Abstract

Causes for employee absenteeism vary. The commonest cause of work absenteeism is “illness-related.” Mongolia’s capital city, Ulaanbaatar, experiences high employee absenteeism during the winter than during other seasons due to the combination of extreme cold and extreme air pollution. We identified direct and indirect costs of absenteeism attributed to air pollution among private-sector employees in Ulaanbaatar. Using a purposive sampling design, we obtained questionnaire data for 1,330 employees working for private-sector companies spanning six economic sectors. We conducted 26 employee focus groups and 20 individual employer in-depth interviews. We used both quantitative and qualitative instruments to characterize the direct and indirect costs of absence due to illnesses attributed to severe air pollution during wintertime. Female employees and employees with a young child at home were more likely to be absent. Respiratory diseases accounted for the majority of reported air pollution-related illnesses. All participants perceived that air pollution adversely affected their health. Individual employee direct costs related to absence totaled 875,000 MNT ($307.10) for an average of three instances of three-day illness-related absences during the winter. This sum included diagnostic and doctor visit-related, medication costs and hospitalization costs. Non-healthcare-related direct cost (transportation) per absence was 50,000₮ ($17.60). Individual indirect costs included the value of lost wages for the typical 3-day absence, amounting to 120,000₮ ($42.10). These total costs to employees, therefore, may amount to as much as 10% of annual income. The majority of sick absences were unpaid. Overall, the cost of wintertime absences is substantial and fell disproportionately on female employees with young children.

Highlights

  • Among the national capital cities, Mongolia’s capital, Ulaanbaatar, is the coldest on earth during the winter season

  • Maji and colleagues found that long-term exposure to PM2.5 was connected to greater mortality in people aged >25 years from stroke, ischemic heart disease, and chronic obstructive pulmonary disease (COPD)

  • Employees were distributed across six private business sectors

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Summary

Introduction

Among the national capital cities, Mongolia’s capital, Ulaanbaatar, is the coldest on earth during the winter season. Many people survive winter by burning coal in domestic heating stoves, which produces >80% of the winter seasonal air pollution in Ulaanbaatar [1]. The extreme levels of PM10, PM2.5, SO2, and NO2 measured in the air are strongly associated with adverse health effects, including respiratory, cardiac and pregnancy-related morbidities [2,3,4,5]. COPD caused 22.9% of PM2.5-attributable mortalities [6]. These detrimental effects are associated with substantial direct and indirect costs to employers, employees, and their children

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