Spatial analysis of physical activity and ambient air pollution in Kuwait: a cross-sectional study.

Air pollution may be associated with lesser physical activity (PA), a major risk factor for cardiometabolic disease. Such an analysis has not been conducted for Kuwait, a major petroleum-producing nation with some of the highest rates of diabetes in the world. This study aimed to assess the associations between spatiotemporally expressed ambient air pollutant concentrations and PA in Kuwait. A cross-sectional study was conducted from 2011 to 2014, involving 2529 adults ≥ 18 years. Participants were classified as physically active if they exceeded 600 MET minutes per week. Monthly mean air pollutant concentrations (hydrogen sulphide, nitric oxide, nitrogen dioxide, nitric oxide, nitrogen oxides, ozone, and PM10) were spatially interpolated to local residential areas using data from local monitoring stations. Random effects logistic regression analysis was conducted to assess the associations between PA and air pollutants (an alpha level of 0.05 was used for all statistical tests). Participants were predominantly male (63%) with mean body mass index 29.3 kg/m². 52% were physically active. The overall air pollutant score was inversely associated with PA (adjusted odds ratio: 0.87, 95% CI 0.79–0.95). A  10 mean increase (ppb) in air pollutant concentration was associated with proportionately lower odds of being physically active for hydrogen sulphide (10%), nitric oxide (14%), nitrogen dioxide (16%), and nitrogen oxides (14%). In contrast, a 10 increase (ppb) in ozone concentration was associated with 15% greater odds of being physically active. Our findings highlight for Kuwait a high level of insufficient PA and a previously undocumented negative association between PA and air pollution, particularly nitrogen-based pollutants and hydrogen sulphide. Research is required to evaluate how air pollution may inhibit PA and whether reductions in emissions could increase PA in Kuwait.