It’s truly an amazing step, and I hope it gets even better over the next few months. I’d like to see a couple improvements:

• Correction, Feb 3: this reading is actually one monitor, on the western side of the city, and not a city-wide average, as I had incorrectly stated before. I’m told that other PM2.5 monitors will be added as the year progresses. Right now the PM2.5 data is a city-wide average. I’d prefer to see hourly updates from each of their monitors. As you can see from their PM10 data, the readings vary widely between city districts and between rural and urban monitors.
• I’d also like an archived database to access previous results
• There is no AQI posted for each PM2.5 number, which decreases its real-world usefulness. You have to convert yourself (just multiply the PM2.5 reading by 1,000 and use this online calculator)

How Does It Compare?

One obvious question is: how do the numbers compare to the US Embassy’s famous Beijing monitor? I’ve checked a couple times and found the numbers relatively the same:

• January 26 morning (10 readings): US Embassy is 73 ug/m3 (= AQI 155) and BJMEMC is 80 ug/m3 (= AQI 159)
• January 27 morning (10 readings): US Embassy is 93 ug/m3 (= AQI 167) and BJMEMC is 72 ug/m3 (= AQI 155)

It’s only a couple readings so far, but those AQI differences are surprisingly and reassuringly similar.

Now What?

I really give credit to the BJMEMC for pushing this data many years ahead of schedule. It’s a very positive step which should be acknowledged. China is now ahead of many developing countries, which mostly publish only PM10 data. So now that there is official data, what’s next?

• Will the US Embassy shut down their site, since it technically is no longer needed?
• Will local schools start having air pollution action plans?
• Will such data actually quicken public efforts to clean the air?

Stay tuned…

PM2.5 Beijing Air Pollution Monitor

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On the January 11 broadcast of EZFM’s Beijing Hour radio show, host Paul James and I discussed the very welcome and long-overdue crackdown on the stem cell industry in China. We also talk about the astoundingly good news that the Beijing Ministry of Environmental Protection will start to publish hourly PM2.5 data by January 23rd — an amazing four years ahead of schedule. You can listen by clicking on the links above.

More Podcast Information

You can always listen live to my radio interview each Wednesday around 7:35am Beijing time, on the Beijing Hour program on EZFM 91.5, which is broadcast from 7-8am every weekday by host Paul James. EZFM is the popular bilingual radio station on the China Radio International network, broadcasting here in Beijing and on multiple stations all over the world, as well as live online here.

You can listen to all my previous podcasts at the podcast archive.

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Step 1: Read Two Crucial Papers

The last two months have been amazing for anyone interested in public health in China. There has literally been an explosion of air pollution information in all forms of media, not only promoting the US Embassy’s PM2.5 monitor but actively discussing and criticizing many official air pollution stats. In other words, regular Chinese people have finally discovered what many expats in Beijing have already known for three years; the official PM10 daily pollution numbers were not nearly as helpful or as realistic as the US Embassy’s PM2.5 hourly feed.

This wonderful data explosion has culminated with two extraordinarily useful and detailed articles from two of my heroes of public health: Steven Andrews and Doctor C. Arden Pope III. Andrews wrote a dramatic research paper in 2008 discussing official pollution data in China, and last week on Chinadialogue he posted what is easily the most researched analysis to date comparing the US Embassy’s data with official data. It’s a must read.

The second is an even more scholarly article from Dr Pope, who has authored or co-authored most of the most important research on air pollution over the last 20 years. In his latest spectacularly useful research from Environmental Health Perspectives, he analyzes death rates from heart disease and lung cancers caused by smoking and air pollution. The detail is stunningly useful, and it also provided me with the data I needed (finally!) to actually measure mortality risk of air pollution, as well as to answer my original question above.

Step 2: Do The Math

First, just what is an average day in Beijing? We get rightfully scared about these occasional 500′s, but those are rare peaks. From Andrew’s paper, we get the data that the official average PM10 level from 2010 is 121 µg/m³, which converts to an AQI of 84, which is “Moderate” on the US EPA’s guideline. Andrew also did us all an enormous benefit and calculated that the US Embassy’s average daily PM2.5 over the last two years is 100 µg/m³ (which converts to an AQI of 171, “Unhealthy” for the US EPA).

