The Makeevs are leaving Beijing this summer. It was a tough decision for the family to make. They've lived here for a decade and have grown attached to the capital's ways, its oddities and its quirks.

But the air pollution, amid a number of concerns, finally became too much for the Russian couple after giving birth to a baby girl last September.

In their home near the East Fourth Ring Road across from Chaoyang Park, the couple stays at home as much as possible on heavily polluted days. Their air purifier runs around the clock, windows stay closed and masks are a must when they do go out.

"Beijing's air got worse in the last year, and this winter was especially bad," said Makeev, who runs an export business in Beijing.

The heavy smog that blanketed eastern parts of China for much of the winter triggered international attention to China's air pollution issue, especially in the capital where some 200,000 expatriates reside.

The US embassy's air quality index classified pollution levels as "beyond the index" several times in January. However, the official index put out by environmental authorities, which usually stands in contrast to the US embassy data, also showed in parts of Beijing that the pollution levels were too high to be read at monitoring stations.

Staying away

"We feel drowsy, we get headaches, we cough. We even noticed differences in the baby's behavior, as she gets cranky and doesn't sleep well," Makeev said. He explained that in Russia, it's common to spend at least two to three hours daily outside to let babies get fresh air. 

Besides air pollution, Makeev also worries about food and water quality. The comfortable and cheap cocoon that lured many expats to Beijing is cracking. Rents are up, high prices are being charged for low-quality products and traffic is an ever-worsening chore, he said. The increasingly evident wealth gap is also making him uncomfortable.

In pursuit of better climate and business opportunities, the couple has decided to leave for Malaysia soon.

Makeev's worries are shared among many in the expat community in Beijing, and the couple are not the only ones planning on leaving.

There were at least two high-profile cases of foreigners asking to be repatriated in January, when PM2.5 readings in Beijing climbed to over 800, said Max Price, a partner at Antal International China office, a global executive recruitment corporation.  A PM2.5 reading over 500 is already considered serious pollution.

Price told the Global Times that a high-ranking lawyer and a senior technical professional working for two German automobile companies respectively insisted on being repatriated to their original countries and left.

"When I speak to my international colleagues, their first questions are never about how business is going or how I am doing personally. They always ask about the pollution," he said. "It's really something I never experienced before."

When speaking to people as a recruiter, quality of life used to be the third question following the actual duties of the job and the salary, but now it has jumped to second on the list, Price said, adding that this mainly happens with people with families.

A lot of foreigners who are keen on staying in China are turning their attention toward second-tier or third-tier cities, as these have increased employment options and better air quality, said Price.

The recent H7N9 bird flu outbreak has also come to complicate matters.

"A lack of communication and a limited number of reports have made people fear the worse and compare it with the SARS outbreak 10 years ago," he said, noting that these aspects are making Beijing and Shanghai less attractive than other Chinese cities to expats.

Although there is no official data on how many foreigners are leaving Beijing or tourists staying away for fear of the pollution, the Beijing municipal tourism data showed a slump of foreign visitors in February and March this year compared to 2012.

According to the statistics, Beijing saw 165,000 foreign visitors in February, 37 percent less than last year.

Protect yourselves

January's heavy smog has led to anxious discussions among Beijing residents who have been scrambling for protection such as air purifiers and air pollution masks. All the major brands sold out quickly, and many are still out of stock due to soaring demand.

At the meantime, the non-medical term "Beijing cough" went viral on social media in January, referring to the dry cough and scratchy throat suffered by foreigners upon arrival in Beijing.

Richard Saint Cyr, a family medicine physician at Beijing United Family Hospital, told the Global Times that most doctors at the hospital, especially in the emergency room, had not noticed an extraordinary increase in respiratory problems.

"But I certainly saw many people coming in with asthma exacerbations or serious coughing. I've had discussions with a few patients, both foreign and local, who are thinking of leaving Beijing due to the pollution," he said.

Sean Dugdale, an American exchange student with Peking University, said he was hoping to work in Beijing after college but had given up that idea because of the pollution.

When the smog hit the city, Dugdale's family grew worried and sent him an e-mail with pictures showing the smog-covered Tiananmen Square. He has now decided to return to the US after his one-year exchange program ends.

Over the past four or five months, Price noticed cases where some foreigners, mostly at American companies, are asking for "danger money" when negotiating a contract with employers if they are to continue working in Beijing.

Danger money, he explained, is an extra bonus one asks for when confronted with safety risks in the country of employment. Traditionally, this is associated with nations like Angola and Nigeria, where security risks are high, and roughly amounts to 10 percent of one's annual salary package.

"I think many young people are more willing to trade the pollution off against the opportunities that are available in Beijing, particularly given the economy in many western countries right now," said Ashley Howlett, a partner at global law firm Jones Day's Beijing office.

He said there are still a lot of foreigners seeking job opportunities in Beijing, although it is becoming more difficult for multinational companies to sell Beijing as a perfect location when hiring.  Howlett's wife and children moved back to New Zealand, their home country, four years ago as the air quality in Beijing was having a bad effect on his 11-year-old asthmatic son.

Matt Hope, a British artist had sought solution to air pollution with his "Breathing Bike," a pedal-powered air filtration system that provides clean air to the rider as it moves.

"Most of my friends came to stay for a while then leave, and some do leave China considering their families' health. For me, I still feel a lot of things are interesting in China for my art practicing," he told the Global Times.

"I think Beijing struggled to attract people before the pollution became a news item.

With its harsh climate and drab concrete skyline it doesn't make a good backdrop for postcards, however what's left of old Beijing still has a fan base," Hope said.

Positive steps

The Beijing government has vowed to make greater efforts to tackle air pollution, including a "clean air pact" that aims to reduce major pollutants concentration by an average of 2 percent by the end of this year.

Experts have also called for more international cooperation on pollution control, both at the official level and via communications among environmental organizations.

Jack Marzulli, a research fellow with New York City-based Natural Resources Defense Council (NRDC) China, told the Global Times that he'll be returning to the US at the end of his one-year post with the organization's Sustainable Cities Team.

"The pollution is definitely one of the reasons that I'm not seriously considering staying in Beijing longer term," said Marzulli. "Ironically, it's also one of the reasons I moved here in the first place."

Having visited Beijing in the past, Marzulli said he wanted to be part of the effort in fighting Beijing's pollution and specifically applied for a post at the NRDC's Beijing office.

"The air pollution constantly reminds me how important our work is," he said.

There is still a lot of work to be done to improve the air quality in Beijing and the rest of China, but environmental organizations are making a lot of progress, he said, while public awareness of air pollution and other environmental issues is increasing significantly.

China has been sparing no efforts in improving air quality and curbing pollution and Japan is glad to offer its assistance to the government, companies and NGOs, said Okazaki Yuta, First Secretary of the Economic Section (Environment) at the Embassy of Japan in China.

"I'd like to extend my heartfelt sympathy to residents who suffered from heavy smog earlier this year. As the father of two children, I'm heartbroken when seeing Chinese kids getting sick because of the air pollution," said Okazaki.

He lives in Beijing with his wife and two sons, and the family has come to depend on its air purifier.

 "Japan also experienced serious air pollution before, and I don't want to see more harm caused by pollution anywhere in this world," he said.

"I'd like to continue working in Beijing, hoping that our experiences, lessons and technologies can help China find a solution."