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Air quality and health in China

I have always been very intolerant of smoke. My 姥爷—my maternal grandfather—was a heavy smoker; when I was very young, he came to the US to visit my family and had to smoke in the garage because I got upset whenever I sensed the faintest fume indoors. Even in the final days of his life, I only ever stopped by his apartment in Beijing but briefly on our quasi-annual family vacations there. If I spent any real length of time inside, I’d cough and make a fuss, wrap my shirt collar around my nose, and then start pawing at the door.

The city of Beijing is now much like my grandfather’s apartment was: I have family living in it and breathing there is hard.

Beijing’s air has always had its share of smog in my memory—the last time I visited, seven years ago, a haze moved in one day and dissipated only after a rain shower washed the muck into the earth. Buildings, or at least their facades, always seem to decay faster there than in most major cities I’ve encountered on this side of the world; the apartment my maternal grandmother —我的姥姥—lived in looked, just a few years after it was built, remarkably like the apartment my 奶奶 had called home for some fifty years. Still, in my memory, Beijing has always been a place with warm sun and blue sky, frequently enough at least. But apparently seven years is a long time, and I was totally unprepared for what I saw when I touched down at PEK this past June.

Surpri—*cough echkh ahem*—se sightlessness

What I saw was just a lot of grey. What I didn’t see, on the other hand, was an airport—or at least not the exterior of one. Beijing International had been renovated since my last time there, and it now featured an enormous multi-story atrium just past the international arrivals terminal, with floor-to-ceiling windows facing what should have been a mass of runways, terminals, shuttle rails, or at least some concrete or asphalt—but was instead a fat, sooty shroud of gaseous gunk. The atrium really was massive, the width probably of a football stadium, and it was the physical boundary of my visibility. I could see every detail on one side of the glass. On the other: lots of grey. A wisp of mushy green here and there—a tree or two, maybe, in the distance. Nothing more.

Ohai the sun. Why are you hiding?

I expected that the shroud would lift after a day or so, but unlike in previous years, even the rain failed to wash it away. I saw blue sky for no more than a full day out of the nine I was there for. Even outside the city, amongst the temples and gardens and picturesque mountains, it was always gloomy, always grey.

Eventually, I tired of not being able to see anything past a handful of blocks through the grainy veil, so I did a bit of homework. Why did it seem so much worse than seven years ago?

According to friends and relatives in Beijing, in recent years, the smog typically sets in during the winter (perhaps because more coal is burnt and people opt to drive in their warm cars instead of biking?), but fades as spring moves in and then transitions into summer. This year was an anecdotal anomaly. My memory of the air quality of Beijing-past could have been mangled by time, but one thing I felt very sure of was that the number of cars on the streets had indeed increased manifold since 2006, season notwithstanding. My grandmother’s apartment complex used to be pretty empty—nice for some short strolls—save for some bicycles by the building entrances. Now it was jam-packed with cars, filling up every curbside space, and then some.

Beijing does take some measure to prevent automotive pollution. Every car in Beijing is banned from the streets one day out of every week determined by its license plate number. (The numbers apparently are doled out randomly, and you can only buy one car every so often.) Families who have enough time, money, and luck to nab two cars with differing license plates modulo prohibited-day can evade this rule, but I suspect those people are few and far between.

Of course, when the Olympics were in town, each car was only allowed on the streets every other day.

City-wide smokers’ lounge

One of the resources I found this summer (readily available via a quick Google search—at least for someone like me lucky enough to have access to a foreign VPN) was this real-time Air Quality Index report. AQIs refer in general to metrics used by governments to communicate air pollution levels to the public; they vary in semantics by country. In China, AQI is reported for a number of different pollutants, the most prominent of which is probably PM2.5, which refers to airborne particulate matter less than 2.5 micrometers in diameter. These particles are of particular concern because they are small enough to easily bury themselves in your lungs.

At the time of this posting, within the last twelve hours, Beijing has spent four hours in “Hazardous” levels, and eight hours in “Very Unhealthy” levels for PM2.5. The US Embassy’s information on Beijing AQI describes the Hazardous level thusly:

Serious aggravation of heart or lung disease and premature mortality in persons with cardiopulmonary disease and the elderly; serious risk of respiratory effects in general population.

They recommend that

Everyone should avoid all physical activity outdoors; people with heart or lung disease, older adults, and children should remain indoors and keep activity levels low.

It’s hard to believe that Olympian athletes competed in conditions like these, where even indoors, it’s recommended that you abstain from activity. I have no concrete idea what the air quality was like in 2008—only that it was enough for the government to get concerned and start coming down hard on driving. But forcing your body to the pinnacle of human exertion seems like it might lead to an early death with your breathing materials in such a state.

The US Embassy also tweets Beijing’s AQI on an hourly basis. This has apparently been a touchy point for diplomatic relations, since the Chinese government doesn’t like their dreary atmospheric conditions being shouted to the world, claiming that the reports are “not only confusing but insulting” and talking of possible “social consequences”. They apparently don’t even like to report PM2.5 among their other AQI numbers.

