Emma J Mew1, Prianka Padmanathan2, Flemming Konradsen3, Michael Eddleston4, Shu-Sen Chang5, Michael R Phillips6, David Gunnell7. 1. Dalla Lana School of Public Health, University of Toronto, Toronto, Canada. Electronic address: emmajmew@gmail.com. 2. School of Social and Community Medicine, University of Bristol, Bristol, UK. Electronic address: prianka.padmanathan@gmail.com. 3. Department of Public Health, University of Copenhagen, Copenhagen, Denmark. Electronic address: flko@sund.ku.dk. 4. Pharmacology, Toxicology and Therapeutics, University of Edinburgh, Edinburgh, UK. Electronic address: m.eddleston@ed.ac.uk. 5. Institute of Health Behaviors and Community Sciences and Department of Public Health, College of Public Health, National Taiwan University, Taipei City, Taiwan. Electronic address: shusen.chang@gmail.com. 6. Suicide Research and Prevention Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Departments of Psychiatry and Global Health, Emory University, Atlanta, USA. Electronic address: mphillipschina@outlook.com. 7. School of Social and Community Medicine, University of Bristol, Bristol, UK. Electronic address: d.j.gunnell@bristol.ac.uk.
Abstract
BACKGROUND: Agricultural pesticide poisoning is a major contributor to the global burden of suicide. Over the last decade there has been a marked decrease in the incidence of suicide worldwide. It is unclear whether pesticide poisoning still plays a significant role in the global incidence of suicide. METHODS: WHO method-specific suicide data were supplemented by a systematic review of the literature between 2006 and 2015, including searches of thirteen electronic databases and Google, citation searching and a review of reference lists and personal collections. Our primary outcome was the proportion of total suicides due to pesticide poisoning. Weighted estimates were calculated for seven WHO regional and income strata. RESULTS: We identified data from 108 countries (102 from WHO data, 6 from the literature). A conservative estimate based on these data indicates that there were approximately 110,000 pesticide self-poisoning deaths each year from 2010 to 2014, comprising 13.7% of all global suicides. A sensitivity analysis accounting for under-reporting of suicides in India resulted in an increased estimate of 168,000 pesticide self-poisoning deaths annually, that is, 19.7% of global suicides. The proportion of suicides due to pesticide self-poisoning varies considerably between regions, from 0.9% in low- and middle-income countries in the European region to 48.3% in low- and middle-income countries in the Western Pacific region. LIMITATIONS: High quality method-specific suicide data were unavailable for a number of the most populous countries, particularly in the African and Eastern Mediterranean regions. It is likely we have underestimated incidence in these regions. CONCLUSION: There appears to have been a substantial decline in fatal pesticide self-poisoning in recent years, largely driven by a reduction in overall suicide rates in China. Nonetheless, pesticide self-poisoning remains a major public health challenge, accounting for at least one-in-seven suicides globally.
BACKGROUND: Agricultural pesticide poisoning is a major contributor to the global burden of suicide. Over the last decade there has been a marked decrease in the incidence of suicide worldwide. It is unclear whether pesticide poisoning still plays a significant role in the global incidence of suicide. METHODS: WHO method-specific suicide data were supplemented by a systematic review of the literature between 2006 and 2015, including searches of thirteen electronic databases and Google, citation searching and a review of reference lists and personal collections. Our primary outcome was the proportion of total suicides due to pesticide poisoning. Weighted estimates were calculated for seven WHO regional and income strata. RESULTS: We identified data from 108 countries (102 from WHO data, 6 from the literature). A conservative estimate based on these data indicates that there were approximately 110,000 pesticide self-poisoning deaths each year from 2010 to 2014, comprising 13.7% of all global suicides. A sensitivity analysis accounting for under-reporting of suicides in India resulted in an increased estimate of 168,000 pesticide self-poisoning deaths annually, that is, 19.7% of global suicides. The proportion of suicides due to pesticide self-poisoning varies considerably between regions, from 0.9% in low- and middle-income countries in the European region to 48.3% in low- and middle-income countries in the Western Pacific region. LIMITATIONS: High quality method-specific suicide data were unavailable for a number of the most populous countries, particularly in the African and Eastern Mediterranean regions. It is likely we have underestimated incidence in these regions. CONCLUSION: There appears to have been a substantial decline in fatal pesticide self-poisoning in recent years, largely driven by a reduction in overall suicide rates in China. Nonetheless, pesticide self-poisoning remains a major public health challenge, accounting for at least one-in-seven suicides globally.
Authors: Lukas Gorecki; Vendula Hepnarova; Jana Zdarova Karasova; Martina Hrabinova; Charlotte Courageux; José Dias; Tomas Kucera; Tereza Kobrlova; Lubica Muckova; Lukas Prchal; David Malinak; Daniel Jun; Kamil Musilek; Franz Worek; Florian Nachon; Ondrej Soukup; Jan Korabecny Journal: Arch Toxicol Date: 2021-01-31 Impact factor: 5.153
Authors: Brad A Hobson; Douglas J Rowland; Sílvia Sisó; Michelle A Guignet; Zachary T Harmany; Suren B Bandara; Naomi Saito; Danielle J Harvey; Donald A Bruun; Joel R Garbow; Abhijit J Chaudhari; Pamela J Lein Journal: Toxicol Sci Date: 2019-08-01 Impact factor: 4.849