Assessing Impacts of the Raw Coal Ban and Adoption of Improved Coal Briquettes on Ambient Air Quality and Cardiovascular Health in Ulaanbaatar, Mongolia
1
Institute of Medical Sciences, Mongolian National University of Medical Sciences, Ulaanbaatar city, Mongolia
2
Faculty of Health Sciences, Curtin University, Perth, WA, Australia
Popul. Med. 2026;8(Supplement Supplement 1):A384
ABSTRACT
INTRODUCTION:
Cardiovascular diseases (CVD) remain the leading cause of mortality worldwide, and ambient air pollution (AAP) is recognised as a major environmental health risk, particularly in developing countries such as Mongolia. Ulaanbaatar, the capital city, was identified as the second-most-polluted city globally in a 2018 World Bank report. In response, the Government of Mongolia allocated approximately USD 28.5 million to reduce air pollution by 80% by 2025. A key component of this initiative was the ban on raw coal and the introduction of a new type of improved coal briquette (ICB) for household use. However, the effects of this intervention on air quality and cardiovascular health have not been assessed.
METHODS:
Air quality and health data from Ulaanbaatar were collected and analysed for the period 2016–2022. Pollutants included particulate matter (PM2.5 and PM10), sulphur dioxide (SO₂), nitrogen dioxide (NO₂), ozone (O₃), and carbon monoxide (CO). Hospital admissions and mortality outcomes were classified using ICD-10 codes. A time-stratified case-crossover design, combined with conditional Poisson regression and distributed lag models, was applied to estimate exposure–lag–response associations. Subgroup analyses examined demographic and seasonal differences across single and multi-pollutant models.
RESULTS:
After the introduction of ICB, daily concentrations of PM2.5 and PM10 declined noticeably. In contrast, levels of SO₂ and CO increased by 2-3 times, while O₃ remained below the WHO Air Quality Guidelines (WHO AQG). Exposure to all pollutants except O₃ was associated with elevated risks of CVD hospitalisations and mortality, with NO₂ and SO₂ demonstrating the strongest associations.
CONCLUSIONS:
Despite reductions in particulate pollution following the ICB intervention, most criteria air pollutants continued to exceed the WHO AQG levels. Generating country-specific evidence is essential for evaluating policy effectiveness, guiding regulatory decisions, reducing health-related costs, and strengthening global understanding of the environmental determinants of cardiovascular health in support of the SDG goals.
Cardiovascular diseases (CVD) remain the leading cause of mortality worldwide, and ambient air pollution (AAP) is recognised as a major environmental health risk, particularly in developing countries such as Mongolia. Ulaanbaatar, the capital city, was identified as the second-most-polluted city globally in a 2018 World Bank report. In response, the Government of Mongolia allocated approximately USD 28.5 million to reduce air pollution by 80% by 2025. A key component of this initiative was the ban on raw coal and the introduction of a new type of improved coal briquette (ICB) for household use. However, the effects of this intervention on air quality and cardiovascular health have not been assessed.
METHODS:
Air quality and health data from Ulaanbaatar were collected and analysed for the period 2016–2022. Pollutants included particulate matter (PM2.5 and PM10), sulphur dioxide (SO₂), nitrogen dioxide (NO₂), ozone (O₃), and carbon monoxide (CO). Hospital admissions and mortality outcomes were classified using ICD-10 codes. A time-stratified case-crossover design, combined with conditional Poisson regression and distributed lag models, was applied to estimate exposure–lag–response associations. Subgroup analyses examined demographic and seasonal differences across single and multi-pollutant models.
RESULTS:
After the introduction of ICB, daily concentrations of PM2.5 and PM10 declined noticeably. In contrast, levels of SO₂ and CO increased by 2-3 times, while O₃ remained below the WHO Air Quality Guidelines (WHO AQG). Exposure to all pollutants except O₃ was associated with elevated risks of CVD hospitalisations and mortality, with NO₂ and SO₂ demonstrating the strongest associations.
CONCLUSIONS:
Despite reductions in particulate pollution following the ICB intervention, most criteria air pollutants continued to exceed the WHO AQG levels. Generating country-specific evidence is essential for evaluating policy effectiveness, guiding regulatory decisions, reducing health-related costs, and strengthening global understanding of the environmental determinants of cardiovascular health in support of the SDG goals.
| eISSN: | 2654-1459 |
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