空气污染严重时运动无益!《柳叶刀》:锻炼环境很重要
2017/12/08
12月5日,发表在顶级医学期刊《柳叶刀》(The Lancet)上的一项研究中,一个国际科学家小组发现,在街道上,短期接触交通废气就能“抵消”散步2小时对老年人的心脏和肺带来的积极作用。


图片来源:The Lancet

这也是关于记录“在街道短期接触空气污染,对健康人群以及患者心肺疾病人群负面影响”的首个研究

研究中,科学家们招募了119名年龄在60岁以上的志愿者,他们要么身体健康,要么患有稳定的慢性阻塞性肺病(obstructive pulmonary disease ,COPD)或缺血性心脏病。

志愿者们于中午(midday)在伦敦的2个位置中的一个行走2个小时。一个位置是相对安静的海德公园(Hyde Park),另一个位置是繁忙的牛津街道(Oxford Street)。其中,牛津街道的污染常常超过世界卫生组织规定的空气质量限制。


图片来源:网络

在走之前和走之后,科学家们都会对志愿者们进行身体检测,进而揭示2小时的运动对每个志愿者心肺健康的影响,包括肺活量、血压、血流和动脉僵硬度。

结果显示,在海德公园散步后的第一个小时内,志愿者的肺活量得到了显著改善,在很多人中,这种“改善”持续超过24小时。相比之下,在牛津街道散步后,志愿者的肺活量在头几个小时增幅很小,之后也没有再增加。

此外,在海德公园散步2小时,使得健康志愿者和COPD患者的动脉僵硬度降低24%以上,使心脏病患者的动脉僵硬度降低19%以上;而在牛津街道散步2小时获益要小得多:健康志愿者的动脉僵硬度最高降低仅4.6%、COPD患者的动脉僵硬度最高降低16%、心脏病患者的动脉僵硬度最高降低8.6%。

参与该研究的杜克大学Junfeng (Jim) Zhang教授说:“我们的结果进一步证实,即便是短暂的暴露于汽车交通污染2小时,也会对心血管和呼吸系统造成负面影响。同时,这些结果也强调了,我们的城市需要更严格的空气质量限制,以及更好的交通控制措施。”


Kian Fan Chung教授(图片来源:Imperial College)

论文的通讯作者、帝国理工学院的Kian Fan Chung教授表示:“对很多人来说,比如老年人或患慢性疾病的人,他们通常唯一能做的锻炼就是走路。我们建议这些人群在绿色空间散步,远离建筑区域和交通污染。结合来自近期其它研究的证据,我们真的不能‘忍受’目前很多街道上的空气污染水平。我们需要降低污染,让每个人都能在任何城市环境下享受体育锻炼带来的好处。

参考资料:

Air pollution cancels positive health effects of exercise in older adults

Respiratory and cardiovascular responses to walking down a traffic-polluted road compared with walking in a traffic-free area in participants aged 60 years and older with chronic lung or heart disease and age-matched healthy controls: a randomised, crossover study

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  • Respiratory and cardiovascular responses to walking down a traffic-polluted road compared with walking in a traffic-free area in participants aged 60 years and older with chronic lung or heart disease and age-matched healthy controls: a randomised, crosso

    Background Long-term exposure to pollution can lead to an increase in the rate of decline of lung function, especially in older individuals and in those with chronic obstructive pulmonary disease (COPD), whereas shorter-term exposure at higher pollution levels has been implicated in causing excess deaths from ischaemic heart disease and exacerbations of COPD. We aimed to assess the effects on respiratory and cardiovascular responses of walking down a busy street with high levels of pollution compared with walking in a traffic-free area with lower pollution levels in older adults. Methods In this randomised, crossover study, we recruited men and women aged 60 years and older with angiographically proven stable ischaemic heart disease or stage 2 Global initiative for Obstructive Lung Disease (GOLD) COPD who had been clinically stable for 6 months, and age-matched healthy volunteers. Individuals with ischaemic heart disease or COPD were recruited from existing databases or outpatient respiratory and cardiology clinics at the Royal Brompton & Harefield NHS Foundation Trust and age-matched healthy volunteers using advertising and existing databases. All participants had abstained from smoking for at least 12 months and medications were taken as recommended by participants' doctors during the study. Participants were randomly assigned by drawing numbered disks at random from a bag to do a 2 h walk either along a commercial street in London (Oxford Street) or in an urban park (Hyde Park). Baseline measurements of participants were taken before the walk in the hospital laboratory. During each walk session, black carbon, particulate matter (PM) concentrations, ultrafine particles, and nitrogen dioxide (NO2) concentrations were measured. Findings Between October, 2012, and June, 2014, we screened 135 participants, of whom 40 healthy volunteers, 40 individuals with COPD, and 39 with ischaemic heart disease were recruited. Concentrations of black carbon, NO2, PM10, PM2.5, and ultrafine particles were higher on Oxford Street than in Hyde Park. Participants with COPD reported more cough (odds ratio [OR] 1·95, 95% CI 0·96–3·95; p<0·1), sputum (3·15, 1·39–7·13; p<0·05), shortness of breath (1·86, 0·97–3·57; p<0·1), and wheeze (4·00, 1·52–10·50; p<0·05) after walking down Oxford Street compared with Hyde Park. In all participants, irrespective of their disease status, walking in Hyde Park led to an increase in lung function (forced expiratory volume in the first second [FEV1] and forced vital capacity [FVC]) and a decrease in pulse wave velocity (PWV) and augmentation index up to 26 h after the walk. By contrast, these beneficial responses were attenuated after walking on Oxford Street. In participants with COPD, a reduction in FEV1 and FVC, and an increase in R5–20 were associated with an increase in during-walk exposure to NO2, ultrafine particles and PM2.5, and an increase in PWV and augmentation index with NO2 and ultrafine particles. In healthy volunteers, PWV and augmentation index were associated both with black carbon and ultrafine particles. Interpretation Short-term exposure to traffic pollution prevents the beneficial cardiopulmonary effects of walking in people with COPD, ischaemic heart disease, and those free from chronic cardiopulmonary diseases. Medication use might reduce the adverse effects of air pollution in individuals with ischaemic heart disease. Policies should aim to control ambient levels of air pollution along busy streets in view of these negative health effects.

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