1.Health impact assessment of ambient air pm2.5 and pm10 of Ulaanbaatar city
Enkhjargal A ; Suvd B ; Burmaajav B ; Enkhtsetseg SH
Mongolian Medical Sciences 2010;153(3):48-54
Air pollution is an increasingly serious problem in Mongolia, especially in the capital city of Ulaanbaatar, Darkhan and several other urban areas.The goal:The goal of this study is to determine the relationships between air pollutants (PM10, PM2.5, NO2 and SO2) and meteorological parameters (average temperature, humidity, and wind speed) and respiratory and cardiovascular morbidity and mortality of all secondary level and tertiary level hospitals of Ulaanbaatar and 8 primary level hospitals. This is a cross sectional study using secondary air quality and hospital morbidity and mortality data.Material and Methods:Sampling unit is a total number morbidity of respiratory and cardiovascular diseases at the selected study hospitals, number of mortality of the selected II and III level hospitals. Data were collected during 1 year and 5 days or 370 days from 1 June 2008 to 5 of June 2009. Hospital morbidity and mortality admission data were obtained from each hospitals statistic department. Daily data of FGPs were collected manually by data collectors in accordance with scheduled date. Emergency data was also been obtained from the City emergency center.Results:The daily concentrations of PM10, PM2.5, SO2 and NO2 had exceeded the MNAAQS mainly in the winter months from November to February. The correlation mainly between respiratory and cardiovascular disease case admissions with meteorological parameters is because the cold winter conditions in Ulaanbaatar result in the accumulation of pollutants in the atmosphere. Thus, population exposure to air pollution is increase significantly during winter months. Based on recent study result, during winter 1 out of 2 diseases admission case of respiratory system disease caused due to average temperature, relative humidity, NO2, and PM10 and cardiovascular disease also caused due to relative humidity, NO2, and PM10 level. So thus, not only fuel based pollutants but also vehicle related pollutants and meteorological conditions also causing onset of cardiovascular and respiratory system disease. Children under 15 years old are more likely get admitted to the hospital due to respiratory system disease cases whereas cardiovascular disease admission more registered among older age group of people. In addition, residents of ger area are more visited to the FGPs than the residents of apartment area.Conclusions:1. The correlation mainly between respiratory and cardiovascular disease case admissions with meteorological parameters is because the cold winter conditions in Ulaanbaatar result in the accumulation of pollutants in the atmosphere.2. Population exposure to air pollution is increase significantly during winter months.3. During winter 1 out of 2 diseases of respiratory system disease caused due to average temperature, relative humidity, NO2, and PM10 and cardiovascular disease also caused due to relative humidity, NO2, and PM10 level.
2.Migration of toxic chemicals from storage and transportation water containers into drinking water
Unursaikhan S ; Ichinkhorloo B ; Khishigbuyan B ; Gantsetseg P ; Sodnomtseren B ; Enkhtsetseg SH
Mongolian Medical Sciences 2010;153(3):67-71
Goal: To study migration of toxic chemicals from water containters into stored waterMaterial and Methods:Experimental study was carried out in the Health Reference laboratory of Public Health Institute. In the study, as examples of water containers that are commonly used among population, the samples of water containers narrow opened container intended for keeping oil, aluminium container, large blue container (plastic), and metal container were purchased from Narantuul market and container with volume of 1 liter for potable water was purchased from supermarket and were tested. For determination of heavy metal migration, dissolving soultion or 3% In the solution of 3% chloric acid and for determination of hygiene parameters 3% acidic acid were used, respectively. In the solution of 3% chloric acid 6 heavy metals including iron (Fe), copper (Cu), zinc (Zn), lead (Pb), cadmium (Cd) and manganese (Mn) were determined by Varian 210 D AAS-10 in accordance with the method stated in the standard of GOST 5370-50. In the solution of 3% chloric acide the content of formalyne was determined by qualitative method of Shiph and quantative titration methodr, ethylen and salicilic acid by qualitative method, oxidation of organic matters by bichromate titration method and formaldehyde by iodometer method, respectively. Results of analysis were processed by Origin 7.0 software.Conclusions:1. The migration of lead from oil container and large blue plastic container as used for water storage and carriage was detected 500-800 times higher in oil container and 60-72 times higher in large blue plastic container than the acceptable maximum limit of WHO reference level and drinking water standard MNS900:2005 (0.01mg/l). 2. The migration of formaldehyde from plastic containers to food products was 1800-3900 times higher in oil container and 3600-6900 times higher in large blue container than the acceptable maximum limit of formaldehyde migration (formaldehyde 0.1 mg/l). Also 27,0-39,17 mg/l of formalin were determined in the oil container and37,67-53,43 mg/l of formalin were measured in large blue plastic container and its concentration increased over time of storage. It shows that these plastic containers can not be used for keeping drinking water and food products. 3. Lead (122-250 times higher) and cadmium (10-53 times higher) migration from aluminum container was higher than the acceptable maximum limit of national standard NMS 900-2005.4. Iron (58-90 times higher), lead (240-360 times) and cadmium (33-70 times) migration from metal container were detected higher than the acceptable maximum limit of national standard NMS 900-2005.5. The migration of formaldehyde from pure water container was 2922-28000 times higher than the acceptable maximum limit of Russian’s hygienist direction approved in 1971 (reference level is 0.1mg/l of formaldehyde).
