The impact of pesticide suicide on the geographic distribution of suicide in Taiwan: a spatial analysis
The impact of pesticide suicide on the geographic distribution of suicide in Taiwan: a spatial analysis
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DOI：
10.1186/1471-2458-12-260
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发表时间：
2012-04-02
影响因子：
4.5
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
背景资料：农药自我中毒是世界上最常用的自杀方法，但很少有研究调查农药自杀是一个主要公共卫生问题的国家的国家流行病学。本研究旨在探讨农药自杀的地理变异及其对台湾自杀空间分布的影响。农药自杀的平滑标准化死亡率（2002-2009）在台湾358个地区绘制（十五岁或以上人口中位数= 27 000），以及它们与农业劳动力规模之间的关系。在2002-2009年，农药中毒是台湾第三大最常见的自杀方式，占所有自杀人数的13.6%（4913/36110）。台湾东部和中部农业区的发病率较高，主要城市的发病率较低。几乎一半（47%）的农药自杀发生在只有13%人口居住的地区。总体自杀者的地理分布与农药自杀者比非农药自杀者更相似。自杀的城乡差异主要是由于农药自杀。农业人口比例较高的地区农药自杀率较高（农业工人比例每标准差增加的调整率比[ARR]= 1.58，95%可信区间[CrI] 1.44-1.74）和总体自杀率（ARR = 1.06，95% CrI 1.03-1.10）但非农药自杀率较低（ARR = 0.91，95%CrI 0.87-0.95）。农药的容易获得似乎影响了台湾自杀的地理分布，强调限制获取剧毒农药等有针对性的预防战略的潜在好处。
Background: Pesticide self-poisoning is the most commonly used suicide method worldwide, but few studies have investigated the national epidemiology of pesticide suicide in countries where it is a major public health problem. This study aims to investigate geographic variations in pesticide suicide and their impact on the spatial distribution of suicide in Taiwan.Methods: Smoothed standardized mortality ratios for pesticide suicide (2002-2009) were mapped across Taiwan's 358 districts (median population aged 15 or above = 27 000), and their associations with the size of agricultural workforce were investigated using Bayesian hierarchical models.Results: In 2002-2009 pesticide poisoning was the third most common suicide method in Taiwan, accounting for 13.6% (4913/36 110) of all suicides. Rates were higher in agricultural East and Central Taiwan and lower in major cities. Almost half (47%) of all pesticide suicides occurred in areas where only 13% of Taiwan's population lived. The geographic distribution of overall suicides was more similar to that of pesticide suicides than non-pesticide suicides. Rural-urban differences in suicide were mostly due to pesticide suicide. Areas where a higher proportion of people worked in agriculture showed higher pesticide suicide rates (adjusted rate ratio [ARR] per standard deviation increase in the proportion of agricultural workers = 1.58, 95% Credible Interval [CrI] 1.44-1.74) and overall suicide rates (ARR = 1.06, 95% CrI 1.03-1.10) but lower non-pesticide suicide rates (ARR = 0.91, 95% CrI 0.87-0.95).Conclusion: Easy access to pesticides appears to influence the geographic distribution of suicide in Taiwan, highlighting the potential benefits of targeted prevention strategies such as restricting access to highly toxic pesticides.