I’ve discussed many wellness topics on my expat health blog, but the major interest — by far — is air pollution. Beijingers are thirsty for quality information about air quality, especially regarding how could it affect their children. Let’s review the data now and also talk about healthy steps.

In terms of health risks, there is accumulating research that air pollution does cause both long-term and short-term risks, and children are considered more at long-term risk mostly because their lungs are still developing. For girls, lungs finish developing at 18 years, while a boy’s lungs mature by their early 20’s. The Academy of Pediatrics has an official position paper in 2004 (http://www.pediatrics.org/cgi/content/full/114/6/1699) which details the health risks and recommends an aggressive community approach, led by pediatricians, to ensure children’s health. One of most concerning research findings is from the USC Children’s Health Study (http://www.arb.ca.gov/research/chs/chs.htm), following thousands of kids in smoggy Los Angeles over 9 years, from 4th to 12th grade. The results showed a worsening of lung function over those years of exposure in those children who had the most exposure to air pollution. In Los Angeles, the average annual Air Quality Index is around 50, which is almost 3 times lower than here in Beijing.

So what can we do about this? I think community action plans, especially in schools, are important. As for guidelines, I think it’s useful to model the air pollution action plans from places such as Los Angeles, which is the most polluted city in the U.S. For example, California law calls an AQI over 200 (a PM10 level >350 ug/m3) as a Stage 1 Episode and asks that “outdoor physical education (PE) classes, sports  practices, and athletic competitions should be re-scheduled or canceled if practicable”. AQI levels above 300 and 400 are considered Stage 2 and 3, and they recommend “all children discontinue all outdoor activities”.

Many schools in Beijing are now following their own action plans using similar criteria, and most are following the air pollution numbers from the US Embassy’s particle monitor in Chaoyang, near east third ring. The best way to access this feed is from the website at iphone.bjair.info. The Chinese government now has a new website which also lists hourly pollution numbers from all over China, including many spots in Beijing. You can access this information at their official website at http://58.68.130.147/air/. It’s a bit complicated to use, but schools and parents all over China now can get the AQI for their area and make informed health decisions for their family.

It’s important to remember that we all spend about 80-90% of our lifetime indoors, so it’s also good to protect your indoor air, which often has similar pollution levels as outside. I do feel that indoor air purifier systems are very effective, whether it’s a stand-alone machine or built-in HVAC filters in your home vents and air conditioning units. Such machines, especially in bedrooms, are very effective in lowering indoor air pollution levels. Indoor plants also help a bit.

And when people must be outside on bad days (which I would say includes any AQI over 200 AQI), I recommend using a good protective mask. The key is to find a good mask, and industrial-grade commercial masks that say “N95” are the best. “N95” means that mask eliminates 95% of larger air particles; this theoretically would bring down an AQI day of 500 to a healthy 25 AQI. You can usually find good masks, especially made by the 3M company, at the local expat stores like April Gourmet or Jenny Lou’s. These masks became more available all over China after the recent H1N1 scare. Many masks are uncomfortable, especially for kids. The Totobobo company has comfortable and less awkward-looking masks made of comfortable transparent plastic. These can also be cut down to fit the smaller faces of your children. They currently are available only from their website but soon should have local distribution.

This article was originally printed in my monthly column in Beijing Kids magazine. You can click here to read the rest of my “The Doc Is In” columns.