Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki305-8577, Japan.
Department of Statistics and Surveillance, National Trauma and Orthopaedic Research Centre, Ulaanbaatar, Mongolia.
Bull World Health Organ. 2023 Jul 1;101(7):470-477. doi: 10.2471/BLT.22.289232. Epub 2023 May 18.
To examine trends in the incidence of carbon monoxide poisoning before and after a ban on domestic use of raw coal in Ulaanbaatar, Mongolia.
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.
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.
Efforts are needed to investigate heating practices among households using briquettes, and to determine factors causing high carbon monoxide concentrations at home.
在蒙古乌兰巴托禁止家庭使用原煤前后，检查一氧化碳中毒的发病率趋势。
利用伤害监测数据和人口估计，我们计算了 2019 年 5 月禁令实施前后（2017 年 5 月至 2019 年 4 月和 2019 年 5 月至 2022 年 4 月）致命和非致命性家庭一氧化碳中毒的每 10 万人年发病率。我们按年龄和性别对数据进行了分析，并将未受禁令影响的地区与禁止家庭使用原煤并改用精制煤球的地区进行了比较。
我们在大约 300 万人口中获得了研究期间 2247 例一氧化碳中毒患者的完整数据。在实施禁令的地区，禁令实施前有 33 例致命和 151 例非致命性一氧化碳中毒，禁令实施后有 91 例致命和 1633 例非致命性一氧化碳中毒。在实施禁令的地区，中毒的年发病率增加，从禁令实施前的每 10 万人年 7.2 例和 6.4 例增加到禁令实施后的每 10 万人年 38.9 例、42.0 例和 40.1 例。尽管努力向公众宣传正确使用煤球的知识以及通风的重要性，但禁令实施后中毒的发病率仍然很高。在没有禁令的地区，一氧化碳中毒的发病率也略有上升。
需要努力调查使用煤球的家庭的取暖方式，并确定导致家中一氧化碳浓度升高的因素。
