General

• Regular exercise improves health, but also increases intake of polluted air into lungs. Respiratory health is primary interface of exposure and is the interface between the environment and immune system (Jin et al., 2024)
• Mobile monitors were able to track hotspots along race (Ribalta et al., 2024)
• Health benefits of physical exercise appear to outweigh negative impacts (Fuller et al., 2023)
• Air pollution leads to immune damage and diseases, it is an inflammatory response and triggers oxidative stress. Luckily, Exercise is anti-inflammatory and enhances immune system (Jin et al., 2024)
• Athletes should be cautious when: close to heavy car traffic, during agricultural work with pesticides, megafires, spring pollen season, hot weather ozone, when on synthetic turf, and when indoors with little ventilation, alcohol-based cleaning products, air fresheners, and new equipment (Bougault, 2024).
• Increases in PM2.5 and PM10 increases marathon and 5km running times.  Increases in ozone impact swimming performance (Bougault, 2024).
• Solar powered air quality sensors in sports facilities used to create training schedules and event organisers.  End up last minute changing time and location of training, logistically tedious but for the safety of athletes (Kimathi, 2024)
• “Someone exercising can take in as much as 20 times more air than a person at rest” (Kimathi, 2024)
• Athletes inhale between 4-10 times more air pollutants as compared to someone at rest (Day, 2024)
• Heart rates increase during exercise when people were exposed to diesel articles an hour before beginning to exercise (American Physiological Society, 2024)
• Athletes in more polluted areas may be able to acclimate to certain pollutants (ozone) (American Physiological Society, 2024)
• 75% athletes have negative impact due to climate change from survey (World Athletics, 2023)
• Elevated pollution slowed elite NCAA 5K runners by 1.5% (Hutchinson, 2023)
• Ozone acclimatisation is purposefully exercising in polluted air so that you become accustomed to it and perform better in similar conditions. Acclimatising desensitises irritant receptors, increases mucus production, and decreases inflammation after a few days (Hutchinson, 2023)
• Impacts athlete performance and longevity, referee/umpire calls, spectator health and satisfaction (Campelli, 2020)
• PM2.5 higher levels increase probability of erroneous move by 26.3% in German football (Campelli, 2020)
• “Major League Baseball umpires make two extra incorrect calls out of 100 due to poor air quality) - 1 ppm increase in CO is 11.5% increase in incorrect calls (Campelli, 2020)
• Slower runners may inhale more O3 and PM due to longer exposure and increase of pollutants over time (Ribalta et al., 2024)
• Increased ventilation can exceed 110L per minute in some elite athletes (Ribalta et al., 2024)
• Being in polluted air before exercising in clean air can still impact performance (Koehle, 2024)
• Fine particulate matter is linked to slower marathon times. An increase by 1 ug/m3 (micrograms per cubic meter) in concentrations of PM2.5, results in slower race times by 32 seconds in males and 25 seconds in females (Bennett, 2024)
• “10 µg/m3 increase of PM10, or fine particulate matter with a diameter of less than 10 microns, was associated with a marathon performance decrease of 1.4%.” (Bennett, 2024)
• The negative impact from air pollution has an effect on individuals who are healthy, such as marathon runners who are assumed to have a “honed” cardiorespiratory fitness. (Brown University, 2024)
• “PM2.5 is small enough to penetrate the lungs and bloodstream, contributing to cardiovascular and respiratory issues.” (Research MD, 2025)
• A 1% increase in air pollution results in a reduction of 0.101% in the number of passes, which is five times larger than the OLS estimation (Li et al., 2024)
• Heterogeneity results suggest that possessing an advantage (physical fitness, technical skills, or playing at home) contributes to mitigating the adverse effects of air pollution. (Li et al., 2024)
• Short-term exposure reduces forced expiratory volume, forced vital capacity, and peak expiratory flow (John et al., 2025)
• Outdoor athletes and some indoor ones–such as ice hockey players and swimmers–are particularly susceptible (John et al., 2025)
  
  • Repeated exposure and increased respiratory demand
  • Often train and compete in urban environments, and during peak times where certain pollutants are higher (like O3)
• Moderate pollution across London and the south of England during the 2025 London Marathon (Keane, 2025)
  
  • Defra recommended people to limit exercise if they had a pre-existing condition
• In the 2020 Australian Open tennis matches, many athletes struggled due to air pollution. Some collapsed and others gave up their matches (Respire, 2024)

Solutions

• Minimise exposure using real-time monitoring and forecasting rules, early mornings (Hutchinson, 2023)
• Antioxidant supplements could help (Vitamins C and E) before competitions (Hutchinson, 2023)
• Wearing N95 before competition can minimise exposure of PM building up (Hutchinson, 2023)
• Wearing a mask increases fatigue, dyspnea, and exercise performance - not widely recommended during exercise, but yes for on the way to and from exercise (Koehle, 2024)
• Have physical education schedules adapted for school sports to avoid heavy traffic times (Respire, 2024)
• Delay outdoor sports or favour low-intensity sports during peak in pollution (Respire, 2024)
• Stop building sports facilities near major roads (Respire, 2024)
• During pollution peaks, close outdoor sports facilities (Respire, 2024)