Athletes from around the world -- representing the pinnacle of physical skill and conditioning -- will be converging in Beijing next month for the 2008 Olympic Games -- pushing the limits of their bodies and striving for international greatness.
The air they'll be breathing, though, isn't in the same league. Athletes may be competing in thick soot and smog, dangerous ozone levels, and air quality ranked among the world's worst.
These environmental conditions are alarming athletes, doctors, and other health advocates, who are questioning how Beijing's air quality will affect the Olympic athletes' performance -- along with the short-term health of competitors, who have been training years for this event.
"It's like living in the middle of a construction zone," says Bob Lanier, MD, a Fort Worth-based allergy and asthma specialist who visits Beijing several times a year. "It's like any big city. I think that when athletes get off the plane they're going to be really paranoid, because it has been really bad."
One nation has already taken a stand against the smog.
Athletics Australia recently ignited a firestorm when it announced it was banning its track and field competitors from marching at the opening ceremony of the games due to concerns about Beijing's air quality. Instead, the team will remain in training camps in Japan and Hong Kong until their competitions.
But are these legitimate worries or overcautious measures? Lanier, who holds an academic appointment at Peking Union Medical College in Beijing, says the city's air-quality conditions during the past few years in the city have gone from "terrible" to "not so bad." He says in terms of air quality, there are worse places to hold such an event that are closer to home.
"If you had the choice of holding the Olympics in L.A. or Beijing, I'd probably choose Beijing," he says.
Nonetheless, China remains notorious for polluted air. The World Bank has cited China as having 16 of the 20 most air-polluted cities on Earth. The European Space Agency, utilizing satellite imagery, has found that Beijing and its surrounding areas have the world's highest levels of nitrogen dioxide, a substance poisonous to the lungs.
Beijing's Efforts to Improve the Air
Beijing Olympic officials have taken steps to try to improve air quality during the games: traffic will be very limited and construction will halt.
Still, Alfred Munzer, MD, director of pulmonary medicine at Washington Adventist Hospital and former president of the American Lung Association, says that shutting down factories and enforcing driving bans won't eliminate what's already in the air.
"During exercise , the movement of air in the lungs goes up about tenfold, which means exposure to air pollution goes up tenfold," Munzer says. "This has a severe affect on the respiratory tract. It will have an effect on healthy athletes."
Scheduling may help some Olympic athletes. The coolest time of the morning offers the most ideal conditions for competition, followed by early evening once the sun sets.
Unfortunately, there's little else athletes -- or even spectators -- can do to prevent exposure to air pollution.
"You can't protect yourself with a mask," Munzer says. "We're talking about a fine gas, so there's no really good protection."
There are other health concerns for the Olympic athletes, as well.
AIRescue International is a California-based critical care evacuation service that assesses potential emergency medical situations for corporate clients. Medical director Francine Vogler, MD, recently traveled to Beijing to complete a survey for a client who will be welcoming guests to the 2008 games.
In addition to smog and pollution, Vogler says the water she was served i restaurants had to be piping hot due to quality concerns. Food probably won't be an issue for most athletes, who will be eating at their teams' commissaries that serve food native to their country.
The area's emergency service is also far different than Westerners are accustomed to receiving, she says, noting that some ambulances contained nothing more than a stretcher.
These shouldn't be concerns for athletes, who will have trainers and top medical resources at their disposal. But spectators in attendance -- especially those with pre-existing medical conditions -- should assess their own risks as well.
"Athletes who have asthma will be well prepared, but visitors will not have the same preparation," Vogler says. "The outdoor environment is challenging not only because of the pollution, but the heat and high humidity."
The weather, in fact, is troubling some Olympic athletes far more than Beijing's air quality. Lanier compares Beijing's climate to New Orleans in the summer -- oppressive heat and thick, smothering humidity.
Former gold medalist Jeanette Bolden, who is head coach of the U.S. Women's Track and Field team, says any of Beijing's air quality issues will pale in comparison to the climate challenges. "They're doing all they can to make sure pollution will not be a problem," says Bolden, who has asthma. "The heat, humidity, and dehydration will be more of a problem."
Carrie Johnson, a 24-year-old Olympic kayaker from San Diego, recently competed in an event in Shunyi, China. She didn't notice any negative effect from breathing the local air. Her training is occupying her focus far more than Beijing's environmental conditions. "As an athlete, the only thing I can concern myself with is the training and preparation."
By Don Fernandez
Reviewed by Brunilda Nazario
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