Nurses check a patient’s respirator in a hospital in Ningqiang county, Northwest China’s Shaanxi Province on February 4, 2019. Photo: VCG

Experts called on China to strengthen the standardized diagnosis and treatment of asthma and to step up efforts in air quality management. 

A national cross-sectional study on 45.7 million Chinese adults published in the Lancet medical journal found that overall prevalence of asthma in the research sample was 4.2 percent. 

The research, the largest ever study of the subject, was led by Wang Chen, president of the Chinese Academy of Medical Sciences (CAMS). Wang told the Global Times that only 10 percent of Chinese people understand the concept of chronic obstructive pulmonary disease (COPD).

“In China, there is relatively high prevalence of chronic respiratory diseases such as COPD and asthma, with a low diagnosis rate, and a low standard treatment rate,” Wang noted. 

With COPD, for instance, less than 10 percent of respondents have had lung function tests, he added. 

In people aged 20 and above, 71.2 percent of asthma cases have never been diagnosed. Only 5.6 percent of patients have received glucocorticoid therapy, according to the research, Wang said, highlighting the prominent problems in the standardized diagnosis and treatment of asthma in China.

Wang said that there are four major causes for the disease, including smoking, air pollution, increasingly complicated pathogens, and an ageing population. 

In 2018, the average concentration of PM10 in 338 prefecture-level and above cities decreased by 26 percent compared with 2013, and the average concentration of PM2.5 decreased by 22 percent compared with 2015, news site sciencenet.cn reported.

China’s measures to tackle air pollution have seen remarkable achievements, but the total amount of pollutants is still high, He Kebin, an academician at the Chinese Academy of Engineering, said at the 2019 Conference on the Innovative Development of the Environmental Protection Industry on June 12. 

“The discharge of major pollutants has been significantly reduced, and the national ambient air quality improved significantly,” He said, according to the Xinhua News Agency. 

Air quality is often assessed using particulate matter (PM 2.5) mass concentration without considering its toxicity. Yao Maosheng, a professor at Peking University, told the Global Times that the influence of PM 2.5 on health depends not only on its mass concentration, but also its toxicity per unit of mass and other biological contents. 

“For example, if you compare the air quality between Beijing and San Francisco, the PM 2.5 mass concentration in Beijing is higher, but its PM toxicity is much lower,” Yao explained, saying in his recent research that PM toxicity varied greatly across major global cities. 

Therefore, solely reducing the PM mass concentration is not necessarily the most cost-effective approach to improving air quality and protecting people’s health, Yao noted. 

Since 2013, China’s total emissions of nitrogen oxides (NOx) and sulfur dioxide (SO2) have fallen by 28 percent and 26 percent respectively, according to data from a NASA satellite. 

Challenges remain

In the future, the coordinated management of PM2.5 average concentration, ozone and total volatile organic compound emission reduction will be crucial, and the government also needs to synchronize the pace in management of germanium and carbon, involving industries, energy and green technologies, He said.

“We all might have noticed that during smoggy days in Beijing, there are increasing numbers of visits to hospital respiratory clinics. This could be due to microbial growth and spread in the humid and polluted air, as our recent work shows,” Yao added. 

With increasing numbers of acclimated or engineered microbes being applied in wastewater treatment or soil remediation, air pollution control might need to additionally consider their release into the air and ecosystem, Yao said. “For future air pollution control, two additional efforts might be needed: controlling the emission of engineered microbes in the air, and spending more on reducing the most toxic PM elements in the air,” Yao suggested. 

“Due to the lack of healthcare awareness and supporting policies, chronic respiratory diseases such as COPD and asthma have caused a large amount of labor loss to China, causing a heavy disease burden,” Wang stressed. 

The treatment of COPD has reached international standards in China’s first-and second-tier cities, but following up with patients is also very important in the processes of prevention, diagnosis and treatment to collect data for research, Wang added.
Newspaper headline: Clearing the air