Bans of WHO Class I Pesticides in Bangladesh-suicide prevention without hampering agricultural output.
Bans of WHO Class I Pesticides in Bangladesh-suicide prevention without hampering agricultural output.
复制标题
DOI：
10.1093/ije/dyx157
复制
发表时间：
2018-02-01
影响因子：
7.7
通讯作者：
Eddleston M
中科院分区：
文献类型：
--
作者：
Chowdhury FR;Dewan G;Verma VR;Knipe DW;Isha IT;Faiz MA;Gunnell DJ;Eddleston M
农药自身中毒是孟加拉国的一个主要问题。在过去的20年里，孟加拉国政府引入了农药立法，禁止在农业中使用高度危险的农药。我们的目的是评估农药禁令对自杀和农业生产的影响。我们从孟加拉国警察局的统计部门获得了非自然死亡的数据，并使用负二项回归来量化2000年从农业中去除世卫组织一级毒性HHPs后农药自杀和非自然死亡的变化。我们评估了1996年至2014年孟加拉国其他风险因素、农药使用和农业生产的同期趋势。2000年禁令后，医院农药中毒死亡率下降：15.1%对9.5%，相对下降37.1%[95%置信区间（CI） 35.4到38.8%]。农药中毒自杀率由1996年的6.3/10万下降到2014年的2.2/10万，下降65.1%（52.0 ~ 76.7%）。与此同时，上吊自杀人数略有上升[上升20.0%(8.4%至36.9%)]，但非自然死亡的总体发生率从14.0/10万下降至10.5/10万[下降25.0%(18.1%至33.0%)]。与基于1996年至2000年趋势预测的数字相比，2001年至2014年农药自杀人数减少了35 071人（95% CI 25 959至45 666）。尽管农药使用量增加，农药中毒入院人数没有变化，但农药自杀率却有所下降，对农业产量没有明显影响。在孟加拉国，加强农药监管和禁止世卫组织一级毒性HHPs与死亡和医院死亡率的大幅下降有关，但对农业产出没有任何明显影响。我们的数据表明，从农业中去除HHPs可以迅速减少自杀，而不会增加大量的农业成本。
Pesticide self-poisoning is a major problem in Bangladesh. Over the past 20-years, the Bangladesh government has introduced pesticide legislation and banned highly hazardous pesticides (HHPs) from agricultural use. We aimed to assess the impacts of pesticide bans on suicide and on agricultural production. We obtained data on unnatural deaths from the Statistics Division of Bangladesh Police, and used negative binomial regression to quantify changes in pesticide suicides and unnatural deaths following removal of WHO Class I toxicity HHPs from agriculture in 2000. We assessed contemporaneous trends in other risk factors, pesticide usage and agricultural production in Bangladesh from 1996 to 2014. Mortality in hospital from pesticide poisoning fell after the 2000 ban: 15.1% vs 9.5%, relative reduction 37.1% [95% confidence interval (CI) 35.4 to 38.8%]. The pesticide poisoning suicide rate fell from 6.3/100 000 in 1996 to 2.2/100 000 in 2014, a 65.1% (52.0 to 76.7%) decline. There was a modest simultaneous increase in hanging suicides [20.0% (8.4 to 36.9%) increase] but the overall incidence of unnatural deaths fell from 14.0/100 000 to 10.5/100 000 [25.0% (18.1 to 33.0%) decline]. There were 35 071 (95% CI 25 959 to 45 666) fewer pesticide suicides in 2001 to 2014 compared with the number predicted based on trends between 1996 to 2000. This reduction in rate of pesticide suicides occurred despite increased pesticide use and no change in admissions for pesticide poisoning, with no apparent influence on agricultural output. Strengthening pesticide regulation and banning WHO Class I toxicity HHPs in Bangladesh were associated with major reductions in deaths and hospital mortality, without any apparent effect on agricultural output. Our data indicate that removing HHPs from agriculture can rapidly reduce suicides without imposing substantial agricultural costs.
登录
查看更多内容
影响因子：
7.7
作者：
Cha, Eun Shil;Chang, Shu-Sen;Lee, Won Jin
通讯作者：
Lee, Won Jin
影响因子：
3.3
作者：
Chang, Shu-Sen;Lu, Tsung-Hsueh;Gunnell, David
通讯作者：
Gunnell, David
影响因子：
4.5
作者：
Chang, Shu-Sen;Lu, Tsung-Hsueh;Gunnell, David
通讯作者：
Gunnell, David
影响因子：
5.4
作者：
Ahmed, MK;van Ginneken, J;Alam, N
通讯作者：
Alam, N
DOI：
10.1080/15563650600584444
发表时间：
2006
期刊：
Clinical toxicology (Philadelphia, Pa.)
影响因子：
--
作者：
Eddleston M;Karunaratne A;Weerakoon M;Kumarasinghe S;Rajapakshe M;Sheriff MH;Buckley NA;Gunnell D
通讯作者：
Gunnell D