Fascinating commentary in JAMA (related primarily to this article). The article and the commentary focus on the extraordinary pollution mitigation and control strategies undertaken by the Chinese government in the lead-up to the 2008 Olympics.

To ensure acceptable air quality during the Olympics (held from August 8-24) and the Paralympics (held from September 6-16), the Chinese government launched a series of aggressive measures to reduce pollutant emissions. To reduce industrial emissions, the operations of combustion facilities were restricted in smelters, cement plants, power plants, nonattainment boilers, and construction and petro-chemical industries. To reduce traffic emissions, certain vehicles and trucks were banned, 70% of government-owned vehicles were kept off the streets, and other vehicles could travel through the city only on alternating days.

The pollutant reductions are striking and substantial — reductions in mean concentrations of sulfur dioxide (-60%), carbon monoxide (-48%), nitrogen dioxide (-43%), elemental carbon (-36%), fine particulate matter (PM2.5, -27%), ozone (-22%), and sulfate (-13%), were reported. (Of note, even during the cleanest days in Beijing, mean concentrations exceeded the worst days in LA).

The study by Rich et al in JAMA (linked above) presents compelling evidence of changes in biomarkers due to the decreased pollution that point towards the vast potential for improved health with air quality regulation. The nitty-gritty scientific details are interesting, but more salient, I believe, are the policy ramifications. The reductions in ambient air pollution under the pressure of the IOC and widespread, international attention prove that change is possible, though at a potentially steep economic cost.

China’s dilemma, like many countries with emerging industries, is how to reconcile rapid economic growth with environmental protection. In recent decades, China has achieved industrialization and urbanization. However, China has been much less successful in maintaining the quality of urban air. Several factors challenge the implementation of air pollution controls in China: heavy reliance on coal as a main heating system, especially in subsidized housing; lack of political incentives for trading slower growth for less pollution; economic factors: most Chinese factories and power plants run on extremely thin margins and fines for polluting are generally lower than the cost of controlling emissions; and economic transformation of the landscape, from ubiquitous construction sites to the rapid expansion of the nation’s vehicle fleet. If air pollution in China and other Asian nations cannot be controlled, it could spread to other continents. A recent study by Lin et al provides compelling evidence that Asian emissions may account for as much as 20% of ground-level pollution in the United States. Clean air is a shared global resource. It is in the common interest to maintain air quality for the promotion of global health.