Suicidal ideation and occupational pesticide exposure among male farmers

Association between exposure to organophosphorus pesticide and suicidal ideation among U.S. adults: A population-based study

OBJECTIVE

This study aims to investigate the potential link between exposure to organophosphorus pesticides (OPPs) and suicidal ideation (SI) among adults.

METHODS

This study encompassed four cycles of the National Health and Nutrition Examination Survey (NHANES), involving 5244 participants aged 20 and above. SI was assessed using the Patient Health Questionnaire-9. The levels of exposure to OPPs were estimated by analyzing concentrations of OPP metabolites in urine samples. Multivariate logistic regression models were used to explore the association between exposure to each OPP and SI. Stratified analyses and interaction tests were conducted across various groups, including pairwise combinations of gender and age, as well as body mass index, smoking status, hypertension, and diabetes. Weighted Quantile Sum (WQS) regression and Bayesian Kernel Machine Regression (BKMR) models were applied to assess the cumulative impact of exposure to the four OPPs on SI, along with their respective contributions. Additionally, the potential interactions among these four OPPs were evaluated.

RESULTS

Multivariate logistic regression revealed that only dimethylthiophosphate (DMTP) among OPPs demonstrated a statistically significant positive association with SI [OR: 1.18; 95 % CI: 1.02-1.37]. Stratified analyses indicated that the influence of OPPs on SI was particularly pronounced in young and older men. The WQS regression analysis revealed a statistically significant association between the mixed metabolites of OPPs and SI [OR = 1.10, 95 % CI: 1.04-1.16], with DMTP (weighted 0.63) contributing the most. Furthermore, the BKMR model supported a positive trend in the overall impact of these OPP metabolites on SI, displaying notable individual exposure-response relationships for DMTP (PIP: 0.77).

CONCLUSIONS

Our study suggests an association between exposure to DMTP and an increased risk of SI. Specifically, young adult males and older males appear particularly susceptible to the effects of OPP exposure.

Anxiety and Associated Stressors Among Farm Women in England and Wales

OBJECTIVES

The findings presented here derive from a wider study that sought to establish a baseline understanding of mental health and wellbeing among the agricultural community in England and Wales. This paper focuses on selected questions that investigated levels of anxiety and associated stress factors among farm women, a group which has been relatively neglected within previous research on farming mental health in the United Kingdom.

METHODS

A questionnaire survey was widely distributed to members of the agricultural community in England and Wales (n = 15,296) in both paper and online formats. The survey included a number of standardised instruments to assess mental health and wellbeing, including the Generalised Anxiety Disorder-7 scale (GAD-7). Focusing on a sub-sample of female respondents (n = 3487), this paper details the findings from the GAD-7, alongside those from a selection of other questions investigating sources of stress, loneliness and perceived business viability.

RESULTS

A significant proportion of female respondents were experiencing anxiety at the time of survey completion, with 23.3% reaching the threshold for clinically relevant anxiety based on their GAD-7 scores (medium or severe anxiety, scores≥10). A further 34.6% were classified as experiencing mild anxiety (scores 5-9) whilst 42.1% were not suffering from anxiety (scores 0-4). Medium/severe anxiety was identified as being associated with a number of stress factors, feelings of loneliness and pessimistic perceptions of farm business viability. There were important age-based differences, with working-aged women identified as more likely to suffer from anxiety, loneliness and certain stressors than older women.

CONCLUSION

The findings reported here indicate concerning levels of anxiety among farming women and this should be seen as a call to action. There are clear associations between anxiety and a range of stressors and, although we cannot ascertain causality, these point to issues that demand attention in efforts to improve mental health within this social group. The factors contributing to anxiety are, however, multiple and complex and farm women may be affected by particular gender-based challenges that have not yet been explicitly explored in relation to mental health. Further research is needed to investigate and understand these issues in greater depth.