I suppose this shouldn’t be terribly surprising. While I was in Beijing, the AQI tended to hover in the “Unhealthy for Sensitive Groups” (i.e., children, the elderly, and those with respiratory conditions) level, which is 101-150 on a 500-point unitless scale varying directly with the actual particulate density. It was maybe once “Good” (0-50) and sometimes “Unhealthy” (151-200). The Hazardous levels of the past twelve hours have gone as high as 331. But the highest recorded was earlier this year, in January, when the PM2.5 AQI went to 755. On a 500 point scale.

This is apparently enough to make the entire city vanish to the naked eye.

At that point, you’re probably worse off than if you lived in my grandfather’s old apartment—he at least had ventilation, and lived in a time before the air thought better of transparency, and decided to be opaque instead.

Soak it in

I started having constant mild headaches after a little while in Beijing, and I supposed it might have been the air; in any case, I decided to invest in one of those facemasks that so many Chinese tourists seem to wear here in the US. My parents and I stopped by a drugstore one morning as we were heading out to see more relatives, and were sold a pack of surgical masks.

Surgical masks are meant to halt the spread of communicable diseases. They are incredibly ineffective at stopping particulate matter less than 2.5 micrometers in size. This seemed intuitively obvious to me, since the masks aren’t tight-fitting and are open on the sides. I tried holding it to my face and attempting to make a seal against my nose, hoping that would be effective. Plenty of citizens roamed the streets with similar masks, but did no such thing—though my guess is that they wore the masks for their intended purpose, to protect from disease in the aftermath of all the flu scares from five years back, rather than to filter the air.

The only one of my relatives who seemed to actively appreciate the air quality issues, who knew immediately that my surgical masks were useless and gave me the kind of respirator that actually protects against PM2.5, was my eldest uncle. This uncle also happens to have been one of China’s Vice Ministers of Construction, urban construction in particular. But my other relatives, especially my mother’s siblings and my father’s parents, are all plenty well-educated as well. All of my maternal aunts and uncles got college degrees and held fine jobs before retirement. They certainly recognize the problematic air quality—but likely the problem is simply too ubiquitous, too hazy and insurmountable, for them to take such extreme action in their daily lives as to wear a respirator mask around outside wherever they go.

But on the other hand, they still open their windows regularly to let in air—even though the recommendation (and, I think, the common sense course of action) when the AQI levels rise and the city bathes in smog soup is to stay indoors and breathe filtered, air-conditioned air. Beijing frequently finds itself in conditions where respirator use is strongly recommended, yet they aren’t available from drugstores, and people instead go around wearing surgical masks for no convincing reasons. It’s as though there’s this haze of health-related ignorance mixed in amongst all the vapors of Beijing’s smog— and it extends well beyond just the issue of smog itself.

For instance, anybody’s who’s travelled abroad is probably at least passingly familiar with TD, every traveller’s favorite unspoken ailment. I contracted a case a few days into my stay. The consensus among my parents and my aunts was that I’d 吃的太猛了—I’d eaten too fiercely. They maintained this consensus five days later.

Excuse me—what? They said I had TD for five days because I ate too fast?

My condition was accompanied by a fever for a day or two, and one of my other uncles suggested that I soak my feet in ginger-steeped water. Infusing your feet with ginger, he said, alleviates fevers. My mother agreed with him, nodding in a sort of “Mmm, it makes sense, it makes sense,” sort of way.

This uncle happens to be a professor of sociology at Peking University.

I was floored. Not at the suggestion that ginger might have some medicinal utility, but rather, that their rationales for believing that it did involved mostly nodding and saying, yes, yes, that make sense. Ginger. Mhm, yes.

My one eldest uncle knows it’s best to just turn on the air filter when his home feels stale, unfortunate though it may be that he oughtn’t lift the glass to freshen up the room. He also prescribed something called montmorillonite powder for my TD. It seemed like another homeopathic remedy at first, but apparently it’s a kind of clay powder with certain detoxifying effects akin to activated charcoal, and has demonstrated effectiveness in treating diarrhea and other similar symptoms according to a small handful of medical studies.

So that’s something.

A second superpower

My grandfather’s old apartment was renovated years ago, and is now home to one of my aunts and her extended family, who all live there smoke-free—except, of course, when they open the windows for some fresh air.

Who will have to move out of China’s highest houses before Beijing can see this kind of detox?

A lot of people seem to talk about China becoming a second superpower in the world, standing on equal footing with the US or the West in general or whatever. My parents talk about this all the time (“You should learn Mandarin better and then start a company in China! That’s where all the growth and success will be soon.”). Personally, I think it’s still a long time coming.

Maybe I’m naive in this belief—but if so, I think it’s only because I underestimate the speed of global technological development. Sure, China’s economy grows by the minute—but I’m just not convinced that a culture of individuals so removed from basic social issues like breathing air quality and related health practices will emerge as a clear world leader in as short a time as, say, a decade. Maybe technology is far along enough that China won’t have to slough through their industrial transitional time the same way occidental nations did.

I’m not convinced it is, but I do hope so—I love visiting my relatives in Beijing, and there’s a lot that’s lovely about the place. It’s just a lot lovelier when you can actually see it.

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