Now we know the daily data. So how much of these particles do we breathe in a day? First, we need to know how much air an average person breathes. This can vary in the research literature, but our esteemed Dr Pope mentions that most studies use an average adult inhalation of 18m³/day of air. Now we can do our calculations. If we use:

• PM10 data: 121 µg/m³ x 18m³/day (÷1,000 to convert µg to mg) = 2.2mg/day of inhaled PM10
• PM2.5 data:  100 µg/m³ x 18m³/day (÷1,000 to convert µg to mg) = 1.8mg/day of inhaled PM2.5

Since Pope’s studies mostly use PM2.5 data for comparisons, we will focus mostly on PM2.5 and not the “official” PM10. As you can see, it’s not a stretch to use the US Embassy’s “unofficial” data, as 2.2mg and 1.8mg are relatively close numbers, in my opinion. Also, since it’s estimated that Beijing’s PM2.5 concentration is roughly 85% of PM10, then the numbers mostly are equal.

Step 3: Compare To A Cigarette

Pope also uses the research standard that an average cigarette contains 12mg of inhaled PM2.5. Yes, there are differences in smoking habits (some of us even claim “I didn’t inhale”…) but this seems to be the standard in most research literature.
So if we compare the above numbers:

• PM2.5 data: 1.8 mg/d air pollution ÷ 12 mg cigarette = 15% of one cigarette

That means that a daily dose of Beijing’s average air pollution is equivalent to 1/6 of one cigarette. Do we agree? If so, let’s continue analyzing this shocking finding.

What About The Really Bad Days?

So what about the really bad days when the US Embassy’s 24-hour data hits “Very Unhealthy” 200; “Hazardous” 300 or “Crazy Bad/Beyond Index” 500? Let’s find out. First, you must convert the AQI to PM2.5 concentration, which is easy to do with the online calculator:

• AQI200 = 150µg/m³ x 18m³/day (÷1,000) = 2.7mg/d ÷12 = 23% of one cigarette a day
• AQI300 = 250µg/m³ x 18m³/day (÷1,000) = 4.5mg/d ÷12 = 38% of one cigarette a day
  
• AQI500 = 500µg/m³ x 18m³/day (÷1,000) = 9.0mg/d ÷12 = 75% of one cigarette a day

This means that even with an extremely rare average of 500, that’s still equivalent to smoking less than one cigarette a day!

What About Your City?

What about Shanghai, or Mexico City, or LA? Just find out the average daily PM2.5 concentration or AQI and plug in the numbers! For example:

• City X: PM2.5 concentration =  __ µg/m³ x 18m³/day (÷1,000) = 0.27mg/d ÷12 = __ % of one cigarette a day

So What Does This Mean?

Honestly, I was quite surprised by these numbers (assuming I did the math correctly). I had grown up hearing apocalyptic quotes such as “living in Mexico City is like smoking a pack a day”. Well, that just seems preposterous right now, in any city. According to Pope, a pack a day equals 240mg of PM2.5, which would be equivalent to a daily PM2.5 concentration of 13,333µg/m³, which is essentially impossible! So how on earth did such misleading urban legends start? And how can no scientist or reporter have answered this common question when these stats have been in Pope’s research papers for years?

My next reaction, as I’m sure many of you feel right now, was this: does this mean that air pollution isn’t as serious as we thought? I say no, it doesn’t mean that, but this data certainly puts things in a new perspective.

My Bottom Line

Once the shock wore off, a few major points lingered with me:

• Yes, this number is a lot lower than I would have assumed. But this absolutely does not mean that air pollution is now less dangerous. Hundreds of studies, many by Dr Pope, have documented the very real health risks of air pollution. And many studies have documented improved community health conditions after their air was cleaned up.
• But my #1 take-home message is that smoking is an astonishingly toxic and destructive addiction, and is far, far worse than the worst air pollution in the world. Even one cigarette a day is more toxic than a day in any city in the world! And China, with limited public health budgets, would get magnitudes more national health benefit if they focused on eliminating tobacco use when compared to eliminating high air pollution.

