Assessing the association between household air pollution exposure and child heath in Mongolia: a birth-cohort study

Abstract Children in Mongolia are exposed to harmful levels of household air pollution (HAP) due to a high reliance on coal for indoor cooking and heating. This study aims to assess the association between HAP and child health outcomes, in a birth cohort from Ulaanbaatar, Mongolia. A composite HAP m...

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Main Authors: Zaiyou Dai, Katherine E. Woolley, Emma Dickinson-Craig, Tsogzolma Bayandorj, Narangerel Gombojav, Bazarragchaa Tsogt, David Warburton, G. Neil Thomas, Semira Manaseki-Holland
Format: Article
Language:English
Published: Nature Portfolio 2025-01-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-024-79927-6
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author Zaiyou Dai
Katherine E. Woolley
Emma Dickinson-Craig
Tsogzolma Bayandorj
Narangerel Gombojav
Bazarragchaa Tsogt
David Warburton
G. Neil Thomas
Semira Manaseki-Holland
author_facet Zaiyou Dai
Katherine E. Woolley
Emma Dickinson-Craig
Tsogzolma Bayandorj
Narangerel Gombojav
Bazarragchaa Tsogt
David Warburton
G. Neil Thomas
Semira Manaseki-Holland
author_sort Zaiyou Dai
collection DOAJ
description Abstract Children in Mongolia are exposed to harmful levels of household air pollution (HAP) due to a high reliance on coal for indoor cooking and heating. This study aims to assess the association between HAP and child health outcomes, in a birth cohort from Ulaanbaatar, Mongolia. A composite HAP measure was created using information on cooking and heating fuels and behaviours collected as part of a randomised control trial assessing the impact of swaddling on child health. Child health outcomes (Bayley Scales of Infant Development scores [BSID-II], pneumonia, height and weight) were collected at 7, 13, and 36 months. Linear and Cox proportional hazard model were used to assess the association between HAP and child health outcomes at each time point, adjusting for child, maternal and environmental confounding factors. An increased risk of pneumonia was observed with an increasing HAP score (adjusted hazard ratio: 1.02 [1.01, 1.04]) at 7 months). An increase in HAP exposure was associated with a decrease in the BSID mental score at 13 months (β: − 0.09 [− 0.17, − 0.01]), BSID psychomotor score at 36 months (β: − 0.12 [− 0.23, − 0.02]). A decrease in height-for-age z-score (HAZ) and weight-for-age z-score (WAZ) were associated with increased HAP exposure at 7 (HAZ β: − 0.019 [− 0.030, − 0.010] and 13 months (HAZ β: − 0.020 [− 0.030, − 0.011], and WAZ β: − 0.012 [− 0.019, − 0.005]), however only HAZ was associated with HAP at 36 months (β: − 0.011 [− 0.020, − 0.002]). An increasing HAP score was associated with an increase in the health outcome composite score at 7 months only (β: 0.019; 95% CI 0.003–0.035). HAP exposure was shown to negatively impact child health sustainably over 3 years. There are implications for development of appropriate public health policies to mitigate HAP exposure throughout Mongolia and similar Central Asia settings.
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spelling doaj-art-6956fcbdb5ea4b6a93184c3753a7fee12025-02-02T12:20:09ZengNature PortfolioScientific Reports2045-23222025-01-0115111310.1038/s41598-024-79927-6Assessing the association between household air pollution exposure and child heath in Mongolia: a birth-cohort studyZaiyou Dai0Katherine E. Woolley1Emma Dickinson-Craig2Tsogzolma Bayandorj3Narangerel Gombojav4Bazarragchaa Tsogt5David Warburton6G. Neil Thomas7Semira Manaseki-Holland8Institute of Applied Health Research, University of BirminghamInstitute of Applied Health Research, University of BirminghamInstitute of Applied Health Research, University of BirminghamPublic Health Institute UlaanbaatarChild and Adolescent Health Measurement Initiative, Department of Population, Family and Reproductive Heath, Johns Hopkins Bloomberg School of Public HealthMongolian Anti-Tuberculosis Coalition, Research and Innovation LeadChildren’s Hospital Los Angeles, Saban Research Institute, University of Southern CaliforniaInstitute of Applied Health Research, University of BirminghamInstitute of Applied Health Research, University of BirminghamAbstract Children in Mongolia are exposed to harmful levels of household air pollution (HAP) due to a high reliance on coal for indoor cooking and heating. This study aims to assess the association between HAP and child health outcomes, in a birth cohort from Ulaanbaatar, Mongolia. A composite HAP measure was created using information on cooking and heating fuels and behaviours collected as part of a randomised control trial assessing the impact of swaddling on child health. Child health outcomes (Bayley Scales of Infant Development scores [BSID-II], pneumonia, height and weight) were collected at 7, 13, and 36 months. Linear and Cox proportional hazard model were used to assess the association between HAP and child health outcomes at each time point, adjusting for child, maternal and environmental confounding factors. An increased risk of pneumonia was observed with an increasing HAP score (adjusted hazard ratio: 1.02 [1.01, 1.04]) at 7 months). An increase in HAP exposure was associated with a decrease in the BSID mental score at 13 months (β: − 0.09 [− 0.17, − 0.01]), BSID psychomotor score at 36 months (β: − 0.12 [− 0.23, − 0.02]). A decrease in height-for-age z-score (HAZ) and weight-for-age z-score (WAZ) were associated with increased HAP exposure at 7 (HAZ β: − 0.019 [− 0.030, − 0.010] and 13 months (HAZ β: − 0.020 [− 0.030, − 0.011], and WAZ β: − 0.012 [− 0.019, − 0.005]), however only HAZ was associated with HAP at 36 months (β: − 0.011 [− 0.020, − 0.002]). An increasing HAP score was associated with an increase in the health outcome composite score at 7 months only (β: 0.019; 95% CI 0.003–0.035). HAP exposure was shown to negatively impact child health sustainably over 3 years. There are implications for development of appropriate public health policies to mitigate HAP exposure throughout Mongolia and similar Central Asia settings.https://doi.org/10.1038/s41598-024-79927-6Household air pollutionMongoliaChild HealthComposite scoreBSID-IIPneumonia
spellingShingle Zaiyou Dai
Katherine E. Woolley
Emma Dickinson-Craig
Tsogzolma Bayandorj
Narangerel Gombojav
Bazarragchaa Tsogt
David Warburton
G. Neil Thomas
Semira Manaseki-Holland
Assessing the association between household air pollution exposure and child heath in Mongolia: a birth-cohort study
Scientific Reports
Household air pollution
Mongolia
Child Health
Composite score
BSID-II
Pneumonia
title Assessing the association between household air pollution exposure and child heath in Mongolia: a birth-cohort study
title_full Assessing the association between household air pollution exposure and child heath in Mongolia: a birth-cohort study
title_fullStr Assessing the association between household air pollution exposure and child heath in Mongolia: a birth-cohort study
title_full_unstemmed Assessing the association between household air pollution exposure and child heath in Mongolia: a birth-cohort study
title_short Assessing the association between household air pollution exposure and child heath in Mongolia: a birth-cohort study
title_sort assessing the association between household air pollution exposure and child heath in mongolia a birth cohort study
topic Household air pollution
Mongolia
Child Health
Composite score
BSID-II
Pneumonia
url https://doi.org/10.1038/s41598-024-79927-6
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