Suicide and suicidality in people exposed to pesticides: A systematic review and meta-analysis

Exposure to pesticides has been proposed to be a positive association in suicide and suicidality. Many studies have explored this topic, but have reported inconsistent findings. We carried out a systematic review and meta-analysis of the now existing evidence on the association between pesticide exposure and the risk of suicide and suicidality. We searched PubMed, EMBASE and Web of Science databases for studies published up to February 1, 2023. For studies that provided detailed data, we applied quantitative meta-analysis to calculate Odds ratio (OR) with 95% Confidence Intervals (CIs) to evaluate the results. Heterogeneity among the included studies was assessed using Cochran's Q test, I² statistic and tau-squared (τ²). Publication bias was evaluated by funnel plots, Egger's test, and Begg's test. In addition, subgroup analyses according to pesticides category and geographical area were performed. 2906 studies were initially identified, and 20 studies were eventually included. Fifteen of the studies were on suicide deaths and suicide attempts, and five were on suicidal ideation. Pesticide exposure was positively related to suicide deaths and suicide attempts (pooled OR = 1.31; 95%CI: 1.04-1.64, p < 0.001) and suicidal ideation (pooled OR = 2.43; 95%CI: 1.51-3.91, p = 0.015). In the subgroup analysis, mixed pesticide type (pooled OR = 1.55; 95%CI: 1.39-1.74) increased the risk of suicide deaths and suicide attempts. The results of the analysis by geographic area showed that the risk of suicide deaths and suicide attempts with pesticide exposure was 2.27 (95%CI = 1.36-3.78), and 1.33 (95%CI = 1.14-1.56) in Asia and Europe, respectively. The risk of suicidal ideation caused by pesticide exposure in Asia and America were 2.19 (95%CI = 1.08-4.42) and 2.99 (95%CI = 1.76-5.06). In conclusion, pesticide exposure may increase the risk of suicide and suicidality based on the current evidence.

Could pesticide exposure be implicated in the high incidence rates of depression, anxiety and suicide in farmers? A systematic review

Pesticide exposure and poisoning may rise the risk of mental health problems and suicidal tendencies. To explore the potential connection between chronic occupational exposure to pesticides and depression, anxiety, and suicide-related outcomes in farmers, a systematic review was performed. Systematic review protocol is available in PROSPERO registration number CRD42022316285. A total of fifty-seven studies met inclusion criteria: twenty-nine on depression or other mental disorders, twelve on suicide (two of them on both depression and suicide), and fourteen on pesticide poisoning or self-poisoning and death. Among the fifty-seven selected studies, eighteen were conducted in Asia, seventeen in North America, fourteen in South America, seven in European Union, one in Africa, and one in Australia/Oceania. Selected studies demonstrated an increased prevalence of depressive disorders in farmworkers exposed to pesticides as well as an increased self-reported prevalence of depression in this population. Moreover, previous pesticide poisoning increased the risk estimates for depression or other mental disorders as compared with chronic pesticide exposure. Severe pesticide poisoning and multiple poisoning showed increased risks of depressive symptoms compared with milder cases. In addition, financial difficulties and poor health were positively correlated with depression. Among studies on suicide, nine of them found that suicide rates increased in areas devoted to agriculture with intensive pesticide consumption. Moreover, studies demonstrate a higher suicide risk among farmers. The present review suggests more attention to the farmer's mental health and more detailed studies on occupational exposure to the mixture of these compounds.

Prevalence and factors associated with suicidal ideation among farmers

This study aimed to analyze the prevalence and factors associated with suicidal ideation among farmers. Cross-sectional study carried out between 2019 and 2020 with 450 farmers in Rio Grande do Norte. The prevalence of suicidal ideation was evaluated using the Beck Suicidal Ideation Inventory, and sociodemographic, health, income, work and alcohol abuse variables were analyzed. The Chi-square test was used to compare the proportions of the outcome between the categories of each variable. Poisson regression with robust variance was used to analyze associated factors and estimate prevalence ratios [PR]. The prevalence of suicidal ideation was 12.4% [95%CI 9.69-15.84] and, in the bivariate analysis, it was associated with sociodemographic, health, income and work variables. In the final multivariate model, the variables that remained significant and were associated with a higher prevalence of SI were: female gender [PR = 3.28], diagnosis of mental disorder in the family [PR = 2.37], presence of common mental disorder [PR = 2.50], alcohol abuse [PR = 2.22] and employment relationship-salaried or temporary [R = 1.91]. Thus, suicidal ideation among farmers is mainly associated with health aspects, especially mental health, work and the female sex, and signals the need to strengthen public policies for suicide prevention with the targeting of effective strategies for the farmers.

