Urban environment and physical activity and capacity in patients with chronic obstructive pulmonary disease
Author
Koreny, Maria
Arbillaga-Etxarri, Ane
Bosch de Basea, Magda
Foraster, Maria
Carsin, Anne-Elie
Cirach, Marta
Gimeno-Santos, Elena
Barberan-Garcia, Anael
Nieuwenhuijsen, Mark
Rodriguez-Roisín, Robert
Garcia-Aymerich, Judith
Publication date
2022ISSN
0013-9351
Abstract
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.
Document Type
Article
Document version
Published version
Language
English
Subject (CDU)
61 - Medical sciences
616.2 - Pathology of the respiratory system. Complaints of the respiratory organs
Keywords
Entorn urbà
Soroll
Contaminació de l'aire
Activitat física
Capacitat d'exercici
Malaltia pulmonar obstructiva crònica
Entorno urbano
Ruido
Contaminación del aire
Actividad física
Capacidad de ejercicio
Enfermedad pulmonar obstructiva crónica
Urban environment
Noise
Air pollution
Physical activity
Exercise capacity
Chronic obstructive pulmonary disease
Pages
10
Publisher
Elsevier
Collection
214; 2
Is part of
Environmental Research
Citation
Koreny, Maria; Arbillaga-Etxarri, Ane; Bosch de Basea, Magda [et al.]. Urban environment and physical activity and capacity in patients with chronic obstructive pulmonary disease. Environmental Research, 2022, 214, 2, 113956. Disponible en: <https://www.sciencedirect.com/science/article/pii/S001393512201283X?via%3Dihub>. Fecha de acceso: 20 oct. 2022. DOI: 10.1016/j.envres.2022.113956
Link to the related item
This item appears in the following Collection(s)
- Ciències de la Salut [740]
Rights
Under a Creative Commons license
Except where otherwise noted, this item's license is described as https://creativecommons.org/licenses/by-nc-nd/4.0/