The impact of ambient air pollution on lung function and respiratory symptoms in elite athletes

Air pollution has become a significant public health concern. During exercise, many physiological factors are thought to increase the effects of air pollution. Air pollution most affects lung function and respiratory symptoms. We investigated the association between lung function, respiratory symptoms, and air pollutant concentration with meteorological factors in elite sports athletes.

A total of 59 elite sports athletes from the Korea National Sports University participated in this prospective, observational study from September 2019 to June 2020. At ten visits, lung function and respiratory symptoms were obtained after a training session. We measured six air pollutants, including SO₂, CO, O₃, NO₂, PM₁₀, and PM_2.5, and two meteorological factors, including humidity and temperature. Air pollutants and meteorological factors were measured by two nearest depositories of the national air pollution information system in Korea.

In a single-pollutant model, PM_2.5, PM₁₀, NO₂, and CO were inversely associated with both FEV₁ and FEV₆, 10 μg/m³ in PM_2.5 was associated with a 32.31 mL decrease in FEV₁ and a 36.93 mL decrease in FEV₆. Meanwhile, O₃ and temperature had positive associations with both FEV₁ (13.00 and 3.15 mL) and FEV₆ (16.91 and 4.76 mL) and humidity with FEV₆ (11.98 mL). In the multi-pollutant model at lag 0, FEV₁ was associated negatively with O₃ and NO₂ (-50.68 and -6.87 mL) and positively with SO₂ and temperature (65.76 and 8.08 mL). In the multi-pollutant model at lag 6, temperature was associated with FEV₁ and FEV₆ (6.01 and 8.89 mL). PM_2.5, PM₁₀, NO₂, CO, and temperature were significantly associated with FEV₁ and FEV₆ through lag 0-6.

Air pollutants and meteorological factors are associated with lung function and respiratory symptoms and have cumulative effects among elite athletes. In the multi-pollutant model, temperature has the most significant effect on lung function.