Air pollution and elite adolescent soccer players performance and well-being; an observational study.

Beavan A, Härtel S, Spielmann J, Koehle M. Air pollution and elite adolescent soccer players’ performance and well-being; an observational study. Environ Int. 2023 May;175:107943. doi: 10.1016/j.envint.2023.107943. Epub 2023 Apr 27. PMID: 37146470.

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Take-Home Message

Greater air pollution during a training session or game relates to impaired performance among elite adolescent soccer players.


While physical activity, such as sports, is associated with positive health outcomes. However, aerobic activities, like soccer, could lead to prolonged exposure to air pollution. It remains unclear how air pollution influences an athlete’s health and performance.

Study Goal

The researchers completed an observational study to investigate whether air pollution concentrations at the time of play relate to elite adolescent soccer players’ performance.


Researchers used previously collected data from an elite U19 soccer team in Germany. The data included GPS data, wellness questionnaires, heart rate, and rate of perceived exertion for all training sessions and games. The authors then cross-referenced those sessions with air pollutant measurements from the area where the training or game occurred according to the GPS data. The authors focused on three air pollutant concentrations 1) coarse particulate matter, 2) ozone, and 3) nitrogen dioxide. All team members were included in the analysis, except for goaltenders. The data set included 26 games and 197 training sessions.


Greater concentrations of coarse particulate matter related to less total distances run and higher perceived exertion scores per session. Greater levels of ozone related to less total distance run and higher average heart rate. Similarly, greater levels of nitrogen dioxide related to a greater average heart rate. Finally, the total inhaled dose of ozone and nitrogen dioxide during each session related to wellness the next morning (e.g., sleep quality, physical performance).   


This study supports the hypothesis that air pollutants, especially course particulate matter, ozone, and nitrogen dioxide, relate with decreased performance and health outcomes. Determining whether air pollution causes poor performance or health outcomes can be challenging. However, these soccer players experienced different levels of air pollution throughout the season, which helps us better understand the relationship between air pollution and performance or health.

Clinical Implications

Clinicians should be aware that environmental factors can impact their athletes. While most clinicians cannot change the locations where activity occurs, clinicians may monitor local air pollution levels and advocate for shorter training sessions when air pollution is high. In the United States, the US Environmental Protection Agency offers the AirNow app to report local air quality.

Questions for Discussion

Do you monitor your local air quality? If so, how does that impact plans?

Written by Kyle Harris
Reviewed by Jeffrey Driban

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