Exposure to pesticides or agroecological practices: suicidal ideation among peasant farmers in Brazil's semi-arid region

Health risks faced by peasant farmers may vary depending on the type of agriculture they practice. This study examined the association between suicide ideation and exposure to pesticides by comparing two groups of peasant farmers of both sexes living in the semi-arid region of the north of Minas Gerais, Brazil: exposed to pesticides and adopting agroecological practices without the use of pesticides. Group participants were selected using convenience sampling and data was collected using a previously validated questionnaire administered through face-to-face interviews. Bivariate analysis was performed, followed by logistic regression. A total of 547 peasant farmers were interviewed (311 in the group exposed to pesticides and 236 in the group adopting agroecological practices). Respondents from the group exposed to pesticides were more likely to report suicidal ideation (OR=2.30; 95%CI 1.16-4.56), harmful alcohol consumption (OR=2.30; 95%CI 1.18-4.48), and lifetime acute pesticide poisoning (OR=8.58; 95%CI 2.98-24.72). The findings suggest that agricultural practices that lead to chronic pesticide exposure are associated with a greater likelihood of suicide ideation, regardless of previous episodes of acute pesticide poisoning or harmful alcohol consumption.

Factors Associated with Suicidal Behavior in Farmers: A Systematic Review

This review aimed to investigate the factors associated with suicidal behavior in farmers in the scientific literature. Two researchers participated independently in searching databases, specifically PubMed/MEDLINE, LILACS, Web of Science, Scopus, PsycINFO, and SciELO. Only observational studies were included. The quality of the selected studies was assessed with a critical assessment checklist for cross-sectional analytical and case-control studies, prepared by the Joanna Briggs Institute. Data related to the publication were collected (author and year; city/country); methodological design; sample/population (gender; average age), outcome, measuring instrument and factors associated with suicidal behavior. A total of 14 studies were included in the systematic review, and factors associated with farmers' behavior in mental health (depression), seasonal impacts (drought), and work exposures (herbicides and insecticides) were identified. However, heterogeneity was found in terms of the method, measurement of suicidal behavior, and associated factors, which indicates the need for further studies.

Propolis-Based Nanofiber Patches to Repair Corneal Microbial Keratitis

In this research, polyvinyl-alcohol (PVA)/gelatin (GEL)/propolis (Ps) biocompatible nanofiber patches were fabricated via electrospinning technique. The controlled release of Propolis, surface wettability behaviors, antimicrobial activities against the S. aureus and P. aeruginosa, and biocompatibility properties with the mesenchymal stem cells (MSCs) were investigated in detail. By adding 0.5, 1, and 3 wt.% GEL into the 13 wt.% PVA, the morphological and mechanical results suggested that 13 wt.% PVA/0.5 wt.% GEL patch can be an ideal matrix for 3 and 5 wt.% propolis addition. Morphological results revealed that the diameters of the electrospun nanofiber patches were increased with GEL (from 290 nm to 400 nm) and Ps addition and crosslinking process cause the formation of thicker nanofibers. The tensile strength and elongation at break enhancement were also determined for 13 wt.% PVA/0.5 wt.% GEL/3 wt.% Ps patch. Propolis was released quickly in the first hour and arrived at a plateau. Cell culture and contact angle results confirmed that the 3 wt.% addition of propolis reinforced mesenchymal stem cell proliferation and wettability properties of the patches. The antimicrobial activity demonstrated that propolis loaded patches had antibacterial activity against the S. aureus, but for P. aeruginosa, more studies should be performed.

The global distribution of acute unintentional pesticide poisoning: estimations based on a systematic review

BACKGROUND

Human poisoning by pesticides has long been seen as a severe public health problem. As early as 1990, a task force of the World Health Organization (WHO) estimated that about one million unintentional pesticide poisonings occur annually, leading to approximately 20,000 deaths. Thirty years on there is no up-to-date picture of global pesticide poisoning despite an increase in global pesticide use. Our aim was to systematically review the prevalence of unintentional, acute pesticide poisoning (UAPP), and to estimate the annual global number of UAPP.

METHODS

We carried out a systematic review of the scientific literature published between 2006 and 2018, supplemented by mortality data from WHO. We extracted data from 157 publications and the WHO cause-of-death database, then performed country-wise synopses, and arrived at annual numbers of national UAPP. World-wide UAPP was estimated based on national figures and population data for regions defined by the Food and Agriculture Organization (FAO).