There is, of course, a much more important question than the parlor trick above: how much does air pollution increase mortality risk? I’ll try to answer that in a post for next week, but here’s a sneak preview of the crucial data from Pope’s article, discussing mortality risks of lung cancer (on the left) and heart disease (on the right) from PM2.5:

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View This Poll

AQI 500 US Embassy Crazy Bad

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First, The Boring Tech Stuff

It’s very important to know that my home’s machines did not have new filters, so true comparisons to these new Alen Air machines cannot be done. My Blueair’s filters were at least 4 months past prime, and my IQAir’s pre-filter was in the red zone. (Still, their data is also interesting). Anyway, I spent a few days wheeling around each machine in one of 4 rooms:

• library, small bedroom and master bedroom: each around 10-12 square meters
• front living room, itself 30 square meters and open into a large hallway and dining room, with no doors

I then measured each room’s pollution levels with a handheld Particlescan machine. This machine measures PM0.3 particles, which are much smaller than the PM2.5 which the US Embassy monitors. These tiny particles are what most scientists think are the causes of pollution-related lung and heart disease, as they easily get absorbed into the blood stream via the lungs.

I was “lucky” enough to be testing on days with the US Embassy readings in the high 200′s, so this was definitely a real-world challenge for any purifier.

The Real World Results

The good news is that both Alen Air purifiers did quite well, and indeed better, than last year’s tests of the IQAir and Blueair. For example, on average:

• The A375 filtered out 94% of PM0.3 (96% at max setting) compared to the unfiltered part of my house (the hallway and back rooms); this was the best number I’ve had for any machine
• The Paralda filtered out 80% (83% at max), also very good
• My oldish-filtered IQAir filtered 76%
• The older-filter Blueair filtered 66%

Another very positive point is that all purifiers did really well in bedrooms with doors closed. In fact, all four machines at maximum settings removed 95-99% of PM0.3! At quieter settings it was less awesome but still very good. I think this is powerful proof that air purifiers in bedrooms can dramatically reduce your pollution risk while you sleep — an issue especially crucial for infants and children.

In last year’s results from my previous apartment:

• The IQAir filtered 74% on average, 84% at max setting
• The Blueair 501 filtered 74% on average, 82% at max setting
• In the small bedroom with closed doors, IQAir filtered 79%, blueair 73%
• In the larger, open dining room, IQAir filtered 61%, Blueair 67%

Compared To Outdoor Air? Awesome

Don’t forget that the above numbers are comparing filtered rooms to a “control” room in a separate part of the house. So if you compare these above numbers to outdoor air, they perform even better. For all readings, I also stuck the Particlescan out of my 15th floor window and recorded this data.

On average, indoor air PM0.3 in my unfiltered hallway was 53% of outdoor air. I think that’s pretty good, and it’s a lot better than my previous apartment a couple years ago, which usually was around 70%. I think it shows how proper ventilation and window protection can help.

But what that also means is that these machines did even better than the numbers above. For example, if you’re comparing each room to outside air, the A375 got rid of 97% of anything bigger than PM0.3. Also:

• Small rooms with closed doors were 95-99% cleaner than outdoor air
• Open, large room was 29-39% cleaner than outdoor air

Don’t Forget Hunter, and Others

Last year I also wrote about a smaller and cheaper HEPA filter from Hunter, which in my readings routinely eliminated 50-70% of PM0.3 pollution even with the constant door opening in my 12-square meter office. At max speed with the door closed for a while, it got 91% of the pollution.

The Bottom Line

Clearly, with good filters, all these machines do really well in smaller rooms with doors, and I’m sure a bunch of other HEPA brands may also be ok. The larger rooms are always more difficult for all, but for the most important room — your bedroom — many HEPA models will probably be fine. Major differences between HEPA models include:

• Price
• Room size
• Reputation
• Noise
• Replacement filter costs
• Resale value
• Other “features” (ozone, UV, remotes…)

Y’all can research all this other stuff; I’m just providing some real-world data to add to your decision mix. By the way, here is what Consumer Search says about the Paralda and the A375.

