Unsafe Storage Practices Research Articles

Improving Identification of Firearm Access in Children With Mental Health Complaints.

To determine if electronic medical record (EMR) changes and implementation of a study on firearm storage practices changed identification of firearm exposure in children presenting to a pediatric emergency department (PED) with mental health complaints. We also sought to determine the accuracy of information collected on firearm storage practices. Retrospective study of EMR documentation of firearm exposure in PED patients with mental health complaints from January 20, 2015 until November 20, 2017. EMR changes occurred on January 20, 2016 and the firearms study began on February 13, 2016. The primary outcome was documentation of firearm exposure. Secondary outcomes were documentation of unsafe firearm storage practices. We also examined differences between clinical and research documentation of unsafe firearm storage practices post-intervention. We compared groups using descriptive statistics and chi-squared tests. We used statistical process control to examine the relationship between interventions and changes in outcomes. 5582 encounters were examined. Identification of firearm exposure increased from 11 to 17% postintervention. Identification of unsafe storage practices increased from 1.9% to 4.4% across all encounters. Special cause variation in both metrics occurred concurrently with the interventions. Postintervention, unsafe firearms storage practices in firearm owning families were under-identified (39% identified as not triple-safe in clinical data vs 75% in research data). EMR changes and implementation of a firearms study improved identification of firearm exposure and unsafe storage practices in families of PED patients being evaluated for mental health complaints. However, unsafe storage practices continued to be under-identified in firearm-owning families.

Storage, Reuse and Disposal Practices of Home - Stored Medicines in Urban Households in Pune, India

Background: Improper home medicine storage is a global issue that leads to medicine wastage contributing to adverse effects. There have only been a few community-based research studies for in-home drug storage methods, reasons for use and its disposal ways among the consumers of India, until date. Methodology: A descriptive, cross-sectional study was done from April 2023 to June 2023. Data were collected by face-to-face interview of household representative using pretested structured questionnaire on medicines in households, their utilization, storage and disposal practices. Results: Most of the participants (78.3%) were educated to the level of graduation and above and their common reported source of procurement for stored medicines was doctor’s previous prescriptions (61.79%) where 42.5% of them stored medicines for anticipated future use. Commonly stored drugs in households were analgesics and antihistaminics and drugs for digestive system while only 5.3% stored antibiotics mostly for ongoing treatment. Unsafe storage practices like storing medicines without proper labelling (65%) and within reach of children (33.49%) were found in the study. Also, 42.45% participants reported to share stored medicines with family members and friends. Major practice for drug disposal was reported as throwing in household garbage (93.1%). Conclusion: In current study, 100% prevalence of in-home storage medication practices among the well-educated consumers without proper care taken for their use, storage and disposal which may pose a risk to the environment as well as humans.

Identity, experience, and threat: Assessing key correlates of firearm ownership and related behaviors in a representative sample of five US States

The purpose of this study was to examine psychosocial, experiential, and demographic correlates of firearm ownership, carrying, and storage methods. We used a representative survey of 3,510 people living in five US states (Colorado, Minnesota, Mississippi, New Jersey, and Texas) conducted in 2022. Individuals provided information on past experiences with firearms, perceptions of threat and neighborhood safety, discrimination, and tolerance of uncertainty alongside demographic items. The analysis was conducted in November 2022. Past experiences with firearms and prior victimization are associated with increased firearm ownership and carrying practices. Threat sensitivity is associated with owning more guns while poorer perceptions of neighborhood safety correspond with owning fewer guns but greater risk for unsafe storage practices like storing a loaded gun in a closet or drawer. Intolerance of uncertainty is associated with owning fewer guns and lower risk for carrying outside of the home but greater risk for unsafe storage. Prior experience of discrimination is associated with risk for carrying firearms outside of the home. Demographic characteristics related to sex, rurality, military service, and political conservatism predict risky firearm-related behaviors related to firearm ownership, carrying frequency, and unsecure storage. Taken together, we find firearm ownership and risky firearm behaviors (e.g. carrying, unsafe storage) are more prominent among groups such as politically conservative males living in rural areas while also being influenced by threatening experiences, uncertainty, and perceptions of safety.

