Pollution: How Is the Smog Affecting Our Health?

I look out the window and I can’t see the skies,

The air pollution is fogging up my eyes

I want to get out of this city life

And make like an ape man

- The Kinks, “Apeman”

We all have bad China days from time to time, but it’s those days when the blue skies are most elusive that we seem to feel the most blue. As much as air pollution may feel like a Chinese phenomenon, it’s been around for decades in big Western cities like London and LA. Case in point, it features in The Kinks’ 1970 hit “Apeman”. It’s a rock ballad about a disenchanted city dweller dreaming of swapping his existence in a concrete jungle for one in a tropical jungle – a familiar bad-air-day fantasy that the London-based rockers would’ve been very familiar with. Eighteen years before the song was released, London was infamously blanketed for five days under a terrible coat of smog in an event known today as the Great Smog. This period of heavy pollution is thought to have caused over 8,000 deaths from respiratory illnesses in the following months (1). Fast-forward to 2018 and China is at a similar stage in its economic development as London was at that time. We in Beijing are in the thick of it and, while you may be aware of the way those high-AQI days make you feel, scientists aren’t sure what it’s doing to our bodies in the long term. Even though air pollution is nothing new, research about its effects on our health is still in its infancy. 

“When it comes to air pollution, we talk about PM2.5 particles and PM10 particles,” says Dr. Nan Zhang, part-time pulmonologist at Beijing United Family Hospital (BJU). These particles are smaller than 2.5 micrometers and 10 micrometers in diameter respectively (a micrometer is 1,000 times smaller than a millimeter). “There are also larger pollutant particles, like dust,” she continues. “These get trapped in our noses and respiratory tracts and can’t reach the lungs, whereas PM2.5 and PM10 particles are small enough to get into our lungs and become deposited into our lung tissue.” Having very small pollution particles becoming deposited in your lungs certainly sounds a little scary – but the concerning thing about it all is that we simply can’t say how this will affect us in the long run. “There aren’t any large-scale studies on the effect that these particles are having on our bodies. Some studies are being carried out in China and they’ve been doing research for many years but there still isn’t any data. Perhaps in three or five years we’ll have data,” Dr. Zhang explains.

So, for now, we can focus on what we do know based on observational evidence, both in terms of how we feel as we go about our days in the Big Smoke and in terms of what our health practitioners notice as they treat us. “I’ve been working for over 20 years as a pulmonologist,” says Dr. Zhang. “In the past five years, I’ve seen an increasing number of patients with asthma and patients with a persistent cough. Twenty years ago, because China’s economic development wasn’t like today, and many people would burn coal to keep warm. At that time, it was more common to get chronic obstructive pulmonary disease (COPD),” she explains referring to a chronic disease caused by long-term exposure to irritants in your airways. COPD, which is often found in smokers, is now the third-leading cause of death in the USA (2) but, as Dr. Zhang observed, it was more prevalent back in China’s more enthusiastic coal-burning days. “Burned coal results in larger particles, so I imagine that pollution, with its smaller particles, is more detrimental to health – but I don’t know for certain,” says Dr. Zhang. “I have seen reports that link pollution to issues in areas such as blood vessels of the heart as well as the eyes and brain, but there still hasn’t been conclusive evidence.” She adds that she’s also seen reports claiming that pollution can cause tumors or other pulmonary diseases but points, once again, to a lack of reliable data that would prove this. “Definitive results on something like this would take a very long time – five or 10 years – and we simply haven’t been studying the effects of pollution for long enough. Only in the past seven years or so have we been paying attention, and realizing that pollution is bad for the body. Perhaps, in five or 10 more years, we’ll be able to see reliable data about the longer-term effects.”So, how does this all affect you as intrepid citizens of the world who find yourselves in China for a few years? Dr. Zhang explains, “When foreigners come to China and are suddenly exposed to pollution, they may find that, if they get an infection of the airways, the infection may be worse and the recovery time will be longer than it might’ve been back home. Soreness in the throat, fluids, and coughing may be more significant. They may find that their recovery will be quite slow while they’re here but, as soon as they leave the pollution, they’ll feel much better, even without medicine.” Dr. Zhang adds that improving your environment as much as possible to ensure you’re breathing in clean air (wearing a mask outside, getting air filters inside, and washing your face and skin on polluted days), and possibly even taking certain allergy medications, could help you recover faster. 

Other foreigners may come to China and be completely unfazed by hazy days while their peers develop irritations and infections in their airways. “People who are most susceptible to issues related to pollution are children and the elderly – as well as those with more sensitive lungs. The defenses in their lungs are weaker. They’re more likely to develop issues like asthma and COPD and then develop more pronounced symptoms. 

Change the filters in your air purifiers often so your lungs look like the clean filters on the right, not the dirty filters on the left

No matter where you fall on the spectrum of lung sensitivity, it remains advisable to do your best to mitigate your exposure to pollution. We still don’t know exactly what it’s doing to our bodies but, until we have more information, it’s safer to assume that’s it’s not doing us any good. To be on the safe side, and to prevent issues like COPD, asthma, and persistent coughs, try to keep your environment as smog-free as possible. Ensure your purifiers are in good working order, replacing your filters when needed. Look for weak spots in your house where polluted air may be entering (under your front door and through the windows) and do what you can to insulate these areas. Wear a pollution mask outdoors when the smog gets heavy. Scrub your skin of pollutants when you get home from a long day in the smog. And finally, if you do develop any discomfort in your airways, or if you’ve been coughing for several weeks, go to see your pulmonologist to see if there’s something else that can be done. 

Dr. Nan Zhang is a part-time pulmonologist at BJU, taking appointments on Thursday afternoons. She speaks English and Mandarin. To make an appointment with her or with one of our other expert pulmonologists, please call the BJU Service Center at 4008-919191.References

(1) A Retrospective Assessment of Mortality from the London Smog Episode of 1952: The Role of Influenza and Pollution. 2004: Bell, Davis, and Fletcher (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1241789/pdf/ehp0112-000006.pdf)

(2) American Lung Association (http://www.lung.org/lung-health-and-diseases/)

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