I practiced workers compensation law for 18 years and developed an informal sub-specialty dealing with lung diseases. (complex large cases just tended to come my way).Here are my basic reactions to the question of pollution and lung disease in China. First, as a general matter, I am surprised how few people I see who have outward signs of difficulty breathing. (Between the smoking and the pollution, one would think signs of this would be everywhere).

Second, my son (Mark) has had minor asthma. Over the last year it cleared up and he hasn’t needed any medication. Was afraid that Wuhan would worsen his breathing. For the past month, he has been using a peak flow meter every day, and his readings in Wuhan are the same as they were in Cincinnati. Am very surprised and pleased about this. Was always ready to bring him home if his stay in Wuhan worsened his breathing.

Third, generally, particles under 10 microns in size are very dangerous because they are so small they evade the lungs’ filters and penetrate into the lungs, which can cause fibrosis of the lungs. This can be very serious and lead to the need for lung transplants. I did a quick Google search and didn’t find anything really scary about lung fibrosis in China although apparently there is a large amount of polluting particles less than 10 microns in size. Again, this surprises me, but if I was in China for long periods of time, I would research this issue and all other lung issues very closely.

Fourth, in my experience, the quality of lung specialists in China is not great. About 2 years ago when my son was only having very minor problems, I decided to have him take a methacholine challenge test while I was in Beijing just to save money on that expensive test. It was administered in one of Beijing’s best hospitals. The conclusion was that Mark had severe asthma. I knew immediately that it was wrong. It turns out that Mark’s pulmonary specialist in the U.S. had spent time in Shanghai, and the specialist told me that the Chinese doctors made lots of mistakes in the administration of pulmonary tests. So, the bottom line here is: choose your specialist carefully, and it may make sense to use an American one.

Personally, if I was in China for an extended period of time, I would be monitoring the condition of my lungs closely.