The 2013-2014 beijingkids Health Guide is the latest resource for Beijing families dedicated to providing information on family health care, maternity, eating and breathing safety, mental health, emergency care and traditional Chinese Medicine. Articles from the guide will be featured twice a week on our website. Find the full version here.
A recent study from The Chinese Society for Environmental Sciences revealed that the average incidence of asthma amongst children in China is a staggering 6.8% and rising. With asthma now being stated as the leading cause of hospitalization amongst infants in China, expats need to be well prepared for the pollution that they and their families are inevitably going to be exposed to in Beijing.
Dealing with Beijing’s pollution can be a big enough challenge for anyone. A dry cough, congested throat and feeling short of breath are common complaints for Beijing residents. But how does one cope when you add asthma to all of these problems? Dr. Pauline Tan, Chief of Pediatrics at Vista Medical Clinic, believes asthma is becoming increasingly common here in the capital. “It’s definitely gotten worse over time,” she announces. “Even in the seven years I’ve been at Vista, I can see a larger number of children coming to the clinic seeking treatment for asthma or related breathing issues.”
For families looking to protect their kid(s) from the Beijing smog she offers the following tips: “The first thing to be aware of is the triggers of asthma,” she advises. “Contrary to popular belief, exercising is not actually the biggest trigger for children. Nor are emotionally stressful situations,” she adds. “As they move into adulthood, exercise becomes more and more of a factor, but for very young children it has minimal impact,” she points out, adding that “Viral infections are what parents should watch out for the most as these can very often induce asthma in children. If your child is sick you should be keep him as far away as possible from places harboring a lot of bacteria, do not send him into school and most importantly, do not smoke in his presence. Studies have shown that children whose parents smoke are at a particularly heightened risk to developing asthma.”
Dean Phelan is 23 year old Irishman living in Beijing who suffers from asthma. He describes his asthma as quiet severe at home in Ireland but says that it has been a lot worse since coming to Beijing. “As an English teacher I have to avoid running around with the children during playtime completely if it’s a very polluted day. I can’t do it without gasping for breath,” he says. “Even running for a bus or climbing a flight of stairs was completely out of the question for me this winter when the pollution was at an all time high.” Phelan also stated that during the winter over 1/3 of his class was absent because of the pollution. “A lot of the parents actually took their children out of Beijing and back to their hometowns just to get them away from the pollution.” he says.
Dr. Tan explains that pollution levels are generally higher in the winter because there is more coal being burned, especially indoors. “People are actually exposed to the majority of pollutants indoors,” she explains. “If you think about it logically it’s where people spend most of their time.”
Dr. Tan advises Beijing resident to buy air purifiers and make sure their houses are properly ventilated. “Many homes in Beijing use gas cookers so this is particularly important. You should also avoid carpets, stuffed toys and any other items that can contain hypo allergens, and I would advise patients to shower in the evenings before they go to bed, especially girls with long hair,” she adds. “You collect so much debris and pollutants throughout the day and it can cling to your skin and hair. It’s better to wash it away before you go to bed so that you aren’t being exposed to it in your sleep.”
And although masks can help reduce pollution intake, they can be somewhat impractical because people just aren’t committed to wearing them. “Of the 24 children in my class, only one wears a mask on a daily basis and these will include many children that come in coughing and wheezing on a regular basis,” says Dean.
Wheezing is cited as one of the main symptoms of asthma and will often become more predominant during the onset of an asthma attack. Abdominal restriction (which can cause chest pain) is another telltale sign, as the abdomen contracts in an effort to draw in more oxygen. According to Dr. Tan, in these types of situations “everyone should have an asthma action plan.”
Asthma can be divided into either intermittent or persistent cases. “For the intermittent cases we provide patients with what we call inter-control medication,” she explains. “The most common thing prescribed for these patients is Salbutamol which taken by an inhaler.”
Persistent cases, the more serious of the two, are defined as a patient having two or more hospitalizations as a result of asthma in one month. “Maintenance meds are prescribed for these types of patients,” Tan elaborated. “A course of steroids is what is mostly used. The word “steroids” will often scare patients and parents,” she says, “but trust me they are necessary severe cases.”
In cases where the patients prescribed medication isn’t effective enough, patients should be brought to the hospital ASAP. “In some cases I’ve seen patients take two or three rounds of a nebulizer before being responsive,” Dr. Tan explains. “I know some parents who bring their child to a clinic everyday to get a dose of a nebulizer,” she adds. “If a child really needs it that much, you can rent the nebulizer from a hospital. Check with your local clinic.”
Dean says that aside from his doctor in Ireland telling him it was a bad idea to go to Beijing in the first place, he prescribed him with steroids before he left, in anticipation of the pollution affecting him badly. “It is actually worse than I was expecting” he confesses. “I take my reliever a lot more over here than I did at home and I have a supply of steroids at the ready just in case.” Phelan said that for him it’s about knowing what his own personal triggers were and what works best for him. “For me, Vicks Vaporub helps a lot,” he says. “It’s best to just stock up on what you need before you come over because you won’t always be able to find it over here. I’ve had friends bring over at least three tubs of Vicks for me since I got here.”
He also cites the lack of smoking ban in China as a problem for him. “Shisha pipes are definitely a personal trigger of mine. When I’m going out I would actually take the smoke levels of a bar into consideration, especially if they sell shisha pipes. Any incidents I have had over here have occurred after being exposed to smoke from shisha pipes. I just can’t be around them,” he says.
When asked if she had ever advised any patients to leave Beijing, Dr. Tan responds by saying that “she would give them the option. You can’t say it to a patient outright,” she said, “and it depends on their priorities because many parents have very high-paid jobs here. I would however, present the facts to them and tell them what it would mean for them and their family’s health if they were to stay in Beijing.”
Dean says that he “could never live in Beijing permanently. I can already see how badly it has affected my health,” he declares.
Every city has its ups and downs, but in Beijing’s case there is little one say to downplay the severity of its air pollution. It can be bad as people say it is and is a serious consideration for people who suffer from breathing problems. No matter how long you are committed staying in Beijing you should be proactive and practical about protecting your lungs while you’re here.
This article originally appeared on page 40-41 of the beijingkids Health Guide.
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Photos by Mitchell Pe Masilun and Sui