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Published in: BMC Public Health 1/2009

Open Access 01-12-2009 | Research article

Pattern of pesticide storage before pesticide self-poisoning in rural Sri Lanka

Authors: Fahim Mohamed, Gamini Manuweera, David Gunnell, Shifa Azher, Michael Eddleston, Andrew Dawson, Flemming Konradsen

Published in: BMC Public Health | Issue 1/2009

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Abstract

Background

Deliberate self-poisoning with agricultural pesticides is the commonest means of suicide in rural Asia. It is mostly impulsive and facilitated by easy access to pesticides. The aim of this large observational study was to investigate the immediate source of pesticides used for self-harm to help inform suicide prevention strategies such as reducing domestic access to pesticides.

Methods

The study was conducted in a district hospital serving an agricultural region of Sri Lanka. Patients who had self-poisoned with pesticides and were admitted to the adult medical wards were interviewed by study doctors following initial resuscitation to identify the source of pesticides they have ingested.

Results

Of the 669 patients included in the analysis, 425 (63.5%) were male; the median age was 26 (IQR 20-36). In 511 (76%) cases, the pesticides had been stored either inside or immediately outside the house; among this group only eight patients obtained pesticides that were kept in a locked container. Ten percent (n = 67) of the patients used pesticides stored in the field while 14% (n = 91) purchased pesticides from shops within a few hours of the episode. The most common reasons for choosing the particular pesticide for self-harm were its easy accessibility (n = 311, 46%) or its popularity as a suicide agent in their village (n = 290, 43%).

