Integrating Quantitative and Qualitative Approaches to Explore Absenteeism Attributed to Air Pollution and its Attributed Direct and Indirect Costs Among Private Sector Companies in Ulaanbaatar, Mongolia

Abstract

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.