Assessment of farmers on their knowledge regarding pesticide usage and biosafety

PurposeInappropriate application of pesticides is quite common in the study area, causing health issues and in some cases fatalities. The intent of the current study is to gauge the farmers’ level of knowledge on the safe usage of pesticides and biosafety to keep the famers healthy through the focused extension programs.MethodologyThe study is carried out in 41 union councils of Tehsil Sahiwal, District Sahiwal, Punjab, Pakistan. Data are collected through a cluster sampling technique by conducting face-to-face interviews. Statistical analysis is used to determine relationships and interpret them.ResultsThe findings show that the majority of farmers (87.2%) earn their livelihoods from farming and 2.1% are traders. More than half of the respondents (51.8%) own small land-holdings with an area of 4–8 ha, with only 16.4% having a land area of more than 12 ha. The results also reveal that the majority of respondents obtain information from private agents and only about one third (34.4%) respondents get information on the safe usage of pesticides from the Department of Agriculture (Extension). The internet has emerged as a fast and reliable source of information in the new paradigm; however, only 14.4% of the respondents take advantage of this economical and fast information tool/medium. The findings also reveal that the farmers employ unhealthy and poor practices by not following the recommendations regarding the safe usage of pesticides. The study also reveals that more than half of the farmers (54.4%) use unsafe storage practices on their farms, and about 48.2% do not follow the instructions.ConclusionsInappropriate application of pesticides can have negative effects on human health and the adoption safety measures are necessary to avoid the harmful effects of pesticides. Due to high illiteracy in the area, farmers mainly seek advice of neighboring farmers, having ignorance on the biosafety issues. Variables like education level, land ownership, total land size and the trainings on safe pesticide usage significantly influence the knowledge level of farmers on the safe usage of pesticides.RecommendationsFarmers do not follow the recommendations of the extension department or the instructions printed on pesticide bottles/containers, therefore educational (formal and informal) and training programs are necessary on the safe pesticide usage to upgrade their skills and expertise on safe usage of pesticides and the importance of biosafety.

Kerosene, Camphor, and Naphthalene Poisoning in Children.

ABSTRACTKerosene poisoning is one of the most common accidental poisoning in children in developing countries due common use of kerosene in house-hold and unsafe storage practices. Aspiration pneumonitis is the most common manifestation of kerosene ingestion due to its low viscosity, high volatility, and low surface tension. The treatment of aspiration pneumonitis due to kerosene poisoning is symptomatic including oxygen support, respiratory monitoring, and careful monitoring of fluid balance. Children with severe respiratory distress and hypoxemia unresponsive to supplemental oxygen and/or severe central nervous system involvement require early intubation and mechanical ventilation. Transfer to the pediatric intensive care unit (PICU) is required at this stage. Emesis, gastric lavage, and administration of activated charcoal are contraindicated due to risk of aspiration. There is no clear benefit of using corticosteroids or prophylactic antibiotics. Asymptomatic children should be kept under observation for atleast 6 hours after exposure. The mortality rate is low and death occurs due to pneumonitis. Camphor is used in house-hold items including vaporized or topical cold preparations, liniments, moth repellents, for performing rituals in religious ceremonies, and in antimicrobial preparations. Camphor poisoning is not very common in childhood. Even small doses of camphor can cause serious toxicity and is potentially fatal. The onset of action is very rapid (5–15 minutes). The common manifestations are confusion, restlessness, delirium, and hallucinations, muscle twitching, myoclonus, ataxia, hyperreflexia, fasciculations, and seizures. Seizures are common and serious complication in camphor toxicity. The treatment is supportive including decontamination, gastric lavage, activated charcoal, and seizure control. Naphthalene is a major constituent of mothballs which are commonly used in household to protect clothes from moths. Though the poisoning with naphthalene is uncommon in children, most of the cases with naphthalene poisoning occur in developing countries where mothballs are still commonly used. The manifestations of naphthalene toxicity are predominantly due to acute intravascular hemolysis leading to anemia, hemoglobinuria, methemoglobinemia, and acute kidney injury (AKI). The treatment of naphthalene toxicity is supportive in form of transfusion of the packed red blood cells, monitoring of fluid and electrolyte balance, administration of alkalis in presence of hemoglobinuria, and renal replacement therapy. Prevention is better than cure. The strategies should be adopted to prevent children being exposed to these toxic compounds in the house-hold. Safe storage of toxic compounds away from the reach of children, avoiding storing kerosene in cold drink and beverage bottles, community education, provision of electricity in rural areas, safe cooking practices, and parental supervision are important interventions to prevent accidental poisoning among children.How to cite this articleKumar S, Kavitha TK, Angurana SK. Kerosene, Camphor, and Naphthalene Poisoning in Children. Indian J Crit Care Med 2019;23(Suppl 4):S278–S281.