Conclusion

Three quarters of people who ingested pesticides in acts of self-harm used products that were available within the home or in close proximity; relatively few patients purchased the pesticide for the act. The study highlights the importance of reducing the accessibility of toxic pesticides in the domestic environment.
Literature
1.
go back to reference WHO: World Health Report 2004, WHO, Geneva; 2004. 2004 WHO: World Health Report 2004, WHO, Geneva; 2004. 2004
2.
go back to reference Eddleston M: Patterns and problems of deliberate self-poisoning in the developing world. QJM. 2000, 93 (11): 715-731. 10.1093/qjmed/93.11.715.CrossRefPubMed Eddleston M: Patterns and problems of deliberate self-poisoning in the developing world. QJM. 2000, 93 (11): 715-731. 10.1093/qjmed/93.11.715.CrossRefPubMed
3.
go back to reference Gunnell D, Eddleston M, Phillips MR, Konradsen F: The global distribution of fatal pesticide self-poisoning: systematic review. BMC Public Health. 2007, 7: 357-10.1186/1471-2458-7-357.CrossRefPubMedPubMedCentral Gunnell D, Eddleston M, Phillips MR, Konradsen F: The global distribution of fatal pesticide self-poisoning: systematic review. BMC Public Health. 2007, 7: 357-10.1186/1471-2458-7-357.CrossRefPubMedPubMedCentral
4.
go back to reference Gunnell D, Eddleston M: Suicide by intentional ingestion of pesticides: a continuing tragedy in developing countries. Int J Epidemiol. 2003, 32 (6): 902-909. 10.1093/ije/dyg307.CrossRefPubMedPubMedCentral Gunnell D, Eddleston M: Suicide by intentional ingestion of pesticides: a continuing tragedy in developing countries. Int J Epidemiol. 2003, 32 (6): 902-909. 10.1093/ije/dyg307.CrossRefPubMedPubMedCentral
5.
go back to reference Conner KR, Phillips MR, Meldrum S, Knox KL, Zhang Y, Yang G: Low-planned suicides in China. Psychol Med. 2005, 35 (8): 1197-1204. 10.1017/S003329170500454X.CrossRefPubMed Conner KR, Phillips MR, Meldrum S, Knox KL, Zhang Y, Yang G: Low-planned suicides in China. Psychol Med. 2005, 35 (8): 1197-1204. 10.1017/S003329170500454X.CrossRefPubMed
6.
go back to reference Konradsen F, Hoek van der W, Cole DC, Hutchinson G, Daisley H, Singh S, Eddleston M: Reducing acute poisoning in developing countries--options for restricting the availability of pesticides. Toxicology. 2003, 192 (2-3): 249-261. 10.1016/S0300-483X(03)00339-1.CrossRefPubMed Konradsen F, Hoek van der W, Cole DC, Hutchinson G, Daisley H, Singh S, Eddleston M: Reducing acute poisoning in developing countries--options for restricting the availability of pesticides. Toxicology. 2003, 192 (2-3): 249-261. 10.1016/S0300-483X(03)00339-1.CrossRefPubMed
7.
go back to reference Eddleston M, Karalliedde L, Buckley N, Fernando R, Hutchinson G, Isbister G, Konradsen F, Murray D, Piola JC, Senanayake N, et al: Pesticide poisoning in the developing world--a minimum pesticides list. Lancet. 2002, 360 (9340): 1163-1167. 10.1016/S0140-6736(02)11204-9.CrossRefPubMed Eddleston M, Karalliedde L, Buckley N, Fernando R, Hutchinson G, Isbister G, Konradsen F, Murray D, Piola JC, Senanayake N, et al: Pesticide poisoning in the developing world--a minimum pesticides list. Lancet. 2002, 360 (9340): 1163-1167. 10.1016/S0140-6736(02)11204-9.CrossRefPubMed
8.
go back to reference Konradsen F, Pieris R, Weerasinghe M, Hoek van der W, Eddleston M, Dawson AH: Community uptake of safe storage boxes to reduce self-poisoning from pesticides in rural Sri Lanka. BMC Public Health. 2007, 7: 13-10.1186/1471-2458-7-13.CrossRefPubMedPubMedCentral Konradsen F, Pieris R, Weerasinghe M, Hoek van der W, Eddleston M, Dawson AH: Community uptake of safe storage boxes to reduce self-poisoning from pesticides in rural Sri Lanka. BMC Public Health. 2007, 7: 13-10.1186/1471-2458-7-13.CrossRefPubMedPubMedCentral
9.
go back to reference Weerasinghe M, Pieris R, Eddleston M, Hoek W, Dawson A, Konradsen F: Safe storage of pesticides in Sri Lanka - identifying important design features influencing community acceptance and use of safe storage devices. BMC Public Health. 2008, 8: 276-10.1186/1471-2458-8-276.CrossRefPubMedPubMedCentral Weerasinghe M, Pieris R, Eddleston M, Hoek W, Dawson A, Konradsen F: Safe storage of pesticides in Sri Lanka - identifying important design features influencing community acceptance and use of safe storage devices. BMC Public Health. 2008, 8: 276-10.1186/1471-2458-8-276.CrossRefPubMedPubMedCentral
10.
go back to reference Hawton K, Ratnayeke L, Simkin S, Harriss L, Scott V: Evaluation of acceptability and use of lockable storage devices for pesticides in Sri Lanka that might assist in prevention of self-poisoning. BMC Public Health. 2009, 9: 69-10.1186/1471-2458-9-69.CrossRefPubMedPubMedCentral Hawton K, Ratnayeke L, Simkin S, Harriss L, Scott V: Evaluation of acceptability and use of lockable storage devices for pesticides in Sri Lanka that might assist in prevention of self-poisoning. BMC Public Health. 2009, 9: 69-10.1186/1471-2458-9-69.CrossRefPubMedPubMedCentral
11.
go back to reference CropLife International: Guidelines for the safe and effective use of crop protection products. 1998, Brussels: Belgium CropLife International: Guidelines for the safe and effective use of crop protection products. 1998, Brussels: Belgium
12.
go back to reference FAO: International Code of Conduct on the Distribution andUse of Pesticides. 2002, Rome: FAO FAO: International Code of Conduct on the Distribution andUse of Pesticides. 2002, Rome: FAO
13.
go back to reference Phillips MR, Yang G, Zhang Y, Wang L, Ji H, Zhou M: Risk factors for suicide in China: a national case-control psychological autopsy study. Lancet. 2002, 360 (9347): 1728-1736. 10.1016/S0140-6736(02)11681-3.CrossRefPubMed Phillips MR, Yang G, Zhang Y, Wang L, Ji H, Zhou M: Risk factors for suicide in China: a national case-control psychological autopsy study. Lancet. 2002, 360 (9347): 1728-1736. 10.1016/S0140-6736(02)11681-3.CrossRefPubMed