RESULTS

In total 141 countries were covered, including 58 by the 157 articles and an additional 83 by data from the WHO Mortality Database. Approximately 740,000 annual cases of UAPP were reported by the extracted publications resulting from 7446 fatalities and 733,921 non-fatal cases. On this basis, we estimate that about 385 million cases of UAPP occur annually world-wide including around 11,000 fatalities. Based on a worldwide farming population of approximately 860 million this means that about 44% of farmers are poisoned by pesticides every year. The greatest estimated number of UAPP cases is in southern Asia, followed by south-eastern Asia and east Africa with regards to non-fatal UAPP.

CONCLUSIONS

Our study updates outdated figures on world-wide UAPP. Along with other estimates, robust evidence is presented that acute pesticide poisoning is an ongoing major global public health challenge. There is a need to recognize the high burden of non-fatal UAPP, particularly on farmers and farmworkers, and that the current focus solely on fatalities hampers international efforts in risk assessment and prevention of poisoning. Implementation of the international recommendations to phase out highly hazardous pesticides by the FAO Council could significantly reduce the burden of UAPP.

Relationship Between Sleep Duration and Suicidal Ideation Among Farmers: Safety for Agricultural Injuries of Farmers Cohort Study of Jeju, Korea

Background

This study was conducted to identify the association between sleep duration and suicidal ideation among farmers in Korea.

Methods

We used Safety for Agricultural Injuries of Farmers cohort data collected from September 2015 to June 2018, which was an agricultural survey on the health and behaviors of adult farmers in Jeju island, Korea.

Results

A total of 964 participants were included in the analysis, and 3.7% of them were identified with having suicidal ideation. The frequencies of average daily sleep duration of <6 h (short sleep), 6-8 h (normal sleep), and >8 h (long sleep) were 24.4%, 70%, and 5.6%, respectively. Multivariate analyses revealed that short sleep duration was significantly associated with suicidal ideation compared with normal sleep duration (odds ratio = 2.49, 95% confidence interval = 1.07-5.77).

Conclusion

Our findings suggest that short sleep duration in farmers result in higher suicidal ideation. Because individuals who have suicidal ideation often commit suicide, careful monitoring is required to prevent suicide in farmers with short sleep duration.

Identification of markers of depression and neurotoxicity in pesticide exposed agriculture workers

Earlier, we reported that chronic exposure to pesticides causes a reduction in the acetylcholinesterase activity and hematological and biochemical alterations in agriculture workers. In continuation with that, the present study aimed to investigate the pesticide-induced neurochemical imbalance and its association with behavior alterations in agricultural workers. A significant increase in depressive symptoms, assessed by the Beck Depression Inventory-II was observed in pesticide exposed workers as compared to the unexposed. A decrease in the level of dopamine in plasma and levels of dopamine, 3,4-dihydroxyphenylacetic acid, homovanillic acids, norepinephrine, serotonin, and hydroxyindoleacetic acid in urine was also observed. An increase in the levels of MAO-A and MAO-B has also been observed in these individuals. The decreased levels of neurotransmitters in the blood and urine have been linked with increased levels of MAO and pesticide residues in plasma and urine. Furthermore, these changes were associated with a higher incidence of depression in agricultural workers.

Exposição a agrotóxicos e agravos à saúde em trabalhadores agrícolas: o que revela a literatura?

Resumo Introdução: a relação entre agrotóxicos e agravos à saúde tem sido investigada em diferentes contextos. Objetivo: reunir evidência científica relevante sobre agravos à saúde associados à exposição ocupacional aos agrotóxicos. Métodos: revisão de literatura de estudos publicados entre 2000 e 2017, nas bases PubMed, Embase e LILACS. Estabeleceu-se como critérios de elegibilidade: a) estudos observacionais; b) população de trabalhadores agrícolas; c) exposição ocupacional; d) agravos à saúde definidos como desfecho; e) comparação estatística de expostos com não expostos; f) idioma inglês, português ou espanhol. Resultados: 59 publicações foram elegíveis - 33 estudos transversais, 22 de coorte e 4 caso-controle. Discussão: os estudos indicam que trabalhadores rurais apresentam maior risco para alguns agravos crônicos (câncer, doenças mentais, neurológicas, endócrinas, renais, auditivas, respiratórias e autoimunes), efeitos subclínicos (danos genéticos e alterações bioquímicas) e sinais e sintomas clínicos de intoxicação aguda. Também foram identificadas limitações dos estudos quanto à avaliação da exposição e do desfecho, delineamento e amostragem. Conclusão: as evidências sugerem a necessidade de se complementar a avaliação da saúde dos trabalhadores expostos aos agrotóxicos utilizando biomarcadores de efeito de genotoxicidade e citotoxicidade, a fim de promover e ampliar a vigilância da exposição e das intoxicações crônicas e suas prevenções.

