This piece is part of Bustle's My Life With, which is all about removing the invisibility around living with a chronic illness.
If you live with anything for long enough, there’s a chance you’ll get complacent about it. This is how I was with my asthma for many years. Given that it’s a chronic lung disease that makes breathing — a key part of staying alive — quite difficult, I’m not exactly proud to admit this. But having lived with the condition since I was a baby, I mostly saw it as a frustrating inconvenience, only paying proper care and attention to it when it was really debilitating. I took my reliever inhaler whenever I felt wheezy, even though doctors recommend only using it once or twice a week, and I was lazy about getting prescriptions filled for my preventer medication. But when I moved from Australia to South Korea in mid-2018, I knew I could no longer afford to act cavalier about my illness. The reason for this shift? South Korea’s air pollution problem.
Of the 36 predominantly wealthy countries in the Organization for Economic Co-operation and Development (OECD), South Korea is ranked as having the worst air quality. To give you perspective on how big an issue it is here, a national survey revealed that air pollution was the most distressing aspect of life in South Korea, while North Korea’s nuclear program ranked fifth.
Having lived here for almost a year, I understand why this is the case. On a bad air day in Seoul, the pollution is so thick you can’t see the surrounding mountains, approximately 2 miles away. Considering that each particle of pollution is smaller than the width of a human hair, the fact that there are so many that they blanket the city in an apocalyptic-looking smog is terrifying. Breathing in these pollutants — which is possible even if you’re wearing a mask — means that they can make their way into your respiratory tract and your bloodstream. Even for people without pre-existing lung problems, short-term exposure can cause symptoms like coughing, itchy eyes and a scratchy throat. Long-term exposure has been linked to lung cancer, strokes, heart conditions and even death.
Being outside on a day where the air is polluted affects everyone, but it affects asthmatics even more so. People with asthma have sensitive airways in our lungs that react to certain triggers by narrowing and making it harder to breathe. Even the simple act of inhaling a pollutant can cause these airways to tighten and swell. “Typically someone with asthma who breathes in an irritant — whether that’s a pollen or a pollution in air — could start to feel the wheeziness and coughing within 10 minutes to an hour,” Dr. Barton Jennings of the Lung and Sleep Specialist Centre in Melbourne, Australia, tells Bustle.
Although I check an air quality app several times a day, sometimes I’ll be caught unprepared by a sudden increase in pollution, only noticing when my chest tightens and my breath becomes short. So when the air is deemed bad enough that emergency alerts are sent out by the Seoul Metropolitan Government, I try to stay inside.
In March 2019, the city was blanketed by extremely high levels of fine dust for a record seven consecutive days. We couldn’t see the sun or the color of the sky. Everything had an eerie, muted feel to it. Spending so much time indoors made me anxious and irritated, but at least I could breathe properly.
This — the ability to breathe properly — is something I can’t take for granted anymore. As climate change gets worse, so does its impact on our health. Greenhouse gas emissions have changed the way air currents move, meaning that pollution builds up and stagnates closer to the ground. Scientists have forecast that by 2030, air pollution will cause an extra 60,000 deaths globally per year. It’s easy to feel helpless in the face of this, which is why it’s so important to focus on what we can control. For me, one of those things is managing my asthma as best I can, no matter how good or bad the air is outside. According to Dr. Jennings, being prepared is key: “The most important thing is to make sure you’ve been on your medication and that you’ve got an action plan for how to manage worsening asthma symptoms,” he says.
For a long time, I saw being proactive about my illness as an admission of weakness. Often in pop culture, being asthmatic is a character trait most often assigned to bullied nerds, the wimpy kids that reach for their inhalers any time they feel under pressure. It’s played as comedically embarrassing, and to an extent, I internalized that shame. But now that I live in a city where air quality is a serious issue, in a world suffering the very real effects of climate change, I finally understand that there is nothing shameful about prioritizing your health.