Home safety hazards associated with unintentional poisoning among children aged 0-5 years in Mongolia: A case-control study.

OBJECTIVE: To examine the association between home safety hazards and unintentional poisoning in children in Mongolia. METHODS: We conducted a case-control study using structured questionnaires to investigate safety behaviours, safety equipment use, and home hazards in households with or without children aged 0-5 years who had suffered from poisoning at home (i.e., cases and controls). We recruited 190 cases (105 medicinal and 84 non-medicinal poisonings, and one each) at the National Center for Maternal and Child Health and 379 controls in the communities between 1 March and 30 October 2021. RESULTS: There were large differences between cases' and controls' households in safety behaviours and home hazards: the failure to store all medicines out of reach of children (68% of cases vs. 25% of controls), the failure to store all medicines safely (out of reach, locked or non-existent) (61% vs. 22%), the failure to put all medicines away immediately after use (77% vs. 43%), the presence of things that a child could climb on to reach high surfaces (82% vs. 67%), the presence of medicines transferred into different containers (28% vs. 9%) and the presence of household products transferred into different containers (28% vs. 16%). These home safety hazards were strongly associated with poisoning after controlling for confounders. CONCLUSION: Children's risk of unintentional poisoning was strongly associated with the unsafe storage of potentially poisonous agents by caregivers and home hazards. Since unsafe storage is widespread, a fail-safe approach such as child-resistant closure of medicines and household products should be considered.

Carbon monoxide poisoning following a ban on household use of raw coal, Mongolia.

Objective: To examine trends in the incidence of carbon monoxide poisoning before and after a ban on domestic use of raw coal in Ulaanbaatar, Mongolia. Methods: Using injury surveillance data and population estimates, we calculated the incidence per 100 000 person-years of fatal and non-fatal domestic carbon monoxide poisoning before (May 2017 to April 2019) and after (May 2019 to April 2022) the ban in May 2019. We analysed data by age and sex, and compared areas not subjected to the ban with districts where domestic use of raw coal was banned and replaced with refined coal briquettes. Findings: We obtained complete data on 2247 people with carbon monoxide poisoning during the study period in a population of around 3 million people. In districts with the ban, there were 33 fatal and 151 non-fatal carbon monoxide poisonings before the ban, and 91 fatal and 1633 non-fatal carbon monoxide poisonings after the ban. The annual incidence of poisoning increased in districts with the ban, from 7.2 and 6.4 per 100 000 person-years in the two 12-month periods before the ban to 38.9, 42.0 and 40.1 per 100 000 in the three 12-month periods after the ban. The incidence of poisoning remained high after the ban, despite efforts to educate the public about the correct use of briquettes and the importance of ventilation. The incidence of carbon monoxide poisoning also increased slightly in areas without the ban. Conclusion: Efforts are needed to investigate heating practices among households using briquettes, and to determine factors causing high carbon monoxide concentrations at home.

Effectiveness of child burn prevention campaigns in Mongolia.

OBJECTIVE: To evaluate the effects of child burn prevention campaigns on medically attended burn injuries in Ulaanbaatar, Mongolia. METHODS: We conducted an interrupted time-series analysis using data on patients aged<5 years who were treated for burn injuries at the Emergency Department of the National Trauma and Orthopaedic Center from January 2009 to December 2018. Since the campaigns focused on scald prevention, we calculated the monthly rate of scald injuries per 10 000 children aged<5 years by sex and injury severity, regressing it on the number of months after January 2009 (the beginning of the study), after June 2014 (the first nationwide campaign started) and after January 2017 (the second facility-based campaign started). RESULTS: During the 10-year study period, there were 23 459 patients, of whom 18 433 (79%) were treated for scald injuries, including 6920 severe injuries. The monthly rate of overall scald injuries started to decrease after the first campaign, with a relative change of -32% at the end of the intervention. However, the rate started increasing before the initiation of the second campaign; this trend continued during and after the campaign. The rate of severe scald injuries did not show any significant changes throughout the study period. The results were consistent for both sexes. CONCLUSIONS: The nationwide burn prevention campaign was effective in reducing non-severe burn injuries among young children. Since the campaign was primarily aimed at increasing public awareness of child burn injury risks, further interventions should be considered with passive measures to prevent severe burn injuries.