I’ve been in America for 2 weeks at conventions, and I must admit that I find Boston’s autumn blue skies absolutely thrilling. I’ve literally been oohing and aahing at the deep blue skies, which are radiating the bright orange leaves, crisp green lawn grasses and white picket fences. Life truly is easier to love when the skies are blue, and after living in Beijing for 5 years I deeply appreciate these rare moments of pure air. I’ve almost felt guilty  (well, ever so slightly…) after seeing the internet postings of last week’s Beijingair AQI days over 400.

In my never-ending quest of researching air pollution, I’ve collected a good library of my favorite articles which I’d now like to share with you below. As I have said multiple times, I think air pollution is a serious public health issue all over China which is obvious to all — and yet precious little actual intervention, treatments or warnings are provided to our community, at least officially. I personally think that we doctors, especially family medicine and pediatrics, have a moral and professional responsibility to do more to help our Beijing population with this issue. Indeed, the American Academy of Pediatrics, in their official position paper on air pollution, specifically mention:

in communities with poor air quality, pediatricians can play a role in educating children with asthma or other chronic respiratory tract disease and their families about the harmful effects of air pollution. Patients and families can be counseled on following the AQI to determine when local air-pollution levels pose a health concern… Pediatricians who serve as physicians for schools or for team sports should be aware of the health implications of pollution alerts to provide appropriate guidance to school and sports officials, particularly in communities with high levels of ozone.

So here are my top articles on air pollution, especially in regards to kids’ health:

• World Health Organization Air Quality Guidelines — this is the essential report, from 2005, which is the official guide for most countries
• The Effect of Air pollution on Lung Development from 10 to 18 Years of Age — one of the scariest studies, in NEJM, a prospective study showing decreased lung function in Los Angeles kids — at levels much, much lower than what we experience here every day
• “Seeing Through The Smog” — a big PDF file discussing air pollution. It’s a great review, from the Wilson Institute. They have a great collection of PDF articles from their China Environment Series.
• Air Pollution Threatens The Health of Children in China — a review from Pediatrics, 2008
• The World Bank: Cost Of Pollution in China – The very important 2007 report; a large PDF file to download. Read chapter 2, starting page 42, Health Impacts of Ambient Air Pollution
• Ambient Air Pollution: Hazards to Children — again from AAP Committee on Environmental Health, 2004
• Air Pollution and Children’s Health — another review article from the AAP, in 2004
• Ambient Air Pollution and Childrens Lung Function in China — a 2009 review showing decreased lung functions in Chinese children
• Children’s Response to Air Pollutants — a review from 2008
• Pollution & Life Expectancy in the US – an excellent, free New England Journal article (PDF file) from January 2009, plus the editorial and a fascinating interactive map – Pollution & Life Expectancy in US Cities
• Beneficial Cardiovascular Effects of Reducing exposure to Particulate Air Pollution With A Simple Facemask — this research (in Beijing!) offers very practical evidence on the use of N95 masks. 

OK, that’s enough to keep everyone busy for a few days. I don’t expect us to work miracles here; I just hope to share the evidence and continue the discussion, and at the very least have us Beijingers take proper precautions for our own families — and lead by example.