Notifiable Diseases Information System and human poisoning by pesticides in Brazil

OBJECTIVE

To analyze trends in pesticide poisoning incidence rates in Brazilian regions, according to sex and circumstances of poisoning, between 2001 and 2014.

METHOD

Ecological time-series study, with data from the national Notifiable Diseases Information System (SINAN). The incidence rates were calculated by dividing the number of confirmed new cases of pesticide poisoning by the total resident population in the same period and location. Both Polynomial regression analysis and Mann-Whitney and Kruskal-Wallis tests were performed. When significant differences were found, these tests were followed by the Bonferroni penalty, in order to identify the difference more precisely.

RESULTS

In Brazil, 80,069 notified poisoning cases were recorded from 2001 to 2014. There was a steadily increasing growth of pesticide poisoning in this population, whose growth trend was 0,377 for 100,000 inhabitants per year. The highest incidence of poisoning occurred in the South and Midest Regions. Regarding sex, no significant differences were found (p < 0,347), and attempted suicide was the most significant circumstance of poisoning (p < 0,001).

CONCLUSION

The incidence of pesticide poisoning in Brazil has been continuously increasing in the twenty-first century.

Relationship between cumulative exposure to pesticides and sleep disorders among greenhouse vegetable farmers

Background

In the northern region of China, many greenhouse vegetable farmers are exposed to high cumulative levels of pesticides due to long-term work in greenhouses that impacts their health. The aim of the current study was to identify the relationship between cumulative pesticide exposure and sleep disorders among farmers in Yinchuan, Northwest China.

Methods

A cross-sectional study was conducted for 3 consecutive years in 2015, 2016 and 2017. Using a random sampling to select the resident teams, 1366 participants were enrolled, and information was collected via face-to-face interviews by trained investigators. Ordinal logistic, multinomial logistic and poisson logistic regression models were used to identify the associations between cumulative exposure intensity (CEI) and sleep disorders.

Results

High CEI (OR = 1.56, 95% CI: 1.02–3.38) was associated with short sleep duration when compared with low CEI in the Full Model. CEI was not associated with long sleep duration. Self-rated sleep quality was associated with medium (OR = 1.46, 95% CI: 1.10–2.00) and high (OR = 2.50, 95% CI: 1.83–3.40) CEI. Similarly, having difficulty sleeping was associated with medium (OR = 1.52, 95% CI: 1.02–2.24) and high (OR = 1.74, 95% CI: 1.16–2.62) CEI. Differences in the associations by gender were also noted.

Conclusion

CEI was associated with sleep disorders, and gender differences were observed. Efforts should be made by local governments to address sleep problems that result from cumulative pesticide exposure in farmers, and gender differences should be considered.

Electronic supplementary material

The online version of this article (10.1186/s12889-019-6712-6) contains supplementary material, which is available to authorized users.

Pesticide exposure, tobacco use, poor self-perceived health and presence of chronic disease are determinants of depressive symptoms among coffee growers from Southeast Brazil

The lifestyle and other factors associated with the appearance of several health conditions that affect quality of life in rural zone is an issue that has been increasingly explored. Brazil is the largest coffee-producing nation in the world and has been a considerable consumer of pesticides since 2008. The aim of the present study was to investigate factors that could be contributing to the appearance of depressive symptoms in rural workers. Two hundred twenty male volunteers from nine cities in Southeast Brazil completed the Beck Depression Inventory-II (BDI-II) questionnaire about depressive symptoms and provided other information about socio-demographic characteristics and additional confounding factors. The adjusted multivariate logistic analysis demonstrated that pesticide exposure, tobacco use, poor self-perceived health and the presence of chronic disease contribute as risk factors for the appearance of depressive symptoms at a level above ups and downs considered normal in the BDI-II. This survey contributes to the search for solutions to improve quality of life and mental health in the rural living to the extent that social determinants of depression are being investigated.

