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Background  Air pollution has become a substantial environmental issue affecting human health and health-related behavior in China. Physical activity is widely accepted as a method to promote health and well-being and is potentially influenced by air pollution. Previous population-based studies have focused on the impact of air pollution on physical activity in the U.S. using a cross-sectional survey method; however, few have examined the impact on middle income countries such as China using follow-up data. The purpose of this study is to examine the impact of ambient fine particulate matter (PM 2.5 ) air pollution on physical activity among freshmen students living in Beijing by use of follow-up data.    Methods  We conducted 4 follow-up health surveys on 3445 freshmen students from Tsinghua University from 2012 to 2013 and 2480 freshmen completed all 4 surveys. Linear individual fixed-effect regressions were performed based on repeated-measure physical activity-related health behaviors and ambient PM 2.5  concentrations among the follow-up participants.    Results  An increase in ambient PM 2.5  concentration by one standard deviation (44.72 μg/m 3 ) was associated with a reduction in 22.32 weekly minutes of vigorous physical activity (95% confidence interval [CI] = 24.88–19.77), a reduction in 10.63 weekly minutes of moderate physical activity (95% CI = 14.61–6.64), a reduction in 32.45 weekly minutes of moderate to vigorous physical activity (MVPA) (95% CI = 37.63–27.28), and a reduction in 226.14 weekly physical activity MET-minute scores (95% CI = 256.06–196.21). The impact of ambient PM 2.5  concentration on weekly total minutes of moderate physical activity tended to be greater among males than among females.    Conclusions  Ambient PM 2.5  air pollution significantly discouraged physical activity among Chinese freshmen students living in Beijing. Future studies are warranted to replicate study findings in other Chinese cities and universities, and policy interventions are urgently needed to reduce air pollution levels in China.

The association between ambient fine particulate air pollution and physical activity: a cohort study of university students living in Beijing