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First I’d like to share my email exchange, almost verbatim, with Respro. It’s a bit technical but the science data is important:

Hi Dr Richard,

We have a European Standard that being EN149 FFP1. The tests carried out are done with particles 0.5 micron in aerodynamic diameter. We do not have Niosh testing (American), EN149 FFP1 is equivalent to N95 – FFP3 is equivalent to N99

Our products are primarily used in non-industrial sectors; motorcycle, cycle markets, some like the FB-1 mask are used by fire police and rescue services in the UK. We feel that it is important for our products to conform to industrial standards as a measure of effectiveness when marketing to the general public. Our products conform to technical specifications of European Standards for PPE (personal Protective Equipment) and our Sportsta and FB-1 masks which both carry P1 certification for lsolid and liquid aerosols ie dusts and mists, were CE Certified for use in industrial environments

EN149 is a homologated European standard applicable for the use of facemasks in the workplace for the filtration of dusts and water soluble aqueous mists. The test protocol used is primarily based on the masks ability to filter a given percentage of particulate material by means of seal and filter media.
The size of particle used in the tests are 0.5 microns in aerodynamic diameter. This particular part of the test is called the inward leakage test. Our Sportsta and Techno masks are rated at and average of 88% and conform to FFP1S levels. (my emphasis) This not to say that the cannot perform more or less efficiently.

Clearly fit is a major issue and the reason why we have two sizes and for the Respro Allergy mask we have four sizes…

URBAN POLLUTION AND FILTER TYPES
Traffic pollution is a cocktail of different gases vapours and particulates. There is no valid test for vehicle pollution and its uptakes, however some studies have suggested that wearing a mask reduces the incidence of cardio vascular disorders.

We use industrial standards for comparison:

Our filters are lab tested for uptakes against various chemicals which are listed below.

Our particle filter material is tested to 0.3 microns in size. The results confirm that 99% of all particles passing through the media is trapped. The typically range of particles found in industry which is where the material is normally used is 0.5 microns in aerodynamic diameter. Typical ranges of particulate pollution are from 0.5 to 10+ microns.

Filter Types:

We offer several types of filter all of which are interchangeable within the range of masks providing they are the same size.

1. Sports filter – for sub-micron particle filtration (Respirable dusts

2. City filter – for micron particle filtration (inhaleable dusts PM10) and Organic vapour uptake. (City Mask/ Nightsite mask standard issue)

3. Techno filter – for sub-micron particle filtration (Respirable dusts

4. Allergy Particle – for sub-micron particle filtration (Respirable dusts

5. Allergy Particle/Chemical filter – for sub-micron particle filtration (Respirable dusts

PM10: = ABOVE 10 MICRONS IN AERODYNAMIC DIAMETER SIZE
PM1: = ABOVE 1 MICRONS IN AERODYNAMIC DIAMETER SIZE AND BELOW 10 MICRONS
SUB MICRON: = LESS THAN 1 MICRON IN SIZE
Particulate Types:

Inhalable and Respirable.

Inhalable particulates: are the particles big enough to be trapped within the nasal hairs and the mucous membranes at the back of the throat.
Respirable particulates: are the particles that pass beyond the nasal hairs and the mucous membranes of the throat and pass into the lung sacs and subsequent blood barrier. These particulates can carry carcinogenic chemicals used in petrol (benzene, pyrene, etc) to the blood barrier…

I hope this is of assistance and please feel free to ask any further advice.

Kind regards
Mairead McClean – Team Respro® Customer services
—————————————————————————————————————-

Dear Mairead,

Thanks for the reply, which is very informative! I have a question: you say that “results confirm that 99% of all particles passing through the media is trapped.”, yet you also say that “Sportsta and Techno masks are rated at an average of 88% and conform to FFP1S levels”. Are you saying that technically the filters are 99% efficient down to PM0.5, but in real world testing, the effectiveness is 88%? The difference is mostly due to fitting issues?

Thanks,

Richard

—————————————————————————————————————-

Hi Dr Richard.

