Air Pollution and Its Effects on Sports and Exercise: A Narrative Review of Impacts and Mitigation Strategies.

Abstract: Air pollution presents a growing, significant threat to health among the general population. Athletes and individuals participating in recreational exercise are particularly vulnerable due to increased ventilation during physical activity. The detrimental impacts of various pollutants on cardiorespiratory function, cognition, and sport-specific metrics have been investigated. Therefore, focus within the sports community has shifted to both personal and organizational strategies to mitigate or even prevent these effects. Limited evidence supports reducing exposure time and proximity, transition to indoor activity, precompetition acclimation, monitoring air quality when choosing location, and the use of masks and supplements. In addition, special considerations should be made for the unique exposures and challenges faced by populations, such as warfighters, para-athletes, or those living in disadvantaged communities. There remains a need for detailed and evidence-driven guidelines on air pollution for those participating in sports.