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Original research
Habitual exercise, chronic exposure to fine particulate matter and high-sensitivity C reactive protein in Asian adults
  1. Yi Qian Zeng1,
  2. Shin Heng Teresa Chan1,
  3. Cui Guo1,
  4. Ly-yun Chang2,
  5. Yacong Bo1,
  6. Changqing Lin3,
  7. Zengli Yu4,
  8. Alexis K.H. Lau3,5,
  9. Tony Tam6,
  10. Xiang Qian Lao1,7
  1. 1 Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, China
  2. 2 Institute of Sociology, Academia Sinica, Taipei, Taiwan
  3. 3 Division of Environment and Sustainability, the Hong Kong University of Science and Technology, Hong Kong SAR, China
  4. 4 Department of Nutrition and Food Hygiene, School of Public Health, Zhengzhou University, Zhengzhou, Henan, China
  5. 5 Department of Civil and Environmental Engineering, the Hong Kong University of Science and Technology, Hong Kong SAR, China
  6. 6 Department of Sociology, The Chinese University of Hong Kong, Hong Kong SAR, China
  7. 7 Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, Guangdong, China
  1. Correspondence to Dr Xiang Qian Lao, Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, 421, 4/F School of Public Health, Prince of Wales Hospital, Sha Tin, N.T., Hong Kong SAR, China; xqlao{at}cuhk.edu.hk

Abstract

Objectives Exercise may increase the inhaled amount of air pollutants and exacerbate the adverse health effects. We investigated the combined effects of chronic exposure to fine particulate matter with an aerodynamic diameter less than 2.5 µm (PM2.5) and habitual exercise on C reactive protein (CRP), a sensitive marker of inflammation.

Methods We selected 40 209 Taiwanese adults who joined a standard medical screening programme between 2001 and 2016. The PM2.5 exposure was estimated at each participant’s address using a satellite-based spatiotemporal model. Information on habitual exercise was collected using a standard self-administered questionnaire. Mixed-effects linear regression models were used to investigate the associations of CRP with PM2.5 and exercise. An interaction term of PM2.5 and exercise was introduced in the models to test the modifying effects.

Results A greater amount of habitual exercise was associated with a decreased level of CRP, while a higher concentration of PM2.5 exposure was associated with an increased level of CRP. The inverse associations of habitual exercise with CRP were not modified by chronic exposure to PM2.5. The participants in the group with a low level of exercise and a high level of PM2.5 exposure exhibited a 19.1% higher level of CRP than those in the group with a high level of exercise and a low level of PM2.5 exposure (95% CI: 13.7% to 24.8%; p<0.001). The longitudinal and sensitivity analyses yielded similar results.

Conclusions Increased levels of exercise and reduced exposure levels of PM2.5 are associated with a lower CRP level. Habitual exercise reduces CRP level regardless of the levels of chronic PM2.5 exposure. Our results support that habitual exercise is a safe approach for reducing systemic inflammation to improve cardiovascular health even for people residing in relatively polluted areas.

  • particulate matter
  • longitudinal studies
  • exercise

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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Footnotes

  • Contributors XQL conceived of and designed the study. L-yC, AKHL, CL, TT and XQL acquired the data. YQZ performed data analysis. YQZ and XQL interpreted the data. YQZ wrote the first draft of the manuscript. All authors critically revised the manuscript and contributed to the development of the manuscript for important intellectual content. XQL acquired the funding. L-yC, AKHL, TT and XQL supervised this study. XQL is the guarantor responsible for the overall content. All authors gave final approval and agreed to be accountable for all aspects of the work ensuring integrity and accuracy.

  • Funding This work was supported by the RGC-General Research Fund of University Grant Committee of Hong Kong (14603019) and Guangdong Basic and Applied Basic Research Foundation (2019A1515011697). YQZ is supported by the PhD Studentship of the Chinese University of Hong Kong. CG is supported by the RGC Postdoctoral Fellowship Scheme of the University Grants Committee of Hong Kong. YB is in part supported by the Faculty Postdoctoral Fellowship Scheme of the Faculty of Medicine of the Chinese University of Hong Kong. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

  • Disclaimer Any interpretation or conclusion related to this manuscript does not represent the views of MJ Health Research Foundation.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.