I’ve previously discussed outdoor pollution, a common worry for expats. Less commonly discussed but possibly more concerning is indoor air pollution. It’s important to realize that a poorly ventilated house can have more dangerous air than outdoor air — especially if a smoker lives there.

Someone (thanks, Liora!) passed along to me an outstanding review of air pollution in China and the dangers to children. Published in 2008 by Pediatrics journal, I think it’s important reading as well as an excellent review of the data. And there’s a lot of data that shows how indoor particulates of PM2.5, carbon monoxide, sulfur, etc. can often be much higher than outdoor air. And there is also a lot of data showing increased childhood lung disease and asthma; cancer risk; impaired growth and developmental impairment. Fortunately, there’s also good data showing clear improvements in health when aggressive measures are taken, such as cutting out leaded gasoline or shutting down local coal plants.

The Main Culprits

In the US, the main concerns of indoor air pollution are radon seeping from the earth, and tobacco particulates. For expats here, the most concerning indoor pollutions include chemicals in building materials, paints and finishings; tobacco; and outdoor air not circulating well. Mold and bacteria are less of an issue here due to the very dry weather, but this can actually become a problem when using winter humidifiers that aren’t cleaned often or properly (good breeding tanks for bugs). For many Beijingers and especially rural Chinese, indoor coal and tobacco smoke are the greatest threats.

Tobacco

As usual, tobacco is one of the most dangerous substances, and probably the easiest to remove (stop smoking indoors!). There is a huge amount of evidence that indoor tobacco, and the 4,000 chemicals from cigarette smoke, has a serious impact on childhood illnesses, both short and long term. It’s estimated that 200 million Chinese, mostly women and children, are at risk from indoor tobacco smoke.

Again, this is a lifestyle issue where you can take personal, empowering control:

1. To protect others, never smoke indoors yourself and aim to quit smoking, getting help to quit if necessary from competent health professionals
2. Keep a smoke-free home both to protect your family, guests and household staff, and to reduce your own tobacco consumption if you are a smoker.
3. Patronise voluntarily smoke-free restaurants, of which there are hundreds in Beijing, and tell them why you appreciate a smoke-free environment.  If a restaurant or bar is very smoky, ask for the non-smoking section, and if that is not smoke-free, tell them that you will come back only when they can offer a smoke-free healthy environment.
4. Don’t give gifts of cigarettes – this is a gift of sickness and death – and don’t offer cigarettes to others.

You can find other resources on tobacco from the WHO’s Tobacco Free Initiative website. There is also a lot of data from the Tobacco-Free Kids website.

Top Tips For Home

The American Lung Association has good information about indoor pollution, including the tips below on making your home safe:

1) Declare your home a smoke-free zone. Secondhand smoke can cause serious health problems, especially for children. Ask smokers to take it outside.
2) Good ventilation reduces indoor air pollution. Leave doors between rooms open most of the time for better air circulation. Open windows when possible to allow for a good supply of outdoor air. Install exhaust fans in bathrooms to remove moisture and chemicals from the house.
3) Keep humidity levels low with a dehumidifier or air conditioner, as needed. Clean both regularly so they don’t become a source of pollutants themselves. Fix all leaks and drips in the home, as standing water and high humidity encourages the growth of mold and other biological pollutants.
4) To prevent carbon monoxide poisoning, have all fuel burning appliances inspected by a qualified technician once a year. Install a carbon monoxide detector near your sleeping rooms.
5) To keep dust mites and other allergens to a minimum, clean regularly. Wash bedding materials in hot water (at least 130°). Consider replacing carpet with area rugs that can be taken up and washed often.
6) Fit your gas range with a hood fan that exhausts the air outside. Use the fan or open a window when cooking to remove gas fumes.
7) Check commercial cleaning products and pesticides for toxic ingredients, and use according to manufacturers directions. Keep your home well ventilated when using these products. Consider switching to less toxic alternatives.

What About Air Filters?

I was already an air purifier user at home, and after reading these latest academic reviews, I’m even more comfortable with my purchase. There are quite a few choices for air purifiers; you can research the more common models and make your own decisions. I trust a couple websites for consumer reviews: ConsumerSearch.com is partly owned by the New York Times and has good reviews; and Consumer Reports also has reviews (paid website, sign up for free trial). Be wary of many websites which are often biased fronts for manufacturers or retail stores.

More Resources

The US EPA has fantastic information about indoor air quality, as well as a Guide For Health Care Professionals. The WHO also has multiple projects regarding indoor air pollution.