You are absolutely correct in your conclusion,. The difference is due to ‘inward leakage’ Face masks are not hermetically sealed to the face so they have something called ‘inward leakage’. That is, a certain amount of unfiltered air will pass around the sealing point on the face. Some air will pass through the seal and as the nose is a very sensitive organ it will pick up minute levels ( PPB Parts per billion). Ensuring the mask is correctly fitted will ensure the minimum of inward leakage. This is why we have 4 sizes.

Respro Vs Totobobo: Who’s The Winner?

So I think 88% real-world is pretty darn good. But if you reread my Totobobo piece, a randomized controlled cross-over study showed a “median (interquartile range) 135-fold reduction in airborne particle counts” with Totobobo masks in a real-world setting in 22 healthy subjects. So real-world testing clearly shows Totobobo is more effective than Respro. I also much prefer Totobobo due to better pricing and also because it’s much less extreme-looking than the Respro series. But you can all make your own decisions; and Respro actually is more effective than I had thought. In any case, it’s nice to finally get this data!

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The most evidence-based official air pollution action plan for schools states that no outdoor activity should be held when the PM2.5 AQI is above 200, with severe restrictions from 150-200. Anyone who tries to enact school action plans with higher cutoffs of 250, 275, etc. really needs to provide strong scientific evidence why their criteria should be less stringent. Using higher cutoffs for the simple reason that this would be “too disruptive” is not a morally justifiable argument. And not having an action plan at all in Beijing, in schools nearby the US Embassy, is simply not acceptable. Local politics does not trump universal science.

I state this upfront because I wanted to get your attention to a good news/bad news document. The good news is that I’ve finally found two credible and official school air pollution action plans: one from the most polluted parts of the US in California, and another from the US Environmental Protection Agency’s website. I’ve been scouring the WHO and other places and this is the best I’ve seen anywhere. So that’s the good news: our local schools finally have a guide from credible sources for our own action plans.

The bad news is that their school activity cutoffs are likely much more strict than what most schools are now doing, and this means more limitations than before. And it soon could be even more strict, as the California scientists are discussing revisions which will lower their highest restriction from a PM2.5 AQI 200 down to 150. And that’s only for the healthy kids; for those with asthma and other diseases, the restrictions are even more strict. And since the annual average PM10 in Beijing is ~140 AQI, and the US Embassy’s PM2.5 readings are often higher, you see how disruptive such strict adherence could be.

The most important document is the image below, which comes from the PDF file you can download here. It comes from California’s San Joaquin Valley school system, based in Fresno county, which is the #2 worst area in the US for PM2.5 pollution and is thus a good model for us in Beijing. Their plan was only implemented last year, on Halloween day 2010. I’ve been conversing via email with their scientists and I am very impressed that they’ve based their findings on discussions with the Sacramento Air District, UCSF-Fresno, the medical advisory committee of the American Lung Association, California and the Fresno-Madera Medical Society. You can click on the image to get a bigger, more printable version:

AQI School Guide San Joaquin Valley RAAN PM2.5 Ozone

I’m sure that school leaders, teachers and parents may want to read the science they based it on. David Lighthall, PhD,  the Health Science Advisor for the San Joaquin Valley Air Pollution Control District, has graciously provided us with their top-sourced scientific evidence at the following links (his wordings from his email):

• “We sponsored a new epi study in the SJV that is now available at www.cvhpi.org. It found compelling evidence of how elevated PM2.5 in particular (even as low as 30 ug/m3 per day) resulting in an elevation of daily ER admissions for asthma with a nearly perfect linear concentration (dose) response function.”
• “The US EPA has created an incredible health policy reference document in the Integrated Science Assessment for PM, which was compiled as part of their scheduled review of the 2006 PM 2.5 and PM 10 NAAQS. It can be found at: http://cfpub.epa.gov/ncea/cfm/recordisplay.cfm?deid=216546#Download along with a companion Policy Assessment. In respect to your issue, I would recommend looking at the studies reviewed and their conclusions in Chapter 3, Source to Human Exposure, and Chapt. 4, Dosimetry. Also, Chapt 6, Health Effects of Short-term Exposure. (You can find even more PM2.5 info here: http://www.epa.gov/ttn/naaqs/standards/pm/s_pm_index.html“

