Current situation of carbon monoxide poisoning and its knowledge, practice and attitudes study among the residents

Abstract

Background: In many developing countries, the use of biomass for heating and cooking exposes populations to indoor air pollutants, including carbon monoxide (CO). In response, the Mongolian government introduced the use of improved coal as per Resolution No. 62 of 2019, subsequently banning raw coal. However, post-implementation in Ulaanbaatar, there was an unexpected rise in CO poisoning cases, hospitalizations, and mortality rates, necessitating this study. Aim: This study aims to assess the current state of carbon monoxide poisoning among Ulaanbaatar residents and to evaluate the knowledge, practices, and attitudes of residents in the Ger districts concerning CO poisoning. Materials and Methods: Employing a cross-sectional study design, we analyzed the total cases of carbon monoxide poisoning recorded in the capital from 2017 to 2022. We surveyed 395 households across six districts using four sets of questionnaires comprising 52 questions to evaluate their knowledge, habits, and attitudes regarding CO poisoning. Results: Between 2017 and 2022, 5,799 CO poisoning incidents were registered in Ulaanbaatar, with 55.9% male and 42.7% female victims (1.4% unknown). The majority of cases (78.4%) involved children and youth (0-17 years: 36.1%, 18-30 years: 21.8%, 31-45 years: 20.5%). Out of the surveyed 395 citizens (37.7% male, 62.3% female), significant differences were found in the knowledge (p=0.0345), practices (p=0.0002), and attitudes (p=0.0029) towards CO poisoning prevention between those who had received informational interventions and those who had not. Practice varied significantly with family member type (p=0.0255), and there were significant differences in knowledge scores based on education (p=0.0007), income level (p=0.0005), and employment status (p=0.0007). There was a direct, albeit weak, correlation between citizens’ knowledge and their habits (p=0.0003; r=0.18) and attitudes (p=0.0000; r=0.26). Conclusion: The districts of Chingeltei and Songinohairkhan exhibited higher incidences of poisoning per 10,000 population compared to other areas. The knowledge of Ger area residents about the symptoms, first aid, and prevention of CO poisoning from incomplete combustion remains inadequate. Future initiatives must enhance the dissemination of information and focus on targeted educational campaigns.