It's in the context of changing attitudes in China that we can examine what we in the U.S. perhaps now take for granted: clean air and its importance for our health.
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A few years ago, I visited China for the first time with my husband and debated moving there. The economy was booming, we had many connections, and he was an avid Chinaphile. Also, the Chinese government seemed to get "green" a whole lot more than its U.S. counterpart.

I was smitten with Shanghai -- it's hard not to be.

Shanghai is shiny and new. It's the latest international gem, and a number of attributes make it feel like the "it city." It's not just new, it's stylish. The waterfront along the Huangpo River is lined with dazzling tributes to modern architecture, from the modern gothic Jin Mao Tower by Skidmore Owings & Merrill to the sleek Shanghai World Financial Center by Kohn Pedersen Fox. There's a new art district. Uber trendy bars and clubs populate the Bund, adorned with beautiful people and spectacular restaurants where an average dinner costs about one month salary for the average waiter. The international brands are all on display. Sitting on a roof bar over looking the River, you could imagine being in any world capital.

My first few days were amazing. But after a week, I was getting sick. My immediate symptom was a scratchy throat that got progressively worse. Then the headache and burning eyes. I realized that I had a case of the "China crud." How did I get it? By breathing.

Good air quality isn't a matter of opinion. It relates to the amount of particulates in the air. And you can measure it. Here are the facts: PM 2.5 and PM 10 refer to pollutants that are 2.5 microns in diameter or less and 10 microns or less. This particular particle is a cause of heart disease, lung cancer, asthma, and acute lower respiratory infections. The average PM 10 level in the U.S. is 18, which is below the World Health Organization's "healthy level" of 20. In China, the average level of PM 10 is 98.

Air pollution is serious. In January, the New York Times reported the following: Zhong Nanshan, a respiratory expert at the Chinese Academy of Engineering, told China Daily last month that without intervention, PM 2.5 particulates would replace smoking as China's top cause of lung cancer. Beijing health experts told the newspaper that while smoking rates were flat, the city's lung-cancer rate had risen 60 percent in the past decade, probably as a result of air pollution.

As more data emerges about the health risks, the Chinese themselves are starting to grow concerned. The Times reported growing activism in China around air quality, and Chinese activists began using an air monitor to record PM 2.5 data and then put the readings on the Internet.

It's not that surprising, then, that Gallup just reported that 57 percent of Chinese residents in 2011 viewed the environment as more important than the economy.

If you don't have your health, what do you really have? Or, as Ingrid Berman said, "Happiness is good health and a bad memory."

The Chinese have made the linkage between health and the environment, much in the same way we did here in the U.S. at the time of the first Earth Day, in 1970.

Earth Day was not just an environmental movement at its start, it was also about health. Linkages were being made between a polluted environment and human health. The men and women who came into the streets in U.S. cities for the first Earth Day -- many of them wearing suits -- were concerned about an unhealthy environment that risked making them and their children sick.

It's in the context of changing attitudes in China that we can examine what we in the U.S. perhaps now take for granted: clean air and its importance for our health.

We have good air quality -- but it's not uniformly good, and in our big cities we continue to have air pollution issues that affect human health. Also last week, the World Health Organization issued a ruling that diesel emissions are carcinogenic -- a Group 1 carcinogen, with smoking and asbestos.

The data point to a problem that we should be taking seriously. We are all exposed to diesel emissions from buses, trucks, and others. While Dr. Otis Brawley, head of the American Cancer Society, said he is more concerned about people who have concentrated and sustained exposure like miners than "people who walk past a diesel vehicle," there is early research to suggest that diesel emissions in cities can have adverse health consequences on children. Meanwhile, research ongoing at Columbia Center for Children's Environmental Health has linked developmental delays to chronic exposure to air pollution (pre-birth into pre-adolesence).

We might throw up our hands and wonder what to do -- except that we actually know what to do. We don't have to burn diesel fuel. We have electric and other alternatives.

The Chinese are making the connection between their environment and their health. We've already done that, but let's not forget about it.

If health is the most important thing, we need to continue to take steps to safeguard it. Improving our air quality -- and eliminating harmful diesel emissions -- is one such step.

Keeping our safeguards in place is another. As China energy and climate policy analyst Melanie Hart points out, without the Environmental Protection Agency (EPA) playing a regulatory role in the U.S., we'd start to look a lot more like China. As she notes, "The reality is that our regulatory system is what separates us from the citizens in China, where air pollution and lead poising are the norm and environmental problems corrode the quality of life in ways that we have not faced in decades."

My husband and I decided not to move to China, after all. We admire a lot of things about China, but we have little appetite for more "crud." And apparently, neither does a growing chorus of Chinese people.

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