The Foreign Service Journal, October 2016

22 OCTOBER 2016 | THE FOREIGN SERVICE JOURNAL Concern about the long-term effects of exposure to pollu- tion leads to understandable anxiety within the Foreign Ser- vice community. It is not uncommon for employees and family members to curtail overseas assignments due to the health effects of extreme pollution (see the article on p. 25 ). Prevention Methods The general medical recommendation when AQI levels rise is to reduce exposure as much as possible. This is particularly true for vulnerable groups. Experts also advocate reducing (if not eliminating) strenuous activity, such as running or exercis- ing, when the air is polluted. Instead, wait until AQI levels have decreased, or exercise in a place with clean air. Home filters can improve indoor air quality, but their effec- tiveness depends largely on how well the building is sealed. The EPA and CDC also recommend home air filters—particu- larly high-efficiency particulate air filters that do not generate ozone and have a replaceable filter. (Don’t forget to change it regularly.) The CDC and EPA further find that these types of air puri- fiers effectively improve home air quality, especially the ones with a high airflow rate. Further, consumers are reminded to minimize additional exposure by not smoking inside the home (or at all) and not having open fires from fireplaces or candles. When outside exposure to high AQI levels cannot be avoided, wear a face mask if possible. Keep in mind that the mask must be able to filter out PM2.5, and it must be worn correctly. Look for masks that have an N95 respirator (filter) and a seal of approval from the National Institute for Occupa- tional Safety and Health (part of the CDC). The N95 designa- tion assures that the filter has been rigorously tested and, if the mask is worn correctly, will block at least 95 percent of fine PM and an even greater percentage of larger PM. Ensuring that the mask fits correctly is trickier than it sounds, for it has to be perfectly sealed around the face. For this reason, face masks are not as efficient for men with facial hair. Be aware that there are currently no recommended N95 face masks for children. While some brands, like Vogmasks, are available in smaller sizes, they have not been stamped with NIOSH’s seal of approval because only the filters have been demonstrated to capture N95, not the combination of filter and mask. Because there is increasing demand for face masks, and because more models are available each year, it is crucial to be aware of these quality-control checks to avoid a false sense of security. Air Pollution and Health While research examining the impact of air pollution is still in its early stages—and has been hampered by a paucity of data and inconsistencies in measurement—the WHO, CDC and EPA concur that air pollution has a host of adverse effects. These range from teary eyes, obstructed breathing and throat irritation to asthma attacks and bronchitis; chronic obstruc- tive pulmonary disease and ischaemic heart/cardiovascular disease, including non-fatal heart attacks; strokes; and cancer. Subgroups of the population that are particularly vulner- able to the effects of air pollution include children, pregnant women, those with existing heart or respiratory problems and older adults. Even though causality cannot easily be established in this line of research, and we still have no way of knowing the critical thresholds for PM level or length of expo- sure, WHO estimates that seven million people die annually as a result of ambient pollution (based on data from 2012). W e thought the air in Manama, Bahrain, was better because we came directly from Cairo. But air quality [in Bahrain] is deceptively more caustic, and mixed auto- motive exhaust smog, desert sand, agricultural burn-back and sewage smells create a stinging cocktail that gives many residents red or teary eyes, a constant low-level cough and post-nasal drip. These are not just allergies, but physiological reactions to processing all the gunk in the air through our nasal passages, throats and lungs. — Bob Castro, who served in Manama from 2013 to 2016 P eople often equate bad air quality with posts in China and India, but Sarajevo is one that often goes under the radar. We are in a valley, surrounded by mountains, and most of the heating here in the winter comes from burning wood or coal, leading to terrible air during the winter months. It got so bad this past December that almost all of the flights in and out of Sarajevo were canceled for about three weeks because planes couldn’t land or take off safely. Lots of people at the embassy developed chronic coughs and runny noses during this period. — Scott Kennedy, who has served in Sarajevo since 2015