Perceptions of firearms and suicide: The role of misinformation in storage practices and openness to means safety measures

BackgroundFirearm ownership and unsafe storage increase risk for suicide. Little is known regarding factors that influence storage practices and willingness to engage in means safety. MethodsUtilizing Amazon's Mechanical Turk program, we recruited an online sample of 300 adults living in the US who own at least one firearm. Firearm storage practices and openness to means safety measures were assessed using items designed for this study. Data were collected and analyzed in 2017. ResultsFirearms stored in non-secure locations and without a locking device were associated with lower beliefs in the relationship between firearm storage and suicide risk. Fearlessness about death moderated the association between current secure versus non-secure storage and beliefs regarding firearm storage and suicide risk, in that storage practices and beliefs were more strongly related at higher levels of fearlessness about death. For both secure and locked storage of a firearm, there was a significant indirect effect of current storage practices on willingness to engage in means safety in the future through current beliefs regarding the relationship between firearm storage and suicide risk. Unsafe storage practices were largely associated with an unwillingness to store firearms more safely or to allow a trusted peer to temporarily store the firearm outside the home in order to prevent their own or someone else's suicide. LimitationsSelf-report and cross-sectional data were used. Results may not generalize to non-firearm owners. ConclusionsFirearm owners are prone to inaccurate beliefs about the relationship between firearms and suicide. These beliefs may influence both current firearm storage practices and the willingness to engage in means safety.

Storage and wastage of drug products in Jordanian households: a cross-sectional survey

Appropriate household storage and use of drug products can reduce drug wastage and unnecessary hazards. We aimed to quantify the amounts and types of medications that were stored in Jordanian households and the extent of drug wastage in terms of the amount and cost of these medications. The setting was households in Amman, Jordan. This was a cross-sectional survey study using a pre-piloted questionnaire. Family members were interviewed in person about use of drug products, and where drug products were stored. The main outcomes were types, storage methods, cost and quantities of drug products in every household. Two hundred and forty-three households were approached, out of which 219 agreed to participate. A total of 2393 (mean 10.9, SD 5.2) drug products were recorded from the 219 households surveyed. A significant positive correlation was noted between the number of drug products in a household and family size (r = 0.19, P < 0.01), the level of the mother's education (r = 0.24, P < 0.01), the level of the father's education (r = 0.28, P < 0.01) and income (r = 0.14, P = 0.034). Eighty nine (40.6%) households had at least one child younger than 6 years of age, and 1122 (46.9%) drug products were stored in unsafe places in the houses, within the reach of children. More than a quarter of drug products (1509, 27.2%) were not in their original containers, 360 (15%) were unused since dispensing, 261 (10.9%) had expired and 44 (1.8%) had no clear expiry date. We estimated that the cost of drug wastage in the 219 households was US$5414. Paracetamol (202, 8.4%), diclofenac (98, 4.1%) and amoxicillin (79, 3.3%) were the most commonly reportedly stored individual drugs. Drug products are stored in large quantities in Jordanian households. Unsafe storage practices have the potential to pose safety hazards, especially to children.

Disparities in firearms ownership and storage practices in North Carolina.

Because household firearms pose a risk to children, this study examined firearms accessibility in North Carolina households with children. In 2008, parents completing the North Carolina Child Health Assessment and Monitoring Program survey were asked how many firearms they owned and their firearms storage practices. Weighted analyses provided estimates of ownership and storage practices and examined variation by sociodemographics. A total of 37% of 2885 parents reported owning firearms. Whites (adjusted odds ratio [aOR] 3.9 [95% confidence interval {CI} 2.9-5.2]), households with income >200% of the federal poverty level (aOR 1.7 [95% CI 1.2-2.5]) and married parents (aOR 2.4 [95% CI 1.8-3.4]) were more likely to own firearms. Ownership of more than one firearm was greater among whites (aOR 2.2 [95% CI 1.4-3.4]) and married parents (aOR 1.8 [95% CI 1.5-2.8]) than other groups. The number of firearms owned increased with children's age. Although most parents reported keeping firearms locked and unloaded (57%), many reported unsafe storage practices, which varied by race/ethnicity. Whites were more likely (45%) to store firearms unlocked and/or loaded than other groups (35%). Many North Carolina youth have access to household firearms, with white youth being more likely to have firearms, a greater number of firearms, and less safely stored firearms than other race/ethnicity groups. Further interventions and policies to reduce youth access to household firearms are needed. Future research should examine and address why whites, married couples, and those with socioeconomic advantages are more likely than individuals not belonging to these groups to own household firearms and store them unsafely.

