Abstract
BACKGROUND: The Vital Capacity Weight Index (VCWI) serves as a pivotal indicator of cardiopulmonary function among children and adolescents, reflecting their tissue oxygenation capacity and athletic potential. This study delves into the influence of environmental greenness and physical activity on VCWI in children residing in China's economically prosperous provinces, who are exposed to air pollutants, namely PM(2.5) and O(3). METHODS: We performed a cross-sectional analysis using data from the 2019 Chinese National Survey on Students' Constitution and Health (CNSSCH), involving 62,987 students from the top eight provinces by GDP. Exposure to PM(2.5) and O(3) was estimated using data from the Tracking Air Pollution in China (TAP) platform. Greenness surrounding schools was assessed based on the China Land Cover Dataset (CLCD). Daily physical activity duration was used to classify participants into moderate or vigorous activity groups. Associations with VCWI were examined using univariate and multivariate logistic regression models. Interaction effects between air pollution and greenness or physical activity were assessed using additive models. RESULTS: Higher concentrations of PM(2.5) and O(3) were significantly associated with lower VCWI. In contrast, greater greenness coverage and engagement in vigorous physical activity were linked to better VCWI outcomes. Interaction analysis showed that increased greenness may enhance the protective effect of lower air pollution levels on VCWI, while the interaction between physical activity and air pollution was not statistically significant. CONCLUSIONS: These findings highlight the potential of green environments and active lifestyles in buffering the negative respiratory effects of air pollution among children. The results provide evidence to inform integrated urban planning and public health initiatives aimed at improving children's lung health.