Effects of air pollution and seasons on health-related quality of life of Mongolian adults living in Ulaanbaatar: cross-sectional studies

Abstract

BackgroundUlaanbaatar, Mongolia, is known as severely air-polluted city in the world due to increased coal consumption in the cold season. The health effects of air pollution in Mongolia such as mortality, morbidity and symptoms have been previously reported. However, the concept of health-related quality of life (HR-QoL), which refers to the individual’s perception of well-being, should also be included as an adverse health outcome of air pollution.MethodsSurveys on the Mongolian people living in Ulaanbaatar were performed in the warm and cold seasons. Self-completed questionnaires on the subjects’ HR-QoL, data from health checkups and pulmonary function tests by respiratory specialists were collected for Mongolian adults aged 40–79 years (n = 666). Ambient PM2.5 and PM10 were concurrently sampled and the components were analyzed to estimate the source of air pollution.ResultsIn logistic regression analyses, respiratory symptoms and smoke-rich fuels were associated with reduced HR-QoL (> 50th percentile vs. ≤ 50th percentile). PM 2.5 levels were much higher in the cold season (median 86.4 μg/m3 (IQR: 58.7–121.0)) than in the warm season (12.2 μg/m3 (8.9–21.2). The receptor model revealed that the high PM2.5 concentration in the cold season could be attributed to solid fuel combustion. The difference in HR-QoL between subjects with and without ventilatory impairment was assessed after the stratification of the subjects by season and household fuel type. There were no significant differences in HR-QoL between subjects with and without ventilatory impairment regardless of household fuel type in the warm season. In contrast, subjects with ventilatory impairment who used smoke-rich fuel in the cold season had a significantly lower HR-QoL.ConclusionsOur study showed that air pollution in Ulaanbaatar worsened in the cold season and was estimated to be contributed by solid fuel combustion. Various aspects of HR-QoL in subjects with ventilatory impairment using smoke-rich fuels deteriorated only in the cold season while those with normal lung function did not. These results suggest that countermeasures or interventions by the policymakers to reduce coal usage would improve HR-QoL of the residents of Ulaanbaatar, especially for those with ventilatory impairment in the winter months.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-017-4507-1) contains supplementary material, which is available to authorized users.

The Impact of Air Pollution, Including Asian Sand Dust, on Respiratory Symptoms and Health-related Quality of Life in Outpatients With Chronic Respiratory Disease in Korea: A Panel Study

“…Although few reports have investigated the relationship between air pollution and HR-QoL, Yamazaki et al [ 15 , 28 ] reported that higher nitrogen oxide and oxidant concentrations were associated with lower vitality scores on the SF-36 in Japan. Our previous study showed that HR-QoL in Mongolian adults with respiratory diseases was worse in the cold season, when air pollution is severe [ 29 , 30 ]. Kamimura et al [ 31 ] reported that perceived environmental pollution levels were associated with HR-QoL, but with different patterns among 3 East Asian countries (China, Japan, and Korea).…”

Air Pollution and Health Status in Sub-Sahara Africa (SSA)

“…Sustained exposure to air pollution is also a cause of shorter life span, particularly in connection with mortality from cardiorespiratory illness (Ebenstein et al 2017). Nakao et al (2017) provides similar evidence showing that air pollution from coal results to a deterioration of health-related quality of life (HR-Qol) for Mongolian adults in Ulaanbaatar. Liu et al (2018) provides similar evidence showing adverse effect of air pollution on public health in China.…”

“…This study covered 545 counties in the United States with separate analysis for each country. Using data for the periods 2000 to 2007, Nakao et al (2017) made use of the logistic regression to examine the effect of air pollution on health-related quality of life (HR-Qol) of Mongolian adults living in Ulaanbaatar: The logistic regression model is applied mainly when the dependent variable is dichotomous and the data set is cross sectional. The logistic regression model was also applied by Liu et al (2018) in examining the health effects of air pollution in China.…”

Environmental Air Pollution and the Risk of Osteoporosis and Bone Fractures

“…In our study, we did not employ specific clinical conditions (e.g., the severity of COPD) as an outcome; instead, we used HR-QoL because we thought that a comprehensive measure was required to assess the impacts of air pollution, which is intimately involved in daily life. In the previous study conducted in Mongolia, various domains of HR-QoL, including the score regarding “pain,” were associated with respiratory function and the use of smoke-rich household fuels such as coal in the winter months [ 1 ], whereas there was no significant association between air pollution and the “pain” score of QoL in the study in Korea. Although the mechanism underlying the relationships between air pollution and the pathogenesis of pain remain unclear, we speculate that inflammation or oxidative stress induced by exposure to severe air pollution might cause musculoskeletal problems.…”