Impact of Seasonal Winter Air Pollution on Health across the Lifespan in Mongolia and Some Putative Solutions

Abstract

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.

Early policy actions and emergency response to the COVID-19 pandemic in Mongolia: experiences and challenges

“…Ulaanbaatar, known to be one of the most polluted capitals in the world during the winter months, with substantial related morbidity and mortality across all age groups, could benefit from a considerable reduction in air pollution from reduced transport and industrial activity. 44 , 45 In other countries this pandemic has led to reports of reduced city smog. 46 However, domestic solid fuel burning is the main source of Ulaanbaatar's air pollution, which is expected to increase because of the home confinements.…”

Risk Factors for Cerebral Aneurysm Rupture in Mongolia

“…Permanent stationary living in a traditional Mongolian ger was most common in the rural population; however, not less than K 15% (18%) of the urban population included in this study used a ger as their permanent place of residence within the city. Presumably, they resided in the ger districts of the city of Ulaanbaatar, which includes more than 200,000 closely spaced households [16,17]. Interestingly, a history of smoking was significantly more prevalent among Mongolian males in the overall cohort (46.7% versus 7% among females, p < 0.0001), and among males with ruptured and incidental aneurysms (Table 2, p < 0.0001 for all subgroups).…”

Macro-Impacts of Air Quality on Property Values in China—A Meta-Regression Analysis of the Literature

“…According to the previous literature, air pollution has substantial effects on the rise in mortality rate and the decline of average lifespan [8,9]; respiratory diseases and cardiovascular diseases including lung cancer, asthma, respiratory allergy, inflammation, heart disease, thromboembolic and sclerosis [10][11][12][13][14]. Due to the significant adverse impacts of air pollution on human health and lifespan [9,11,12,14], it has received increasing attention from scholars and governments as well as residents.…”