I've got exercise-induced asthma, and I'm sure it's not helping me any that my running workouts are usually during rush hour and take me over the Brooklyn Bridge and its car-choked roadway. Pollution is a concern for all outdoor exercisers, for performance reasons and especially for its negative effects on the heart as well as the lungs.
That's especially true for athletes preparing for the upcoming Olympics, where the Beijing smog is infamous and the stakes are much higher than the personal satisfaction I get from hoofing it across the bridge within one Billy Idol song. (One scientist is even encouraging athletes to wear masks when they're not competing, and the world record holder in the marathon said he won't race in Beijing because of the bad air, heat, and humidity.)
I talked to Bob Lanier, a clinical professor of pediatrics and immunology at the University of North Texas Health Science Center and a guest professor at the Peking Union Medical College in Beijing, about what the Olympians might face and how exercisers everywhere can minimize their risk of problems.
So what's the air like in Beijing?
It's sort of like San Francisco in some respects; it's a microclimate with a lot of fog. And like a lot of cities right now, the main issue has to do with the number of vehicles. But the main thing in the last 10 years is the unbelievable, science fiction-style construction. It produces a lot of construction dust. Has the moratorium on new construction helped?
Yes. I won't say that the air is perfect, but it's now no different than Mexico City or Los Angeles. It's got lots of automobile traffic, but that's manageable. I think people will get off the airplane and find it's like any large city in the middle of the week. There's also the weather, though. The heat and humidity in August are like they are in Texas. Do you think the effects of pollution will be as bad as some have feared?
There'll be a smog layer, but I think folks will accommodate to that pretty quickly. When it comes to ozone issues and general pollution, people usually [perform] better than anticipated. We're amazingly tolerant for a certain level of airborne pollutants. This is speculation, but I think you're going to see world records and the athletes do better than expected. And you say that athletes with allergic asthma may actually have fewer problems in Beijing?
Yes. In the U.S., the big problem is allergic asthma, which affects about 60 percent of people with asthma. But to react to an allergen, you have to have [been exposed to it] before. So if you go from this country to Beijing with allergic asthma, you may not have as many problems because the pollens are low this time of year, and they're different from what we have in the U.S.—for example, no ragweed. What can recreational outdoor athletes with asthma do here at home?
With allergic asthma, the prime thing to do is to avoid what causes allergies. That can be hard to do. But if allergies are a factor in your asthma, avoid [exercising] outside at the highest pollen time, which is early in the morning. Maybe run later in the day or in the evening, when things have cooled off. And those of us with asthma that is triggered by exercise?
If you're running and having problems, you don't have to put up with it. We can give athletes tons of improvement in performance. Albuterol inhalers make a difference, since they open up the lungs. But it's rare to see someone who only has exercise-induced asthma. They usually will have it at other times too, but they only notice it when they exercise. You've done a ton of clinical trials on asthma treatments. What's the latest?
The combination of steroids and a bronchodilator into one inhaler was a big breakthrough 10 years ago. Those work, but after asthma is initiated. But the major research now—and what I've been involved in—is to get deeper into why the disease occurs and prevent [it] in the first place. We aren't just happy to say we can keep you out of the ER; we want to get to the root of the issue, which in many cases is the allergy antibody immunoglobulin E, or IgE. The new drugs work against the allergy antibody itself.