World Health Organization issues recommendations to tackle health impacts of air pollution in Mongolia

The World Health Organization (WHO) today released a set of long-, medium- and short-term recommendations for the Government of Mongolia to tackle air pollution. Air pollution causes more than 4000 deaths every year in this Central Asian lower-middle income country with a population of 3 million. WHO is urging the Government to keep air pollution as a top priority for policies and implementation throughout the year.

Air pollution takes many forms. The most harmful for health is fine particulate matter (PM2.5). It is a major cause of diseases such as stroke, heart disease, lung cancer, acute and chronic respiratory diseases. In 2012, one out of nine deaths in Mongolia was the result of air pollution-related diseases. More than half of child deaths from pneumonia in Mongolia are due to indoor air pollution. In Mongolia, indoor and outdoor air pollution account for 132 deaths per 100 000 people per year, whereas the global average is 92 deaths per 100 000 people.

Data from the Mongolian National Agency for Meteorology and Environment Monitoring indicate that air quality in Ulaanbaatar improved from 2011 to 2015. However, the annual mean concentration of PM2.5 in the air in Ulaanbaatar remains 6-10 times higher than the level considered safe by WHO air quality guidelines. During the winter months (from November to March) the mean concentration of particulate matter is 8-14 times higher than the WHO guideline values.

“Air pollution has become one of the most challenging issues in Mongolia. WHO is pleased to see the Government’s efforts to identify comprehensive solutions to the air pollution situation in Ulaanbaatar, which will be vital for people’s health”, said Dr Sergey Diorditsa, the acting WHO Representative in Mongolia.

Half of the people in Mongolia’s capital live in traditional felt dwellings called gers. They heat them in the long winter months by burning raw coal. This is the main source of Mongolia’s air pollution, accounting for 80% of air pollution in the country from November to April. WHO recommends switching to efficient, renewable and clean energy options both at production and consumption levels.

In the short term, WHO recommends the introduction of a ban on burning plastic, tires, and vinyl and other waste as fuel and calls for creating sustainable support schemes to help low-income groups adopt affordable cleaner technology. In addition, WHO recommends improving indoor air quality by banning smoking indoors, improving ventilation in gers and other homes, and controlling the overuse of burning solid fuels while using better insulation to reduce the need for heating. At the same time, WHO highlights the need to increase public awareness of the need to substitute solid fuel with processed, then clean fuels.

Around 10% of Mongolia’s air pollution comes from motor vehicle traffic in Ulaanbaatar. To combat this, WHO advises implementing measures to prevent traffic congestion and reduce the need for motorized transport. These include creating green areas and re-locating offices and commercial spaces to places that are convenient for pedestrians and cyclists. Integrating environmental and health considerations in urban planning requires long-term multi-sectoral coordination.

As a medium-term intervention, WHO recommends more stringent national standards for outdoor air quality to reduce air pollution concentrations to those recommended by WHO’s Air Quality Guidelines. Concrete steps advised by WHO include introducing better solid waste management, paving roads in the Ger areas of the capital, and joining the WHO and UN Environment-led BreatheLife campaign to increase public awareness and action on air pollution.

The 2017 Mongolia National Program on Reduction of Air and Environmental Pollution provides a roadmap to decrease air pollutants by 80%, prohibit the use of unprocessed coal anywhere except thermal power plants in Ulaanbaatar, and reduce air and environmental pollution by at least 50% by 2025.

“The National Programme is a product of a truly multi-sectorial collaboration—all ministries were involved in drafting it since air pollution cannot be tacked by one sector alone. However, the health sector must play a leading role in the whole-of-society fight against air pollution. Hence we have identified 15 health sector measures in our joint plan of action for implementation of the Programme,” said Mongolia’s Minister of Health, Ms Sarangerel Davaajantsan.

“It is crucial to conduct a systematic assessment of the sources of air pollution, and identify the most effective interventions to eliminate or control them,” said Dr Sergey Diorditsa. “The Government of Mongolia can consider a range of policy options to reduce emissions. There are good lessons to learn from other countries, such as the Irish Government’s ban in 1990 on the marketing, sale, and distribution of bituminous coal within the city of Dublin, which led to a 70% decrease in black smoke; or the historic success of the post-WWII Clean Air Act in the United States.”

Currently WHO is conducting a systematic review on the effectiveness of using personal masks and air purifiers as measures to mitigate the health impact of air pollution. The global review is expected to be released in mid 2018.

KEY FACTS: Air Pollution in Mongolia

  • Each year in Mongolia, an estimated 3,010 people die from diseases attributable to indoor air pollution and a further 1,123 people die from diseases attributable to outdoor air pollution. These include:
    • ischaemic heart disease
    • stroke
    • lung cancer
    • pneumonia
    • chronic obstructive pulmonary disease
  • In 2011, 29% of heart and lung disease deaths and 40% of lung cancer deaths in Ulaanbaatar were attributable to outdoor air pollution (joint study by Mongolian and Canadian researchers).
  • The prevalence of childhood asthma in Ulaanbaatar is higher than the global and Asia-Pacific averages, and the prevalence of asthma in adults has increased for the past decade (International Study of Asthma and Allergies in Childhood).
  • In 2011 spontaneous abortion incidence was 3.6 times higher in December (the month when the air pollution level is high) than in May (study by the National Centre for Maternal and Child and a USA research team).
  • Data from the Mongolian National Agency for Meteorology and Environment Monitoring shows that annual mean concentration of PM has been decreasing between 2011 and 2015. However, annual mean concentration remains around 2-3 fold higher than national guideline values.
  • In 2017, in the winter months (November to March), the mean concentration of particulate matter was 8-14 times higher than WHO guideline values for air quality.
  • There are 40 air quality sentinel monitoring stations in Mongolia, including in Ulaanbaatar and provincial centres. They measure major pollutants, but only 8 stations out of 15 in Ulaanbaatar measure PM2.5.

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For more information:

Nomin Lkhagvasuren
Communication and Health Promotion
Tel: +976-99-134-426
Email: lkhagvasurenn@who.int

Delgermaa Vanya
Environment and Health Programme
Tel: +976-11-327-870
Email: delgermaav@who.int

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