The second official document is from the US Environmental Protection Agency, which last summer created a School Flag Program website. This provides their evidence-based recommendations on what schools should do during air pollution crises regarding PM2.5 and ozone.  Their link above has multiple handouts which may be invaluable to schools for setting up their own plans, as well as for providing the background on why these action plans are necessary in communities such as ours. They also have an incredibly useful PDF file, called “Air Quality and Outdoor Activities: Recommendations for Schools“ that gives exact details as to what schools should do at the different AQI levels for ozone. That’s the catch for now — it’s only for ozone and not for PM2.5, which is much more important to us here. The US Embassy’s monitor also publishes an hourly ozone AQI next to the PM2.5, but in general terms the PM2.5 is more important to monitor. I emailed the EPA and they are working on a PM2.5 chart for schools  – but they specifically mentioned the above Fresno county chart as the only one they were aware of for PM2.5.  Here’s a small screenshot of the ozone guide:

AQI Action Plan for Schools -- Ozone

My Bottom Line

I think I’ve made it pretty clear, today and over the last two years of this blog, that it’s my personal opinion that Beijing schools have a moral imperative to provide a safe environment for their students, and that air pollution action plans are now essential to us lucky Beijingers because we can access hourly PM2.5 data from the US Embassy — a luxury that no one else in China currently gets.

My views are my own, and mine is not an official policy statement of my clinic or any other company, so you’re perfectly welcome to disagree with me. Having said that, I honestly see no reason now why Beijing schools couldn’t simply adopt the San Joaquin Valley plan above (first image) and follow the US Embassy’s AQI. I think it’s perfectly reasonable to debate the cutoffs, but again you’d have to have a good reason why not to follow what seems to be the world’s most well-researched recommendations. And again, there really is no excuse for not having any plan at all.

One more thing: simply keeping kids inside the gym on bad days is not a total cure — not if your  school isn’t controlling their indoor air systems with proper air filters. If the kids are playing in the gym on an outdoor AQI day of 300 but the gym AQI is 250, that’s not much of a help.

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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.

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Air Pollution: How Bad Is It, Really?

One of this blog’s all-time most popular posts, this lays out the basics and also lists some of the top PDF files to read.

Air Pollution in China: New Slideshow

Here’s an easy, graphics-based way to understand this complex issue

Air Pollution: What About Indoor Air?

Don’t forget that 90% of our lives are spent indoors — and air pollution levels can often be worse inside…

My Air Quality Journal: 太可怕！

One of my personal favorites, this detailed my fun and frantic running around Beijing with my air particle monitor, detailing the surprising results.

Schools & Air Quality: Here’s A Sample Action Plan

This, and other pieces, have helped frame the debate in local schools to set up their own action plans. What does your school do?

How Good are N95 Masks For Pollution?

Masks are an essential tool during peak days, but you need to choose the correct ones.

Air Pollution in China: New Slideshow For Schools & Parents

Another slideshow, this time more for schools to show their students.

Indoor Plants: Natural Air Purifiers

Plants are natural anti-pollutants, but a few are even more so.

Using the Beijing Air Quality Index (AQI) – Part I

Here’s an always-popular piece from Chris Buckley walking us through the confusing AQI system.

Good News: Biking In Beijing Helps More Than Hurts

Yes, it’s true; on most days, the health benefits of outdoor biking far outweigh the risks.

Pollution Masks: Which Are Best? Consider Totobobo…

I detail the data on masks, especially my new consumer favorite, Totobobo.

Blueair vs. IQAir Purifiers: And The Winner Is…

This popular piece details my personal experience, including pure data, comparing my home’s IQAir and Blueair purifiers.

Air Pollution & Kids: Reviewing The Best Evidence

This newer piece details the research, unfortunately growing, which details the very real dangers of pollution exposure to a child’s lungs.

