Hi All -

Our family is planning a trip to Hong Kong & China for 3 weeks (leaving end June 2009; returning to NYC mid July 2009). Our youngest son is 13 years old and has always dreamed of visiting China which is why we are going. He has pretty severe asthma for which he is being treated and he is also extremely sensitive to cigarette smoke.

We hear that the pollution in Beijing is very bad and we are concerned that his asthma might act up.

What can you tell us about the cigarette smoke in China & Hong Kong? What about the pollution we hear about... is it really that bad?

Should we reconsider our trip? Or are there other asthmatics out there who have travelled to China & HK and were okay?

Please advise. Thanks.

zverybestfamily

Cigarette smoke is not existent in Hong Kong. It's as smoke-free as you can get unless you go to some bars - and that's going to change too.

But Hong Kong also gets the pollution from all the factories in the Pearl Delta region. Good news is that summer time, the prevailing wind is from the S or SW, so pollution is lower than in the winter. In fact, you may even find a few totally clear days in June.

Really the only person to ask for medical advice is a medical professional, and one familiar with your son's condition. But if he's extremely sensitive to cigarette smoke he's likely to have a difficult time in China, which has only recently started to introduce rather limited restrictions on smoking, which is omnipresent. Smoking is banned from buses, on planes, and on trains is restricted to the ends of the carriages, and there are some restaurants and large public spaces such as major shopping malls where you can now largely avoid the smoke. But no smoking signs, where they exist, are generally ignored unless there's someone in authority to enforce them. People smoke in elevators all the time, for instance. Not every adult male smokes his head off. It just looks that way.

Those who happen to visit Beijing in the autumn, for instance, when winds blow the sky blue, come back saying 'What pollution?' and those who live there just live with it. But in fact particulates in the atmosphere are often several multiples of the WHO maximum safe levels, and although the government got lucky with wind and rain during the Olympics, not only have most of the pollution restrictions in force then gone away, but nearby factories have been working harder in order to catch up with lost production. The general economic collapse, which has already seen vast numbers of bankruptcies and closures in the manufacturing sector may ease things a bit. It's manufacturing, power generation (mostly from low quality coal), domestic heating and cooking, and construction, not cars, that produce most of the problem. Ordinary robust visitors shrug it off with a few days of runny nose and pink eyes, and those living in cities with lesser pollution may not feel much effect. But expat residents often use filtered airconditioning systems as much as they can.

It should also be pointed out that while pollution levels vary across China, the whole country is heavily polluted in general, and it isn't only Beijing that suffers from very high levels of suspended particulates.

You might like to look at a few local comments and press reports:

http://news.imagethief.com/blogs/chi...-a-series.aspx

http://www.chinadialogue.net/article...ion-in-Beijing

http://www.guardian.co.uk/news/2005/...hina.pollution

http://www.wri.org/stories/2008/07/b...-isnt-the-cars

None of which stops me spending typically a few months a year in China, and, of course, most of China's very large population, asthmatics and all, live their lives there, although a steep rise in pollution-related diseases is just one of several time-bombs waiting to go off. I hate to say it, but a severe asthmatic should think twice about a trip there. However, professional medical advice should be sought. You can look at the index on the right side of this page:

http://english.mep.gov.cn/

to see the API for various Chinese cities. You'll note that many cities have worse readings than Beijing, although perhaps not many you'd want to visit anyway except Xi'an, which often has much higher readings. These are fudged by the government, of course, to make things look better than they are, but you can see if you can find a comparable index for your own city and perhaps share this data with your son's doctor to see what he thinks the impact might be, and what steps might be taken to alleviate the impact, if necessary.

There's a summary in English of the Chinese government's recommendations for different levels of particulates (accuracy of information unknown--this is Wikipedia) at:

http://en.wikipedia.org/wiki/Air_Pollution_Index

The Hong Kong interpretation is also given.

Peter N-H

Hi Z,

Some of the questions to ask yourself are:

1) how well controlled are his symptoms with the meds he's currently using?

2) will smoke/pollution easily trigger an attack or does he have some tolerance?

3) if he has an attack, can you manage his symptoms with the meds you have for him or does he require a trip to the ER?

4) have you consulted with his asthma doctor about the trip?

If you do go, and I hope you can, bring ALL your own medications from the US of everything you think your son could potentially need.

I have asthma triggered by foods including soy and other things and have been to China and am leaving in a few days for another trip.

Check with the doctor, tell him where you will be. Take all medicines you might need for the worst case.

