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Air pollution accounted for 8.1 million deaths globally in 2021, becoming the second leading risk factor for death, including for children under five years. United Nations Children's Fund. Retrieved 2025-08-22 from \u3008https:\/\/www.unicef.org\/press-releases\/air-pollution-accounted-81-million-deaths-globally-2021-becoming-second-leading-risk\u3009."},{"key":"10.1016\/j.ecoenv.2026.120098_bib143","unstructured":"Union, I.-P. Pursuing gender parity on panels: A guide for parliamentarian, Geneva, 2019. \u3008https:\/\/www.ipu.org\/sites\/default\/files\/documents\/pursuing_gender_parity_on_panels.pdf\u3009 (accessed 22 February 2026)."},{"issue":"4","key":"10.1016\/j.ecoenv.2026.120098_bib144","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1089\/ars.2019.8015","article-title":"Particulate matter induces tissue oxinflammation: from mechanism to damage","volume":"33","author":"Valacchi","year":"2020","journal-title":"Antioxid. 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J. Respir. Crit. Care Med"},{"key":"10.1016\/j.ecoenv.2026.120098_bib152","article-title":"Pro-thrombotic effect of exercise in a polluted environment: a P-selectin- and CD63-related platelet activation effect","author":"Wauters","year":"2015","journal-title":"Thromb. Haemost. 113(01) 118-124"},{"issue":"3","key":"10.1016\/j.ecoenv.2026.120098_bib153","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1111\/j.1574-695X.2006.00132.x","article-title":"Antimicrobial peptides and proteins, exercise and innate mucosal immunity","volume":"48","author":"West","year":"2006","journal-title":"FEMS Immunol. Med Microbiol"},{"key":"10.1016\/j.ecoenv.2026.120098_bib154","doi-asserted-by":"crossref","first-page":"513","DOI":"10.15585\/mmwr.mm6823a1","article-title":"Trends in meeting physical activity guidelines among urban and rural dwelling adults \u2014 United States, 2008\u20132017","volume":"68","author":"Whitfield","year":"2019","journal-title":"MMWR Morb. Mortal. 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Retrieved 2026-02-27 from \u3008https:\/\/www.who.int\/health-topics\/adolescent-health\u3009."},{"issue":"4","key":"10.1016\/j.ecoenv.2026.120098_bib158","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1161\/CIRCHEARTFAILURE.112.966580","article-title":"Cardiovascular remodeling in response to long-term exposure to fine particulate matter air pollution","volume":"5","author":"Wold","year":"2012","journal-title":"Circulation Heart Failure"},{"issue":"3","key":"10.1016\/j.ecoenv.2026.120098_bib159","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1016\/j.jaci.2017.12.981","article-title":"Inflammatory health effects of indoor and outdoor particulate matter","volume":"141","author":"Wu","year":"2018","journal-title":"J. Allergy Clin. 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