Environmental pollution of the air, water, and soil comprise an increasingly urgent challenge to global health, well-being, and productivity. The impact of environmental pollution arguably has its greatest impact across the lifespan on children, women of childbearing age, and pregnant women and their unborn children, not only because of their vulnerability during development, but also because of their subsequent longevity. Ulaanbaatar, Mongolia, is a highly instructive, perhaps extreme, example of what happens with recent, rapid urbanization. It is the coldest capital city on Earth, where average ambient temperatures routinely fall below -40°C/F between November and February. During the cold winter period, more than 200,000 "Gers" (traditional felt-lined dwellings) in the "Ger district" burn over 600,000 tons of coal for domestic heating (>3 tons each). Thus, outdoor ambient particulate levels frequently exceed 100 times the WHO-recommended safety level for sustained periods of time, and drive the majority of personal particulate matter exposure. Indoor levels of exposure are somewhat lower in this setting because Gers are equipped with chimneys. Major adverse health impacts that we have documented in the Ger districts include the following: respiratory diseases among those between 1 and 59 years of age and cardiac diseases in those over 60; alarming increases in lung cancer rates in females are also beginning to emerge; and fertility and subsequent successful completion of term pregnancy falls by up to half during the winter pollution season, while early fetal death rises by fourfold. However, the World Bank has intervened with a Ger stove replacement project that has progressively reduced winter pollution by about 30% over the past 5 years, and this has been accompanied by an increase in mean term birth weight of up to 100g. Each incremental decrement in air pollution clearly has beneficial effects on pregnancy, which are likely to have the greatest positive health and macroeconomic impact across the lifespan. However, innovative policies and solutions are clearly needed to eliminate coal heating in Gers and thus further reduce the markedly negative health impact of this practice.
Causes for employee absenteeism vary. The commonest cause of work absenteeism is “illness-related.” Mongolia’s capital city, Ulaanbaatar, experiences high employee absenteeism during the winter than during other seasons due to the combination of extreme cold and extreme air pollution. We identified direct and indirect costs of absenteeism attributed to air pollution among private-sector employees in Ulaanbaatar. Using a purposive sampling design, we obtained questionnaire data for 1,330 employees working for private-sector companies spanning six economic sectors. We conducted 26 employee focus groups and 20 individual employer in-depth interviews. We used both quantitative and qualitative instruments to characterize the direct and indirect costs of absence due to illnesses attributed to severe air pollution during wintertime. Female employees and employees with a young child at home were more likely to be absent. Respiratory diseases accounted for the majority of reported air pollution-related illnesses. All participants perceived that air pollution adversely affected their health. Individual employee direct costs related to absence totaled 875,000 MNT ($307.10) for an average of three instances of three-day illness-related absences during the winter. This sum included diagnostic and doctor visit-related, medication costs and hospitalization costs. Non-healthcare-related direct cost (transportation) per absence was 50,000₮ ($17.60). Individual indirect costs included the value of lost wages for the typical 3-day absence, amounting to 120,000₮ ($42.10). These total costs to employees, therefore, may amount to as much as 10% of annual income. The majority of sick absences were unpaid. Overall, the cost of wintertime absences is substantial and fell disproportionately on female employees with young children.
Background Ulaanbaatar, Mongolia, the coldest national capital city, has the highest winter seasonal mean concentrations of PM2.5 and PM10. During January, the coldest month, peak pollution levels are > 8 times higher than the World Health Organization (WHO) guideline values are reached, on average, 15.7 times. Over 80% of this seasonal air pollution is due to domestic heating with coal stoves in large ger residential communities that surround much of the city. This report presents an analysis of the direct and indirect costs of wintertime seasonal air pollution due to the absenteeism of private-sector employees.Methods Questionnaire data were obtained for 1330 employees working for private sector companies over six economic sectors. To assess employee’s direct and indirect costs, healthcare-related costs such as cost per hospitalization, medication, and outpatient visits were calculated using the Cost-of-Illness approach. Non-healthcare costs, such as transportation and food, were also estimated in the study. Individual Indirect costs were calculated with the Human Capital Approach, which estimates the hours of work lost by the person due to disease and then multiplies total lost hours by the hourly wage.Results Approximately 60% of employee absences occurred during the coldest and hence most air polluted time of 4 months of the year from November to February. Female employees were proportionately more likely to be absent than their male counterparts. Individual direct healthcare costs attributed to air pollution related-sickness absences totaled 1,005,000₮ ($361.50) per year due to being absent from work an average of 3 days three times during the winter in Ulaanbaatar. The median cost of lost wages for 3 days’ absence is 120,000₮ ($43.20).Conclusions We conclude that wintertime pollution has a major impact on absenteeism rates among private-sector employees, and therefore, we postulate that this must be a significant driver of opportunity costs, affecting not only corporate bottom lines but also employees.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.