All China Expats: Here’s How To Find Out Your City’s Real-Time Air Quality

This is a how-to guide for other cities all over China to figure out their city’s hourly AQI, by using China’s new air pollution website

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So I’d like to refresh the facts for everyone:

You need to protect yourself and your children when the AQI is over 300. We’re not messing around here; these numbers are truly dangerous for everyone and are at the highest ranking in the EPA system. It’s especially risky for anyone with a bad heart or lung disease, as heart attack rates skyrocket during air pollution spikes. As for children, these air pollution spikes definitely can damage their still-developing lungs. Most international schools in Beijing would keep their students inside with AQI over 200 or 250, and certainly the current 300′s. In the USA, many air pollution alerts kick in after an AQI over 150. In the US, the EPA officially says “people with heart or lung disease, older adults, and children should avoid all physical activity outdoors” — and that’s for AQI >200! As of now, we are at 338 AQI…

Air pollution masks definitely work, especially the ones rated N95. Here’s again the graph that shows how well they work:

Don’t forget that the key is to find a mask that is certified N95; this is an official rating that the mask filters out 95% of particulate matter in the air. The best company, in my opinion, is 3M, which makes multiple versions of N95 masks mostly for professional use in hazardous jobs. They are the most effective, but unfortunately they’re not exactly consumer-friendly or pretty on the eyes. I’m sure there are many companies in China making N95 masks, but I just couldn’t vouch for them, so if you can get 3M, stick with that. They usually are a thick white rounded mask with yellow ties, such as this one:

Where to buy:

International clinics. Here at BJU, we sell the 3M N95 masks at the gift shop in our new hospital wing (lobby level, left side, behind the plants). Each mask is 16 RMB. I’m pretty sure that the pharmacies at SOS and the other clinics sell them as well.

Expat markets April Gourmet and Jenny Lou’s. I’ve seen most of these expat markets carry a pile of N95 masks, usually behind the cash registers. If you don’t see it, ask them! The Chinese words for mask is 口罩。So you could ask them for their “wu1 ran2 kou3zhao4″ 污染口罩 and hopefully they will understand. If they do not sell them, please ask them to buy them and keep them in stock!

Online Websites. This may be your best bet; you can order from a trusted website such as amazon.cn and buy a big box of masks, pay easily with credit card and get delivered, often for free. My favorite website is amazon.cn, and you simply search for “3M N95 口罩” and get yourself a box: this link (hopefully) takes you directly to their page of 3M N95 masks, including model 8210; a box of 20 is only 160 RMB.

I’m very wary of taobao and other sites, as I’ve heard that the counterfeit rates are extraordinarily high on many items there. Perhaps 3M also has a direct supply via their own websites?

Torana Air: Torana Clean Air Center is a store with two outlets in Beijing (here’s their website) and they sell my favorite air pollution mask, the Totobobo mask. As I mentioned in my article last year, Totobobo masks are the most consumer-friendly masks, can be cut down for kid faces, and their filters can be switched very quickly and extremely cheaply. They sell two versions for 150RMB each. They even come with a handy bag; I always carry one in my bag just in case I need it (which happens way too often…)

Local pharmacies and supermarkets. This is much more hit-and-miss, but especially local pharmacies may carry N95 masks since the H1N1 flu scare a few years ago. They should definitely carry regular surgical masks.

Watsons and 7/11. These stores don’t carry the hardcore N95 masks but they usually do have clean surgical masks, often from Japan or Korea, which are much better than nothing. If you look at the graph above, a properly fitted surgical mask (best with the metal nose-bridge to pinch tighter) can ideally filter 80% of particulates.

My Bottom Line.

OK, now you don’t have to feel helpless anymore since you now know where to get these masks. That means you now you have no excuse next time the AQI is over 200-250 (like, um, most days here…) And especially regarding the Totobobo masks, now parents have a viable option for their kids if they absolutely must be outside on the bad days.

Double Protected -- Totobobo mask and bike helmet

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Totobobo Masks Finally Available in Beijing	Flu News: Cheap Surgical Masks Don’t Work	Pollution Masks: Which Are Best? Consider Totobobo…

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