{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T11:46:47Z","timestamp":1791373607323,"version":"4.3.1"},"reference-count":178,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,11,8]],"date-time":"2021-11-08T00:00:00Z","timestamp":1636329600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008454","name":"Boehringer Ingelheim Foundation","doi-asserted-by":"publisher","award":["collaborative research group \u201cNovel and neglected cardiovascular risk factors: molecular mechanisms and therapeutics\u201d"],"award-info":[{"award-number":["collaborative research group \u201cNovel and neglected cardiovascular risk factors: molecular mechanisms and therapeutics\u201d"]}],"id":[{"id":"10.13039\/501100008454","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100017578","name":"Stiftung Mainzer Herz","doi-asserted-by":"publisher","award":["Mainzer Herz 17 and 21"],"award-info":[{"award-number":["Mainzer Herz 17 and 21"]}],"id":[{"id":"10.13039\/100017578","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010447","name":"German Centre for Cardiovascular Research","doi-asserted-by":"publisher","award":["Partnersite Rhine-Main, Mainz"],"award-info":[{"award-number":["Partnersite Rhine-Main, Mainz"]}],"id":[{"id":"10.13039\/100010447","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antioxidants"],"abstract":"<jats:p>Both exposure to higher levels of polluted air and physical inactivity are crucial risk factors for the development and progression of major noncommunicable diseases and, in particular, of cardiovascular disease. In this context, the World Health Organization estimated 4.2 and 3.2 million global deaths per year in response to ambient air pollution and insufficient physical activity, respectively. While regular physical activity is well known to improve general health, it may also increase the uptake and deposit of air pollutants in the lungs\/airways and circulation, due to increased breathing frequency and minute ventilation, thus increasing the risk of cardiovascular disease. Thus, determining the tradeoff between the health benefits of physical activity and the potential harmful effects of increased exposure to air pollution during physical activity has important public health consequences. In the present comprehensive review, we analyzed evidence from human and animal studies on the combined effects of physical activity and air pollution on cardiovascular and other health outcomes. We further report on pathophysiological mechanisms underlying air pollution exposure, as well as the protective effects of physical activity with a focus on oxidative stress and inflammation. Lastly, we provide mitigation strategies and practical recommendations for physical activity in areas with polluted air.<\/jats:p>","DOI":"10.3390\/antiox10111787","type":"journal-article","created":{"date-parts":[[2021,11,8]],"date-time":"2021-11-08T22:08:41Z","timestamp":1636409321000},"page":"1787","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Physical Activity in Polluted Air\u2014Net Benefit or Harm to Cardiovascular Health? A Comprehensive Review"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7823-7671","authenticated-orcid":false,"given":"Omar","family":"Hahad","sequence":"first","affiliation":[{"name":"Department of Cardiology\u2014Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany"},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, 55131 Mainz, Germany"},{"name":"Leibniz Institute for Resilience Research (LIR), 55122 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2435-851X","authenticated-orcid":false,"given":"Marin","family":"Kuntic","sequence":"additional","affiliation":[{"name":"Department of Cardiology\u2014Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4103-0882","authenticated-orcid":false,"given":"Katie","family":"Frenis","sequence":"additional","affiliation":[{"name":"Department of Hematology\/Oncology, Boston Children\u2019s Hospital and Harvard Medical School, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sourangsu","family":"Chowdhury","sequence":"additional","affiliation":[{"name":"Atmospheric Chemistry Department, Max Planck Institute for Chemistry, 55122 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6307-3846","authenticated-orcid":false,"given":"Jos","family":"Lelieveld","sequence":"additional","affiliation":[{"name":"Atmospheric Chemistry Department, Max Planck Institute for Chemistry, 55122 Mainz, Germany"},{"name":"Climate and Atmosphere Research Center, The Cyprus Institute, Nicosia 2121, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"Lieb","sequence":"additional","affiliation":[{"name":"Leibniz Institute for Resilience Research (LIR), 55122 Mainz, Germany"},{"name":"Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2769-0094","authenticated-orcid":false,"given":"Andreas","family":"Daiber","sequence":"additional","affiliation":[{"name":"Department of Cardiology\u2014Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany"},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5503-4150","authenticated-orcid":false,"given":"Thomas","family":"M\u00fcnzel","sequence":"additional","affiliation":[{"name":"Department of Cardiology\u2014Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany"},{"name":"German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.2165\/00007256-200636120-00003","article-title":"Adolescent physical activity and health: A systematic review","volume":"36","author":"Hallal","year":"2006","journal-title":"Sports Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e1077","DOI":"10.1016\/S2214-109X(18)30357-7","article-title":"Worldwide trends in insufficient physical activity from 2001 to 2016: A pooled analysis of 358 population-based surveys with 1.9 million participants","volume":"6","author":"Guthold","year":"2018","journal-title":"Lancet Glob. 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