14.
go back to reference Bose A, Sandal Sejbaek C, Suganthy P, Raghava V, Alex R, Muliyil J, Konradsen F: Self-harm and self-poisoning in southern India: choice of poisoning agents and treatment. Trop Med Int Health. 2009 Bose A, Sandal Sejbaek C, Suganthy P, Raghava V, Alex R, Muliyil J, Konradsen F: Self-harm and self-poisoning in southern India: choice of poisoning agents and treatment. Trop Med Int Health. 2009
15.
go back to reference Eddleston M, Karunaratne A, Weerakoon M, Kumarasinghe S, Rajapakshe M, Sheriff MH, Buckley NA, Gunnell D: Choice of poison for intentional self-poisoning in rural Sri Lanka. Clin Toxicol (Phila). 2006, 44 (3): 283-286.CrossRef Eddleston M, Karunaratne A, Weerakoon M, Kumarasinghe S, Rajapakshe M, Sheriff MH, Buckley NA, Gunnell D: Choice of poison for intentional self-poisoning in rural Sri Lanka. Clin Toxicol (Phila). 2006, 44 (3): 283-286.CrossRef
16.
go back to reference Census of population and housing 2001. 2001, Department of Census and Statistics, Government of Sri Lanka, Sri Lanka Census of population and housing 2001. 2001, Department of Census and Statistics, Government of Sri Lanka, Sri Lanka
17.
18.
go back to reference Eddleston M, Buckley NA, Gunnell D, Dawson AH, Konradsen F: Identification of strategies to prevent death after pesticide self-poisoning using a Haddon matrix. Inj Prev. 2006, 12 (5): 333-337. 10.1136/ip.2006.012641.CrossRefPubMedPubMedCentral Eddleston M, Buckley NA, Gunnell D, Dawson AH, Konradsen F: Identification of strategies to prevent death after pesticide self-poisoning using a Haddon matrix. Inj Prev. 2006, 12 (5): 333-337. 10.1136/ip.2006.012641.CrossRefPubMedPubMedCentral
19.
go back to reference Wilks MF, Fernando R, Ariyananda PL, Eddleston M, Berry DJ, Tomenson JA, Buckley NA, Jayamanne S, Gunnell D, Dawson A: Improvement in survival after paraquat ingestion following introduction of a new formulation in Sri Lanka. PLoS Med. 2008, 5 (2): e49-10.1371/journal.pmed.0050049.CrossRefPubMedPubMedCentral Wilks MF, Fernando R, Ariyananda PL, Eddleston M, Berry DJ, Tomenson JA, Buckley NA, Jayamanne S, Gunnell D, Dawson A: Improvement in survival after paraquat ingestion following introduction of a new formulation in Sri Lanka. PLoS Med. 2008, 5 (2): e49-10.1371/journal.pmed.0050049.CrossRefPubMedPubMedCentral
20.
go back to reference Oliver RG: Rise and fall of suicide rates in Australia: relation to sedative availability. Med J Aust. 1972, 2 (21): 1208-1209.PubMed Oliver RG: Rise and fall of suicide rates in Australia: relation to sedative availability. Med J Aust. 1972, 2 (21): 1208-1209.PubMed
21.
go back to reference Hawton K, Townsend E, Deeks J, Appleby L, Gunnell D, Bennewith O, Cooper J: Effects of legislation restricting pack sizes of paracetamol and salicylate on self poisoning in the United Kingdom: before and after study. BMJ. 2001, 322 (7296): 1203-1207. 10.1136/bmj.322.7296.1203.CrossRefPubMedPubMedCentral Hawton K, Townsend E, Deeks J, Appleby L, Gunnell D, Bennewith O, Cooper J: Effects of legislation restricting pack sizes of paracetamol and salicylate on self poisoning in the United Kingdom: before and after study. BMJ. 2001, 322 (7296): 1203-1207. 10.1136/bmj.322.7296.1203.CrossRefPubMedPubMedCentral
22.
go back to reference Hawton K, Bergen H, Simkin S, Brock A, Griffiths C, Romeri E, Smith KL, Kapur N, Gunnell D: Effect of withdrawal of co-proxamol on prescribing and deaths from drug poisoning in England and Wales: time series analysis. BMJ. 2009, 338: b2270-10.1136/bmj.b2270.CrossRefPubMedPubMedCentral Hawton K, Bergen H, Simkin S, Brock A, Griffiths C, Romeri E, Smith KL, Kapur N, Gunnell D: Effect of withdrawal of co-proxamol on prescribing and deaths from drug poisoning in England and Wales: time series analysis. BMJ. 2009, 338: b2270-10.1136/bmj.b2270.CrossRefPubMedPubMedCentral
23.
go back to reference Roberts DM, Karunarathna A, Buckley NA, Manuweera G, Sheriff MH, Eddleston M: Influence of pesticide regulation on acute poisoning deaths in Sri Lanka. Bull World Health Organ. 2003, 81 (11): 789-798.PubMed Roberts DM, Karunarathna A, Buckley NA, Manuweera G, Sheriff MH, Eddleston M: Influence of pesticide regulation on acute poisoning deaths in Sri Lanka. Bull World Health Organ. 2003, 81 (11): 789-798.PubMed
24.
go back to reference Manuweera G, Eddleston M, Egodage S, Buckley NA: Do targeted bans of insecticides to prevent deaths from self-poisoning result in reduced agricultural output?. Environ Health Perspect. 2008, 116 (4): 492-495.PubMedPubMedCentral Manuweera G, Eddleston M, Egodage S, Buckley NA: Do targeted bans of insecticides to prevent deaths from self-poisoning result in reduced agricultural output?. Environ Health Perspect. 2008, 116 (4): 492-495.PubMedPubMedCentral
25.
go back to reference Gunnell D, Fernando R, Hewagama M, Priyangika WD, Konradsen F, Eddleston M: The impact of pesticide regulations on suicide in Sri Lanka. Int J Epidemiol. 2007, 36 (6): 1235-1242. 10.1093/ije/dym164.CrossRefPubMedPubMedCentral Gunnell D, Fernando R, Hewagama M, Priyangika WD, Konradsen F, Eddleston M: The impact of pesticide regulations on suicide in Sri Lanka. Int J Epidemiol. 2007, 36 (6): 1235-1242. 10.1093/ije/dym164.CrossRefPubMedPubMedCentral
Metadata
Title
Pattern of pesticide storage before pesticide self-poisoning in rural Sri Lanka
Authors
Fahim Mohamed
Gamini Manuweera
David Gunnell
Shifa Azher
Michael Eddleston
Andrew Dawson
Flemming Konradsen
Publication date
01-12-2009
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2009
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-9-405

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