (FEF25–75%) (91 mL)), lung inflammation (fraction of exhaled nitric oxide, FeNO, (0.89 ppb)), and systemic inflammation markers interleukin-6 (52.3%), leucocytes (9.7%) and neutrophils count (18.8%). Interquartile increases in coarse particulate matter were statistically significantly associated with increased FeNO (0.80 ppb) and neutrophil count (5.7%), while PM2.5 and PM10 (particulate matter smaller than 2.5 and 10 µm in diameter, respectively) increased leucocytes (5.1% and 4.0%, respectively). We found no consistent evidence for an interaction between TRAP and PA for any of the outcomes of interest.

Conclusions In a healthy population, intermittent moderate PA has beneficial effects on pulmonary function even when performed in a highly polluted environment. This study also suggests that particulate air pollution is inducing pulmonary and systemic inflammatory responses.

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