3.The report on baseline survey for use of mercury-based medical devices in health care organizations of Mongolia
Ichinkhorloo B ; Ulziisaikhan S ; Tsengelmaa M ; Enkhtsetseg SH ; Unursaikhan S
Mongolian Medical Sciences 2010;153(3):72-77
Goal: To conduct mercury-based medical devises used in health care organizations and develop strategy and recommendations on futher activityMaterial and Methods:A cross-sectional study design was used. Totally 578 units of 38 governmental and private health care organizations inUlaanbaatar, Darkhan, Erdenet cities and Uvurkhangai aimags were conducted in the survey. The survey was conductedby means of a questionnaire given to the medical workers and doctors to complete. There were 3 parts of questions. Thefirst part of the questionnaire dealth with the use of mercury-based medical devices, working, transportation and storageconditions, and waste management. The second section was concerned with knowledge, attitude and practice (KAP) ofmedical personals for safety handling, storage and disposal of mercury containing devices. The third part of the questionnairedealth with the dental amalgam.Mercury concentration of dental amalgam samples were detected by portable mercury vapor analyser RP-91, PYRO-915+ in the Poison Information Center of Public Health Institute. Data processing was done by using statistical programSPSS-10.Conclusions:1. Mercury containing devices such as thermometer, blood pressure sphygmomanometer, energy saving fluorescencelamp and termostates were used in urban and rural hospitals. There are not any regulations for safe handling,storage, and transportation and disposal system of mercury containing divices.2. Knowledge on handling, storaging and disposing mercury based devices are not enough among the medical personals.The current situations for inapproiprate disposal system can be posed to increase riskes of environmentalpollution with mercury.3. Knowledge on health impact of spilled mercury from broken mercury based medical devices is not enoughamong the medical workers. Safety manual for handling, storage and disposal of mercury based medical devicesand promotion materials for health adverse effect and prevention methods have not been developed.4. 14.7% of the investigated dental hospitals and cabinets were used dental amalgam for treatment. Of these wasinvolved the fist stage hospitals. Dental amalgams were imported from China and Russia. Any special recommendationsand rules for safe use, storage and disposal of dental amalgam have not developed.
4.Result of laboratory analyses for study health effects related to mercury in Bornuur andJargalant soum of Tuv aimag
Unursaikhan S ; Ichinkhorloo B ; Enkhtsetseg SH ; Mineshi SAKAMOTO ; Stephan BOESE-OҐREILLY ; Philip FERSTL ; Gabriele ROIDER ; Kersten GUTSCHMIDT
Mongolian Medical Sciences 2010;153(3):55-62
Goal: To make mercury exposure assessment among private gold miners, who live in Jargalant and Bornuur soums ofTuv province.Objectives:1. To collect human bio-samples, including hair, urine and blood, then determine mercury concentrations.2. To asess the mercury exposure situation for those of two soum civilizationsMaterials and MethodsThe MoH-lead investigations were undertaken in collaboration with the Institute of Public Health from UMIT University in Hall, Austria as well as national Mongolian partners from the National Emergency Management Agency (NEMA), the National Public Health Institute , the and other institutions. The Mongolian WHO office supported the mission. The urine samples were analyzed by the Department of Forensic Toxicology, Institute of Forensic Medicine, University of Munich, (LMU) Germany and the National Institute for Minamata Disease, Japan. The blood samples were analyzed by the Chemical Hazards and Poisons Division, Centre for Radiation, Chemical and Environmental Hazards, HPA, Chilton, Didcot, Oxon, UK through the Health and Safety Laboratory, Harpur Hill, Buxton, Derbyshire, UK.Results and Conclusions• The median level of mercury in urine for the control area is 0.10 μg/l, compared to 2.88 μg/l for the group exposed by living in the area and 4.37 μg/l for the group working with mercury. The blood results do differ significantly as well (median 0.24 μg/l for control group, median 0.33 μg/l for the group living in an exposed area, median 0.55 μg/l for the group working with mercury).• The hair results do differ significantly as well (median 0.11/0.08 (root/tip) μg/l for control group, median 0.0.25/0.19 (root/tip) μg/l for the group living in an exposed area, median 0.31/0.26 (root/tip) μg/l for the group working with mercury).• Laboratory tests performed on urine, blood and hair samples collected in Bornuur and Jargalant Soum indicate that the population is very likely to have been recently exposed to mercury. The participants from Bornuur soum and Jargalant soum show results above HBM I to a high percentage and even above HBM II, indicating a much higher exposure to mercury compared to Khushaat soum.