Welcome to the World

Unintentional injuries are the most common cause of morbidity and mortality in young children, and most injuries occur in the home. To report findings from a primary prevention program that trained paramedics to conduct home safety surveys, provide family safety education, and identify common pediatric injury risks in the home. We retrospectively reviewed standardized records from each survey, abstracting information on family demographics, safety devices and practices, and provision of educational materials and safety equipment. We descriptively analyzed and reported statistics as means and percent frequencies. Two-hundred sixty-two families participated and had children averaging 21 months of age. Ninety-eight percent (250/255) had a smoke detector, and 65% (140/215) had a fire extinguisher, with 77% (192/250) and 76% (107/140) of these respective devices functional. Twenty-seven percent (55/202) had a fire evacuation plan, and 33% (18/55) reported ever practicing their plan. For bathwater sites, 56% had temperatures measured less than 120 degrees F. Eighty-five percent (218/257) had medications, and 53% (134/249) had household chemicals out of reach of children, but most reported storage in an unlocked location. Eighty-five percent (42/49) reported storing guns unloaded, and 45% (22/49) stored all guns in locked locations. Paramedics distributed 63 smoke detectors, 46 fire extinguisher vouchers, 234 first-aid kits, and 225 educational packets. Participating families had high rates of fire/burn hazards and unsafe storage practices. Paramedics can recognize common hazards in the home, can provide education and mitigation to reduce risks of pediatric injury, and can distribute home safety devices in a community injury prevention program.

Standardizing the Storage and Labelling of Medications: Part 2

Several studies have addressed the need for pharmaceutical companies to improve medication labelling. Criticisms have generally related to small font size, poorly designed and visually cluttered labels, and inadequate warnings. In addition, similarities between medication names (i.e., lookand sound-alike names) and labels (i.e., look-alike packaging), as well as unsafe storage practices, have been cited as contributing to medication incidents and errors. Coupled with research in human factors, this information can prompt and guide health care organizations to improve labelling in medication storage areas. Building on our previous article, which outlined an initiative within the Calgary Health Region to simplify the storage of medications, the current article highlights specific improvements in medication labelling that were made in the inpatient care and pharmacy areas in an effort to enhance safety and improve efficiency.

Modifying Children's Responses to Unsecured Firearms and Modifying the Keeping and Storage of Firearms in Families of Elementary School Children: A Possible Role for Child Behavior Therapy

ABSTRACT This paper reviews the literature on young children (children under 13) at-risk of firearms injuries, and outlines potential strategies for reducing the disproportionate rate of firearms accidents among low-income children. The available evidence suggests that this problem stems from risky gun storage practices common in low-income homes keeping guns for protection, and these practices, in turn, are a response to high rates of crime victimization and fears of crime. The role that child behavior therapy could assume to reduce the risk of firearm injury to young children and other persons due to these unsafe storage practices is the primary focus of this paper.

Regulating Firearm Advertisements-Reply

To the Editor. —At the outset, it may be helpful to recall what our article did (and did not) conclude. We found convincing arguments can be made that a number of handgun advertisements are unfair, deceptive, or both, because they do not present consumers with accurate information about the risks of gun ownership in the home or because they depict unsafe storage practices. Despite the content of the foregoing letters, our article does not advocate trying to remove guns from those of us who respect and admire them. Dr Orr and Dr Blackman each cite a survey by Kleck and Gertz to support their point that handguns frequently are used in self-defense. The reasons that this survey is incapable of yielding an accurate estimate of defensive gun use are described at length in the Hemenway 1 work referenced in our article and in 2 other recently published works by Cook et al. 2,3