The family problem

From his recruitment experience, Cuerdon said air quality is a big consideration for expats with families, looking for an assignment lasting three to five years. The problem is not so great for single people who plan to stay 18 months or so.

Many of Friedman's friends who have plans to start families in the next two years have said they will leave because the air is too dangerous for children.

"That conversation was happening everywhere among all my foreign friends," said Friedman. "They are thinking: Oh my God, maybe we should leave? Maybe we should move to another city? Maybe we should rethink what we are doing here, because it's really quite dangerous."

Niclas Hellqvist, managing director of Nordic Ways Sports Event Co in Beijing, said, "It is, of course, very sad about the extremely poor air quality, especially when you like outdoor sports and activities. It is not good when the air quality prevents our kids from outdoor recess and everyone from enjoying normal healthy activities like running," said Niclas Hellqvist, managing director of Nordic Ways Sports Event Co in Beijing.

"The continuous poor situation certainly makes you start to think twice and consider the alternatives. However, I believe the authorities will address the situation and take action to improve it, even though it will take time and the immediate results will not be seen overnight," he added.

Richard Saint Cyr, a general practitioner at Beijing's United Family Hospital, expressed similar concerns.

"Children and the elderly are especially vulnerable to air pollution spikes. I think that now that there is official hourly monitoring of PM2.5 all over China, all school systems should create air pollution 'action plans' based on the science," he said.

"I still plan to be here for many years, but pollution spikes such as this make me very concerned for vulnerable people, such as the elderly or people with bad heart or lung conditions."

However, Saint Cyr refused to buy into the phrase "Beijing cough", which was coined by the expat community and has gained increasing popularity among local media and residents.

"Honestly, I think it's more of an urban myth than reality. I don't think there's anything specific here in Beijing that causes a unique cough."

Wu Wencong contributed to this story.

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What they say