Factors associated with the decline in suicide by pesticide poisoning in Taiwan: A time trend analysis, 1987-2010
Factors associated with the decline in suicide by pesticide poisoning in Taiwan: A time trend analysis, 1987-2010
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DOI：
10.3109/15563650.2012.688835
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发表时间：
2012-07-01
影响因子：
3.3
通讯作者：
Gunnell, David
中科院分区：
文献类型：
--
作者：
Chang, Shu-Sen;Lu, Tsung-Hsueh;Gunnell, David
Objective.农药自我中毒占全球自杀的三分之一，但很少有研究调查农药自杀是常用方法的国家的国家流行病学。我们调查了台湾这个快速发展的东亚国家农药自杀的趋势，以及与这种趋势相关的因素。方法.我们进行了一项生态研究，使用图形方法和斯皮尔曼的相关系数，以检查农药自杀的趋势（1987-2010年）在台湾的农药销售，禁止选定的农药，农业劳动力的比例和失业。我们比较了台湾政府禁止的农药产品与市场上仍然存在的产品以及台湾中毒死亡人数最多的农药。结果农药自杀率从1987年的每10万人7.7人（占所有自杀人数的42%）下降到2010年的每10万人2.5人（占所有自杀人数的12%），下降了67%，而其他方法的自杀率则上升了69%。农药中毒是1987年最常用的自杀方法，但到2010年已成为第三大最常见的自杀方法。农业劳动力减少了66%，但没有强有力的证据表明其与农药销售趋势、特定农药产品禁令或失业有关。这些禁令大多是在农药自杀事件下降之后颁布的;此外，这些禁令不包括造成大多数死亡的产品（如百草枯），而且主要限于选定的高浓度配制产品，而与之相当的低浓度产品则没有被禁止。结论.农业劳动力的规模表明，农药的获得似乎影响农药自杀在台湾的趋势。有针对性的农药禁令应该集中在那些造成大多数死亡的产品上。
Objective. Pesticide self-poisoning accounts for one-third of suicides worldwide, but few studies have investigated the national epidemiology of pesticide suicide in countries where it is a commonly used method. We investigated trends in pesticide suicide, and factors associated with such trends, in Taiwan, a rapidly developing East Asian country. Methods. We conducted an ecological study using graphical approaches and Spearman's correlation coefficients to examine trends in pesticide suicide (1987-2010) in Taiwan in relation to pesticide sales, bans on selected pesticides, the proportion of the workforce involved in agriculture and unemployment. We compared pesticide products banned by the Taiwanese government with products that remained on the market and pesticides that accounted for the most poisoning deaths in Taiwan. Results. Age-standardised rates of pesticide suicide showed a 67% reduction from 7.7 per 100,000 (42% of all suicides) in 1987 to 2.5 per 100,000 (12% of all suicides) in 2010, in contrast to a 69% increase in suicide rates by other methods. Pesticide poisoning was the most commonly used method of suicide in 1987 but had become the third most common method by 2010. The reduction was paralleled by a 66% fall in the workforce involved in agriculture but there was no strong evidence for its association with trends in pesticide sales, bans on selected pesticide products or unemployment. The bans mostly post-dated the decline in pesticide suicides; furthermore, they did not include products (e.g. paraquat) that accounted for most deaths and were mainly restricted to selected high-strength formulated products whilst their equivalent low-strength products were not banned. Conclusions. Access to pesticides, indicated by the size of agricultural workforce, appears to influence trends in pesticide suicide in Taiwan. Targeted bans on pesticides should focus on those products that account for most deaths.