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June 30, 2008
NO PARTICULATE PLACE TO GO: Why the Air is So (Ob)Noxious in Beijing (Part III )

Of all the unpredictable-and highly volatile--competitors who will show up for the 2008 Olympics, none are going to be more fearsome than the 3-Hs of Haze, Heat and Humidity. While the latter two are a highly predictable fixture of the Beijing summer, it's The Haze (pollution) that promises to most affect the athletes (and the spectators!). That's because athletes in particular increase their level of ventilation with many track and field and endurance sports-and deliver a larger quantity of pollutants to the airways.

So, as each Olympic athlete no doubt evaluates his or her competition, let's look at the inside story around Haze and why it's the "wild card" no one wants to face during the Games.

The Chinese government, which represents 16 of the "Top 20" most polluted cities in the world, has been working hard to convince everyone that the severe air pollution in Beijing is improving and that it will not adversely affect the health of athletes in the Olympics. Recently, it reported that emissions of three of the most important pollutants, including sulfur dioxide, carbon monoxide and particulate matter had begun to decline.

While that may reflect a certain truth, China's overall emissions and associated pollution levels remain very high. And, they promise to grow substantially for many years to come because they are bound to the country's strong economic growth engine and its particular mix of industry and power sources.

Here's The Haze three component breakdown-and why there is absolutely nothing that any competitor can do to control the unnatural forces at work:

1. First, there's NO2 and SO2 (Nitrogen and Sulfur Dioxide) from factory emissions.

China depends heavily on coal as an energy source and has experienced rapid growth in some of the planet's biggest polluting industrial sectors, for example, cement, aluminum and plate glass. Eighty percent of the world's coal demand (for factories) comes from China. Twenty per cent of its emissions come from cement kilns, essential for growing construction needs. And when NO2 combines with oxygen in sunlight and hot temperatures, it forms ozone, the main component of smog. Ozone is a very noxious respiratory irritant that adversely affects lung function and performance. As ozone levels in the air rise, so do emergency room visits and hospitalizations.

2. Next, there's CO (Carbon Monoxide) from vehicle emissions.

China has become the world's third-largest car manufacturer and automobiles have become the country's leading air pollution source, including the 3.29 million in Beijing. Eighty percent of carbon monoxide (CO) comes from these vehicle emissions. CO is harmful and adversely affects performance because it reduces oxygen delivery to the body's organs and tissues. It is particularly harmful to those who suffer from respiratory and heart diseases.

3. And, last but certainly not least, there's Particulate Matter generated from construction dust and diesel exhaust.

Air quality experts calculate that up to 90 percent of deaths from air pollution in China are caused by tiny particles of soot, part of the Particulate Matter (PM) family of solids or liquids suspended in a gas. The biggest contributors in cities are ultra fine, airborne particles of diesel exhaust. Biggest natural sources of PM are dust, volcanoes and forest fires; biggest human contributors are the burning of fuels in internal combustion engines in automobiles and power plants, and wind-blown dust from construction sites and other land areas where water or vegetation has been removed.

PM levels in the air around Beijing--which sits in a basin that, depending on the wind direction, fills with smoke from factories or dust from construction sites or the Mongolian plains-may affect competitors in specific events on a day-by-day basis. PM inflames airways, sinuses, and eyes and can affect health and performance. Increased PM levels are linked to health hazards such as airway inflammation, a decline in lung function and possibly reduced overall longevity.

Speaking of The Haze collective and component effects on Olympic athletes, what about the three million visitors expected in Beijing to attend The Games? Spectators should limit their exercise because of the pollution and smog levels.... especially those with pre-existing heart or lung conditions. Those with asthma should take extra precautions, for example, a pre-trip visit to their physician to evaluate their lung function and devise a treatment plan should symptoms be triggered. Ditto for spectators with heart conditions.

To give you an idea of what athletes and visitors are facing, the following is a pollution level history from four of the past five Olympiads.

