Impact of AIr Pollution on Athletic Performance and Health: A Comprehensive Review

Air pollution represents a major global health challenge and has been increasingly recognized as an important environmental factor influencing respiratory and cardiovascular function as well as athletic performance. During exercise, elevated minute ventilation and oral breathing increase inhaled pollutant dose and modify particle deposition patterns within the respiratory tract. Particulate matter (PM₂.₅ and PM₁₀), nitrogen oxides, ozone, sulfur dioxide, and carbon monoxide are among the most relevant pollutants affecting exercise physiology. Inhaled pollutants may induce oxidative stress, systemic inflammation, endothelial dysfunction, and autonomic imbalance. Biological effects are mediated through reactive oxygen species generation, inflammatory cytokine activation, and potential translocation of ultrafine particles across the alveolar-capillary barrier. In athletes, these mechanisms may lead to transient reductions in pulmonary function, bronchial hyperresponsiveness, decreased maximal oxygen uptake (VO₂max), and impaired exercise performance. Although short-term exposure may cause acute functional impairment, regular physical activity remains beneficial for health. Monitoring air quality, adjusting training intensity, and optimizing exercise timing are recommended preventive strategies. Further prospective studies are needed to evaluate long-term exposure effects on athletic adaptation and cardiovascular outcomes.