Summary

The behavioural advice that accompanies the current Daily Air Quality Index (DAQI) indicates, depending on the air pollution band, whether individuals should “consider reducing”, “reduce” or “avoid” strenuous physical exertion. One of the considerations of the Committee on the Medical Effects of Air Pollutants’ (COMEAP) (Air Quality Information System (AQIS) Sub-group is whether this advice regarding physical activity is still appropriate.

The available evidence indicates that, for most people, the long-term benefits of regular physical activity outweigh the possible risks of experiencing adverse symptoms from undertaking physical activity during short-term periods of elevated air pollution. A loss of the benefits of physical activity, for both the general population and susceptible groups, is one of the possible unintended consequences of the current DAQI advice. Advice could therefore focus on reducing personal exposure to outdoor air pollution, rather than on discouraging physical activity. Specific advice, during a pollution episode, on where and when air pollution is most likely to be high would help individuals reduce exposure.

Effects of exercising during elevated air pollution are likely to vary between individuals. Information that enables individuals to respond appropriately for their individual circumstances might be more appropriate than providing the same, directive, advice to everyone. This could include advice for individuals to monitor their symptoms and to respond according to plans developed with their clinicians.

Evidence suggests that health outcomes may be affected for at least a week after short-term exposure to air pollution. Therefore, advising individuals to monitor their symptoms for several days following exposure is appropriate.

Other considerations relevant to the current advice include the potential impacts of indoor air pollution, if individuals are encouraged to avoid outdoor air pollution, and other environmental triggers such as pollen, if they choose to conduct physical activity in green spaces.

For mass participation sporting events, organisers should be advised to raise awareness of the potential health impacts of short-term exposure to air pollution during air pollution episodes. This would enable participants to make informed choices regarding participation, based on their individual circumstances, and allow them to monitor symptoms.