*Pollution Levels (micrograms per cubic meter):

Beijing (2008)

Particulate matter 89
Sulphur dioxide 90
Nitrogen dioxide 122

Athens (2004)

Particulate matter 43
Sulphur dioxide 34
Nitrogen dioxide 64

Sydney (2000)

Particulate matter 20
Sulphur dioxide 28
Nitrogen dioxide 21

Barcelona (1992)

Particulate matter 35
Sulphur dioxide 11
Nitrogen dioxide 43

Seoul (1988)

Particulate matter 41
Sulphur dioxide 44
Nitrogen dioxide 60

*supplied by The London Times, February 6, 2008


Part 1 - To Breathe Or Not To Breathe In the Beijing Olympics, That Is The Question

Part 2 - Running with the 3Hs: Maximizing Performance and Minimizing Short-Term Health Risks
Posted by Dr. Janis Schaeffer at 8:29 AM - Link to this entry  E-Mail This Entry
June 25, 2008
Running with the 3Hs--Maximizing Performance and Minimizing Short-Term Health Risks (Part 2)

For many Olympic endurance athletes who have prepared for years striving for medals and world-record times, Beijing's air pollution may present three vastly underrated competitors far tougher than any other athlete.

Their names: The "3Hs"--Haze, Heat and Humidity. On their own or collectively, they can prevent the kind of superior performance an elite athlete has worked so hard to create for the world's greatest multi-sport event. Plus present some short-term health risks.

Beijing's "3H" days are typically ones for which there are health advisories against outdoor exertion, especially for those with asthma and other respiratory conditions, heart disease, as well as the very young and elderly. It's definitely worth mentioning, that, as a matter of standard practice, pulmonologists would strongly emphasize that even "mere mortals" avoid any strenuous outside activities during these types of days.

Okay, most aspiring Olympians didn't spend the last four years complaining about the polluted environment they would face, they trained hard to bring their greatest performances and compete with the world's best.

So here's what Olympians need to know about maximizing performance and minimizing short-term health risks in Beijing:

1. Approximately one of four or five elite athletes have exercise-induced asthma. Anyone who has the least bit of concern about occasional breathing difficulty or cough during or soon after exertion should get checked out PRONTO. Since use of many asthma medications is closely regulated under the strict IOC anti-doping regulations, medical documentation of exercise-induced asthma must be completed prior to arrival in Beijing. Ditto for a therapeutic use exemption.

2. It's critical that an athlete with asthma have the condition under excellent control before arriving in Beijing. A careful review and tweak of the individualized treatment plan in partnership with a pulmonologist (lung doctor) or asthma specialist can be accomplished in quick order. Most importantly, the athlete should also have a contingency asthma plan ready to put into effect should air quality begin to trigger asthma symptoms.

3. Athletes should train in non- or less polluted areas, for example, Japan or South Korea, prior to the event. This action protects the lungs and airways from unneccessary irritation and inflammation, as well as a decline in lung function that occurs with exposure to pollution.

4. From the time athletes arrive in Beijing, they should utilize a high-tech activated carbon filtration mask that filters out a minimum of 80% of the main air pollutants. Utilize it until just prior to the event.

5. Olympians should maintain a well-balanced diet but immediately begin to incorporate foods rich in anti-oxidants (i.e., fish oil, fatty fish) and Vitamins C (i.e., fruits and vegetables) and Vitamin E (i.e., nuts, if not allergic). The objective: protect against some of the airway inflammation triggered by inhaling the hazy, polluted air.

6. Hydrate, hydrate, hydrate! Does this exhortation bear repeating under the circumstances? OK, so hydrate! The excessive heat (greater than 90 degrees) and humidity (greater than 95%) in Beijing at this time of year sets the stage for heat exhaustion and heat stroke. Ditto for sporting event spectators and attendees!

And while the Chinese authorities appear to be diligently applying an extra-strength series of "clean air" temporary bandaids in time for the Olympic Games, they are clearly offered in the face of long-term environmental challenges facing a rapidly growing, newly industrialized nation. Thus far, the Chinese have spent more than 17 billion dollars in an effort to decrease air pollution. In advance of opening ceremonies, they plan to halve the more than 3 million cars normally on the road, toughen car emission standards, regulate the opening and closing times of gas stations and shut down factories and major construction sites.

Despite these best laid plans, the problem remains that Olympic athletes cannot train for pollution. So what should the mantra in the interim become for the Olympic athlete with asthma? Hope for the best, be prepared for the worst... to maximize performance, minimize risk.


Part 1 - To Breathe Or Not To Breathe In the Beijing Olympics, That Is The Question

Part 3 - No Particulate Place To Go: Why the Air is So (Ob)Noxious in Beijing
Posted by Dr. Janis Schaeffer at 4:50 PM - Link to this entry  E-Mail This Entry
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