Urban environment and physical activity and capacity in patients with chronic obstructive pulmonary disease
Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved..
BACKGROUND: Physical activity and exercise capacity are key prognostic factors in chronic obstructive pulmonary disease (COPD) but their environmental determinants are unknown.
OBJECTIVES: To test the association between urban environment and objective physical activity, physical activity experience and exercise capacity in COPD.
METHODS: We studied 404 patients with mild-to-very severe COPD from a multi-city study in Catalonia, Spain. We measured objective physical activity (step count and sedentary time) by the Dynaport MoveMonitor, physical activity experience (difficulty with physical activity) by the Clinical visit-PROactive (C-PPAC) instrument, and exercise capacity by the 6-min walk distance (6MWD). We estimated individually (geocoded to the residential address) population density, pedestrian street length, slope of terrain, and long-term (i.e., annual) exposure to road traffic noise, nitrogen dioxide (NO2) and particulate matter (PM2.5). We built single- and multi-exposure mixed-effects linear regressions with a random intercept for city, adjusting for confounders.
RESULTS: Patients were 85% male, had mean (SD) age 69 (9) years and walked 7524 (4045) steps/day. In multi-exposure models, higher population density was associated with fewer steps, more sedentary time and worse exercise capacity (-507 [95% CI: 1135, 121] steps, +0.2 [0.0, 0.4] h/day and -13 [-25, 0] m per IQR). Pedestrian street length related with more steps and less sedentary time (156 [9, 304] steps and -0.1 [-0.1, 0.0] h/day per IQR). Steeper slope was associated with better exercise capacity (15 [3, 27] m per IQR). Higher NO2 levels related with more sedentary time and more difficulty in physical activity. PM2.5 and noise were not associated with physical activity or exercise capacity.
DISCUSSION: Population density, pedestrian street length, slope and NO2 exposure relate to physical activity and capacity of COPD patients living in highly populated areas. These findings support the consideration of neighbourhood environmental factors during COPD management and the attention to patients with chronic diseases when developing urban and transport planning policies.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:214 |
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| Enthalten in: |
Environmental research - 214(2022), Pt 2 vom: 01. Nov., Seite 113956 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Koreny, Maria [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 29.08.2022 Date Revised 29.09.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.envres.2022.113956 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 245 | 1 | 0 | |a Urban environment and physical activity and capacity in patients with chronic obstructive pulmonary disease |
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| 500 | |a Date Revised 29.09.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Physical activity and exercise capacity are key prognostic factors in chronic obstructive pulmonary disease (COPD) but their environmental determinants are unknown | ||
| 520 | |a OBJECTIVES: To test the association between urban environment and objective physical activity, physical activity experience and exercise capacity in COPD | ||
| 520 | |a METHODS: We studied 404 patients with mild-to-very severe COPD from a multi-city study in Catalonia, Spain. We measured objective physical activity (step count and sedentary time) by the Dynaport MoveMonitor, physical activity experience (difficulty with physical activity) by the Clinical visit-PROactive (C-PPAC) instrument, and exercise capacity by the 6-min walk distance (6MWD). We estimated individually (geocoded to the residential address) population density, pedestrian street length, slope of terrain, and long-term (i.e., annual) exposure to road traffic noise, nitrogen dioxide (NO2) and particulate matter (PM2.5). We built single- and multi-exposure mixed-effects linear regressions with a random intercept for city, adjusting for confounders | ||
| 520 | |a RESULTS: Patients were 85% male, had mean (SD) age 69 (9) years and walked 7524 (4045) steps/day. In multi-exposure models, higher population density was associated with fewer steps, more sedentary time and worse exercise capacity (-507 [95% CI: 1135, 121] steps, +0.2 [0.0, 0.4] h/day and -13 [-25, 0] m per IQR). Pedestrian street length related with more steps and less sedentary time (156 [9, 304] steps and -0.1 [-0.1, 0.0] h/day per IQR). Steeper slope was associated with better exercise capacity (15 [3, 27] m per IQR). Higher NO2 levels related with more sedentary time and more difficulty in physical activity. PM2.5 and noise were not associated with physical activity or exercise capacity | ||
| 520 | |a DISCUSSION: Population density, pedestrian street length, slope and NO2 exposure relate to physical activity and capacity of COPD patients living in highly populated areas. These findings support the consideration of neighbourhood environmental factors during COPD management and the attention to patients with chronic diseases when developing urban and transport planning policies | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Air pollution | |
| 650 | 4 | |a Chronic obstructive pulmonary disease | |
| 650 | 4 | |a Exercise capacity | |
| 650 | 4 | |a Noise | |
| 650 | 4 | |a Physical activity | |
| 650 | 4 | |a Urban environment | |
| 650 | 7 | |a Particulate Matter |2 NLM | |
| 650 | 7 | |a Nitrogen Dioxide |2 NLM | |
| 650 | 7 | |a S7G510RUBH |2 NLM | |
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| 700 | 1 | |a Bosch de Basea, Magda |e verfasserin |4 aut | |
| 700 | 1 | |a Foraster, Maria |e verfasserin |4 aut | |
| 700 | 1 | |a Carsin, Anne-Elie |e verfasserin |4 aut | |
| 700 | 1 | |a Cirach, Marta |e verfasserin |4 aut | |
| 700 | 1 | |a Gimeno-Santos, Elena |e verfasserin |4 aut | |
| 700 | 1 | |a Barberan-Garcia, Anael |e verfasserin |4 aut | |
| 700 | 1 | |a Nieuwenhuijsen, Mark |e verfasserin |4 aut | |
| 700 | 1 | |a Vall-Casas, Pere |e verfasserin |4 aut | |
| 700 | 1 | |a Rodriguez-Roisín, Robert |e verfasserin |4 aut | |
| 700 | 1 | |a Garcia-Aymerich, Judith |e verfasserin |4 aut | |
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