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Effects of a provincial ban of two toxic organophosphorus insecticides on pesticide poisoning hospital admissions

BACKGROUND. Pesticide self-poisoning causes one third of global suicides. Sri Lanka halved its suicide rate by banning WHO Class I organophosphorus (OP) insecticides and then endosulfan. However, poisoning with Class II toxicity OPs, particularly dimethoate and fenthion, remains a problem. We aimed...

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Autores principales: Eddleston, Michael, Adhikari, Sriyantha, Egodage, Samitha, Ranganath, Hasantha, Mohamed, Fahim, Manuweera, Gamini, Azher, Shifa, Jayamanne, Shaluka, Juzczak, Edmund, Sheriff, MH Rezvi, Dawson, Andrew H., Buckley, Nick A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Informa Healthcare 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3793265/
https://www.ncbi.nlm.nih.gov/pubmed/22372788
http://dx.doi.org/10.3109/15563650.2012.660573
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author Eddleston, Michael
Adhikari, Sriyantha
Egodage, Samitha
Ranganath, Hasantha
Mohamed, Fahim
Manuweera, Gamini
Azher, Shifa
Jayamanne, Shaluka
Juzczak, Edmund
Sheriff, MH Rezvi
Dawson, Andrew H.
Buckley, Nick A.
author_facet Eddleston, Michael
Adhikari, Sriyantha
Egodage, Samitha
Ranganath, Hasantha
Mohamed, Fahim
Manuweera, Gamini
Azher, Shifa
Jayamanne, Shaluka
Juzczak, Edmund
Sheriff, MH Rezvi
Dawson, Andrew H.
Buckley, Nick A.
author_sort Eddleston, Michael
collection PubMed
description BACKGROUND. Pesticide self-poisoning causes one third of global suicides. Sri Lanka halved its suicide rate by banning WHO Class I organophosphorus (OP) insecticides and then endosulfan. However, poisoning with Class II toxicity OPs, particularly dimethoate and fenthion, remains a problem. We aimed to determine the effect and feasibility of a ban of the two insecticides in one Sri Lankan district. METHODS. Sale was banned in June 2003 in most of Polonnaruwa District, but not Anuradhapura District. Admissions with pesticide poisoning to the district general hospitals was prospectively recorded from 2002. RESULTS. Hospital admissions for dimethoate and fenthion poisoning fell by 43% after the ban in Polonnaruwa, while increasing by 23% in Anuradhapura. The pesticide case fatality fell from 14.4% to 9.0% in Polonnaruwa (odds ratio [OR] 0.59, 95% confidence interval [CI] 0.41–0.84) and 11.3% to 10.6% in Anuradhapura (OR 0.93, 95%CI 0.70–1.25; p = 0.051). This reduction was not sustained, with case fatality in Polonnaruwa rising to 12.1% in 2006–2007. Further data analysis indicated that the fall in case fatality had actually been due to a coincidental reduction in case fatality for pesticide poisoning overall, in particular for paraquat poisoning. CONCLUSIONS. We found that the insecticides could be effectively banned from agricultural practice, as shown by the fall in hospital admissions, with few negative consequences. However, the ban had only a minor effect on pesticide poisoning deaths because it was too narrow. A study assessing the agricultural and health effects of a more comprehensive ban of highly toxic pesticides is necessary to determine the balance between increased costs of agriculture and reduced health care costs and fewer deaths.
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spelling pubmed-37932652013-10-10 Effects of a provincial ban of two toxic organophosphorus insecticides on pesticide poisoning hospital admissions Eddleston, Michael Adhikari, Sriyantha Egodage, Samitha Ranganath, Hasantha Mohamed, Fahim Manuweera, Gamini Azher, Shifa Jayamanne, Shaluka Juzczak, Edmund Sheriff, MH Rezvi Dawson, Andrew H. Buckley, Nick A. Clin Toxicol (Phila) Research Article BACKGROUND. Pesticide self-poisoning causes one third of global suicides. Sri Lanka halved its suicide rate by banning WHO Class I organophosphorus (OP) insecticides and then endosulfan. However, poisoning with Class II toxicity OPs, particularly dimethoate and fenthion, remains a problem. We aimed to determine the effect and feasibility of a ban of the two insecticides in one Sri Lankan district. METHODS. Sale was banned in June 2003 in most of Polonnaruwa District, but not Anuradhapura District. Admissions with pesticide poisoning to the district general hospitals was prospectively recorded from 2002. RESULTS. Hospital admissions for dimethoate and fenthion poisoning fell by 43% after the ban in Polonnaruwa, while increasing by 23% in Anuradhapura. The pesticide case fatality fell from 14.4% to 9.0% in Polonnaruwa (odds ratio [OR] 0.59, 95% confidence interval [CI] 0.41–0.84) and 11.3% to 10.6% in Anuradhapura (OR 0.93, 95%CI 0.70–1.25; p = 0.051). This reduction was not sustained, with case fatality in Polonnaruwa rising to 12.1% in 2006–2007. Further data analysis indicated that the fall in case fatality had actually been due to a coincidental reduction in case fatality for pesticide poisoning overall, in particular for paraquat poisoning. CONCLUSIONS. We found that the insecticides could be effectively banned from agricultural practice, as shown by the fall in hospital admissions, with few negative consequences. However, the ban had only a minor effect on pesticide poisoning deaths because it was too narrow. A study assessing the agricultural and health effects of a more comprehensive ban of highly toxic pesticides is necessary to determine the balance between increased costs of agriculture and reduced health care costs and fewer deaths. Informa Healthcare 2012-03 2012-02-29 /pmc/articles/PMC3793265/ /pubmed/22372788 http://dx.doi.org/10.3109/15563650.2012.660573 Text en © 2012 Informa Healthcare USA, Inc. http://creativecommons.org/licenses/by-nc/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the source is credited.
spellingShingle Research Article
Eddleston, Michael
Adhikari, Sriyantha
Egodage, Samitha
Ranganath, Hasantha
Mohamed, Fahim
Manuweera, Gamini
Azher, Shifa
Jayamanne, Shaluka
Juzczak, Edmund
Sheriff, MH Rezvi
Dawson, Andrew H.
Buckley, Nick A.
Effects of a provincial ban of two toxic organophosphorus insecticides on pesticide poisoning hospital admissions
title Effects of a provincial ban of two toxic organophosphorus insecticides on pesticide poisoning hospital admissions
title_full Effects of a provincial ban of two toxic organophosphorus insecticides on pesticide poisoning hospital admissions
title_fullStr Effects of a provincial ban of two toxic organophosphorus insecticides on pesticide poisoning hospital admissions
title_full_unstemmed Effects of a provincial ban of two toxic organophosphorus insecticides on pesticide poisoning hospital admissions
title_short Effects of a provincial ban of two toxic organophosphorus insecticides on pesticide poisoning hospital admissions
title_sort effects of a provincial ban of two toxic organophosphorus insecticides on pesticide poisoning hospital admissions
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3793265/
https://www.ncbi.nlm.nih.gov/pubmed/22372788
http://dx.doi.org/10.3109/15563650.2012.660573
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