Cardiotoxic Electrophysiological Effects of the Herbicide Roundup(®) in Rat and Rabbit Ventricular Myocardium In Vitro

Roundup (R), a glyphosate (G)-based herbicide (GBH), containing unknown adjuvants is widely dispersed around the world. Used principally by farmers, intoxications have increasingly been reported. We have studied R effects (containing 36 % of G) on right ventricular tissues (male Sprague-Dawley rats, up to 20,000 ppm and female New Zealand rabbits, at 25 and 50 ppm), to investigate R cardiac electrophysiological actions in vitro. We tested the reduced Ca(++) intracellular uptake mechanism as one potential cause of the electrical abnormalities after GBH superfusion, using the Na(+)/K(+)-ATPase inhibitor ouabain or the 1,4-dihydropyridine L-type calcium channel agonist BAY K 8644 which increases I Ca. R concentrations were selected based on human blood ranges found after acute intoxication. The study showed dose-dependent V max, APD50 and APD90 variations during 45 min of R superfusion. At the highest concentrations tested, there was a high incidence of conduction blocks, and 30-min washout with normal Tyrode solution did not restore excitability. We also observed an increased incidence of arrhythmias at different doses of R. Ouabain and BAY K 8644 prevented V max decrease, APD90 increase and the cardiac inexcitability induced by R 50 ppm. Glyphosate alone (18 and 180 ppm) had no significant electrophysiological effects. Thus, the action potential prolonging effect of R pointing to I Ca interference might explain both conduction blocks and proarrhythmia in vitro. These mechanisms may well be causative of QT prolongation, atrioventricular conduction blocks and arrhythmias in man after GBH acute intoxications as reported in retrospective hospital records.

Glyphosate-based herbicides potently affect cardiovascular system in mammals: review of the literature

In glyphosate (G)-based herbicides (GBHs), the declared active principle G is mixed with several adjuvants that help it to penetrate the plants' cell membranes and its stabilization and liposolubility. Its utilization is growing with genetically modified organisms engineered to tolerate GBH. Millions of farmers suffer poisoning and death in developing countries, and occupational exposures and suicide make GBH toxicity a worldwide concern. As GBH is found in human plasma, widespread hospital facilities for measuring it should be encouraged. Plasma determination is an essential prerequisite for risk assessment in GBH intoxication. Only when standard ECGs were performed, at least one abnormal ECG was detected in the large majority of cases after intoxication. QTc prolongation and arrhythmias along with first-degree atrioventricular block were observed after GBH intoxication. Thus, life-threatening arrhythmias might be the cause of death in GBH intoxication. Cardiac cellular effects of GBH were reviewed along with few case reports in men and scanty larger studies. We observed in two mammalian species (rats and rabbits) direct cardiac electrophysiological changes, conduction blocks and arrhythmias among GBH-mediated effects. Plasmatic (and urine) level determinations of G and electrocardiographic Holter monitoring seem warranted to ascertain whether cardiovascular risk among agro-alimentary workers might be defined.

Mortality from and incidence of pesticide poisoning in South Korea: findings from National Death and Health Utilization Data between 2006 and 2010

Pesticide poisoning has been recognized as an important public health issue around the world. The objectives of this study were to report nationally representative figures on mortality from and the incidence of pesticide poisoning in South Korea and to describe their epidemiologic characteristics. We calculated the age-standardized rates of mortality from and the incidence of pesticide poisoning in South Korea by gender and region from 2006 through 2010 using registered death data obtained from Statistics Korea and national healthcare utilization data obtained from the National Health Insurance Review and Assessment Service of South Korea. During the study period of 2006 through 2010, a total of 16,161 deaths and 45,291 patients related to pesticide poisoning were identified, marking respective mortality and incidence rates of 5.35 and 15.37 per 100,000 population. Intentional self-poisoning was identified as the major cause of death due to pesticides (85.9%) and accounted for 20.8% of all recorded suicides. The rates of mortality due to and incidence of pesticide poisoning were higher in rural than in urban areas, and this rural-urban discrepancy was more pronounced for mortality than for incidence. Both the rate of mortality due to pesticide poisoning and its incidence rate increased with age and were higher among men than women. This study provides the magnitude and epidemiologic characteristics for mortality from and the incidence of pesticide poisoning at the national level, and strongly suggests the need for further efforts to prevent pesticide self-poisonings, especially in rural areas in South Korea.