I have been able to manage my asthma while there.

Have a great trip.

I can only speak from my personal experience. We visited China in the spring and the air pollution in Bejing, Xian and Shanghai were far beyond anything I expected. It was so bad that the sun looked like a filtered bright spot in the sky. As for cigarette smoke it is very prevelant in restaurants, hotels, etc.You plan on going in June/July which is likely the worst time for air pollution as the temps are hotter thsn spring or fall.If your son's asthma is as bad as you indicate and he is super sensitive to tobacco smoke I would not take him to China! If I were to still consider it I would do it in October.I know that others may disagree with me but as I said I can only speak from personal experience.

I`d go elsewhere. It isn`t worth the chance you would have problems. Especially since you are going for 3 weeks. It`s like pea soup. I still remember the burning throat, and watering eyes from being in China. Beijing wasn`t even as bad as Souchou.

My experience (from a 21 day trip in June 2007), is that pollution in China is far worse than you can ever imagine. By the end of our trip, we just couldn't wait to leave......and that was purely because of the air quality.

I would think very carefully about taking a child with severe asthma.

Cigarette smoking is everywhere.....in my experience.

I haven't been to China, but seeing the replies of other posters it now seems that it might be prudent to change your travel plans.

Your son is only 13, no need to rush him to China right now with these kinds of medical concerns.

Experience of myself and family is that after just 2 weeks in Hong Kong, more often than not (>50%) one will have some respiratory problem. Often just some cough, but it does happen.

And we have all lived in Hong Kong for years; just that we live in the US now. And air quality in most of eastern China is worse than that in Hong Kong.

Hello,
I am in my 40's and have had asthma and allergies my whole life, triggered by smoke, trees, animals, you name it. We went to China in 2004 for a month for an adoption and I had a very hard time. I would reconsider your trip until you son is older. My experience is below, but as an adult aged 40 when we went I felt that I could monitor myself and insist upon going to a hospital if necessary. There were days when I told my husband that if I woke him up and made hand motion across my throat, that would mean I could not breath and needed the epi pen. When we returned home my doctor said I probably should have been on prednisone during the trip. I would not want to put a 13-year old in the position of having to feel this way and not know whether to "sound the alarm" about an asthma attack. He would also know that he would be "ruining" the day for his family. I once held out as a child when we were at an amusement park -- till I blacked out and was rushed to the emergency room. So consider the pressure this will put on your son.

I consulted with my doctor ahead of the China trip and doubled the strength of my allergy and asthma medicines for a week prior to our trip and during our trip. However, the entire time we were there I felt very short of breath and felt like I was on the verge of my throat closing up.

In the first 'Non-smoking' hotel room that we had it smelled like a musty moldy ashtray. I could not lay down, and even reclining on pillows I coughed nonstop. I had brought an air filter mask. I had to go buy a new foam pillow, cover it with my allergy dust mite cover, my own pillow case from home, wear the face mask, and then be propped up sitting all night long to "sleep". Other hotel rooms were not as bad.

Our entire family ended up with upper respiratory infections and on antibiotics during the trip. At times I could barely walk up stairs, and there are a LOT of stairs when sightseeing in China.

From what I saw, there are no ambulances to rush your son to the hospital. If he has an attack, you would need to bring an epi-pen with you and hope that it is enough. I'd talk to your doctor about that and ask if you could not get your son to the hospital for an hour or more, woud he be okay?

I'm sorry for this negative reply but I'd be careful. This would be really hard on him I think.

BMarie

I’m a Brit who has lived in the West of China for the past five years. We lived in Chengdu for 4 years - but the pollution was so bad - that a year ago we moved out to live in the countryside. When we travel back into the city we go through a smog border which starts about 10km outside the city outskirts - when we have sun out here inside the city there is often a haze - we were often sick when living in Chengdu, we haven't had any illness in our countryside home. We spend a lot of time traveling the country in the West of China - here we can still find clean air.
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Chengdu Travel Blog - http://chengdutravel.blogspot.com/

Pollution in Beijing is ok,not bad after Olympic Games,Like LA.
Smoke is every where here but you can find non-smoking area at nice restaurants.

Violet is a Beijing guide, and the self-serving view she puts forward here is, like so much else said by guides in China, highly misleading (to put it very kindly).

Work with the data provided and the views of foreign visitors whose views on and previous experience of air quality are likely to resemble yours, who have no national pride to worry about, nor financial interest in the outcome of your deliberations.