1
|
Schölin L, Hashini P, Kanapathy R, van Schalkwyk MCI, Eddleston M, Konradsen F, Weerasinghe M. "Ad hoc policy decisions" in the news: Media framing analysis of a pesticide import ban in Sri Lanka. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003497. [PMID: 39012886 PMCID: PMC11251609 DOI: 10.1371/journal.pgph.0003497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 06/24/2024] [Indexed: 07/18/2024]
Abstract
Modern agriculture relies on pesticides to maximise outputs. While many highly hazardous pesticides (HHPs) are banned in places like the European Union due to concerns about harm to the environment and human health, their use continues in many low- and middle-income counties (LMICs). Pesticide suicide is a public health problem unique to countries where HHPs are used, and Sri Lanka has successfully implemented several HHP bans as part of a suicide prevention strategy. On 27 April 2021, the Sri Lankan government announced an imminent import ban of all fertilizers and pesticides which was later revoked in November 2021. The aim of this article was to explore the media framing of the import ban as it pertained to pesticides. Guided by Entman's typology of frame functions, we analysed newspaper articles from nine Sri Lankan newspapers (N = 102) between 20 April to 31 October 2021. Overall, most framings were supportive of the ban, captured by framings that articulated the ban through a health, environment, and organic farming narrative. Framings that foregrounded farmer or industry livelihoods and the pesticide market were primarily adopted to express opposition to the ban. The presence of frames opposing the ban within media articles increased over time during the study period. There was a greater proportion of opposing frames in private newspapers compared to government (78% vs 22%). Many of the articles analysed described the widespread impact of the ban, but only 11% of articles represented the voices of policy end users. This study adds understanding to the ways communication via outlets like mainstream newspapers may shape public support or opposition to pesticide bans in a LMIC. Mass media is an under-recognised factor in policy implementation and this study may inform planning to implement pesticide bans in other countries.
Collapse
Affiliation(s)
- Lisa Schölin
- Centre for Pesticide Suicide Prevention, University of Edinburgh, Edinburgh, United Kingdom
| | - Pramila Hashini
- Faculty of Medicine, South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
| | - Rajaratnam Kanapathy
- Faculty of Medicine, South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
| | - May CI van Schalkwyk
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Michael Eddleston
- Centre for Pesticide Suicide Prevention, University of Edinburgh, Edinburgh, United Kingdom
| | - Flemming Konradsen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Manjula Weerasinghe
- Centre for Pesticide Suicide Prevention, University of Edinburgh, Edinburgh, United Kingdom
- Faculty of Medicine, South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
- Faculty of Medicine and Allied Sciences, Department of Community Medicine, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka
| |
Collapse
|
2
|
Tambuzzi S, Vacchiano L, Gentile G, Boracchi M, Zoja R, Migliorini AS. A Forensic Case of Suicide Ingestion of Paraquat Herbicide: New Histological Insights and Revision of the Literature. Am J Forensic Med Pathol 2024; 45:81-87. [PMID: 37728953 DOI: 10.1097/paf.0000000000000878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
ABSTRACT Paraquat (PQ) is one of the most widely used herbicides in the world, and poisoning is generally associated with accidental, suicidal, or homicidal events. Therefore, in the forensic context, PQ could be in various ways involved as a possible cause of death of a subject. However, even though its systemic toxicity is known, the biological effects exerted on individual viscera have been explored only to some extent, especially in case of victim's survival. Therefore, a case concerning a suicidal ingestion of PQ with survival of 3 days was deemed of interest. Clinical toxicological analyses confirmed acute PQ intoxication, and after the death of the victim, an autopsy was performed showing local and systemic signs of ingestion of a caustic substance. Histologic examination revealed marked cellular damage to the major viscera, particularly the gastroesophageal tract, liver, kidneys, and lungs, with initial alveolar fibrosis noted despite the patient's short survival. This finding represents a new element in the context of PQ lung injury, as it has not been previously documented in the literature. Thus, histological findings in lethal intoxications after survival can reveal specific peculiarities still unknown and, therefore, assume transversal relevance not only at forensic but also clinical level.
Collapse
Affiliation(s)
- Stefano Tambuzzi
- From the Laboratory of Forensic Histopathology and Forensic Microbiology, Institute of Forensic Medicine, Department of Biomedical Sciences for Health, University of Milan
| | - Laura Vacchiano
- From the Laboratory of Forensic Histopathology and Forensic Microbiology, Institute of Forensic Medicine, Department of Biomedical Sciences for Health, University of Milan
| | - Guendalina Gentile
- From the Laboratory of Forensic Histopathology and Forensic Microbiology, Institute of Forensic Medicine, Department of Biomedical Sciences for Health, University of Milan
| | - Michele Boracchi
- From the Laboratory of Forensic Histopathology and Forensic Microbiology, Institute of Forensic Medicine, Department of Biomedical Sciences for Health, University of Milan
| | - Riccardo Zoja
- From the Laboratory of Forensic Histopathology and Forensic Microbiology, Institute of Forensic Medicine, Department of Biomedical Sciences for Health, University of Milan
| | | |
Collapse
|
3
|
Li S, Nianogo RA, Lin Y, Wang H, Yu Y, Paul KC, Ritz B. Cost-effectiveness analysis of insecticide ban aimed at preventing Parkinson's disease in Central California. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 912:168913. [PMID: 38042187 PMCID: PMC11121568 DOI: 10.1016/j.scitotenv.2023.168913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 11/24/2023] [Accepted: 11/24/2023] [Indexed: 12/04/2023]
Abstract
BACKGROUND Our study assessed whether banning specific insecticides to reduce the PD burden in three Central California (CA) counties is cost-effective. METHOD We applied a cost-effectiveness analysis using a cohort-based Markov model to estimate the impact and costs of banning seven insecticides that were previously associated with PD in these counties as well as mixture exposures to some of these pesticides. We relied for our estimations on the cohort of 65- and 66-year-olds living in these counties who were unaffected by PD at baseline in 2020 and projected their incidence, costs, and reduction in quality-adjusted-life-years (QALY) loss due to developing PD over a 20-year period. We included a shiny app for modeling different scenarios (https://sherlockli.shinyapps.io/pesticide_pd_economics_part_2/). RESULTS According to our scenarios, banning insecticides to reduce the occurrence of PD in three Central CA counties was cost-effective relative to not banning insecticides. In the worst-case scenario of exposure to a single pesticide, methomyl, versus none would result in an estimated 205 (95 % CI: 75, 348) additional PD cases or 12 % (95 % CI: 4 %, 20 %) increase in PD cases over a 20-year period based on residential proximity to pesticide applications. The increase in PD cases due to methomyl would increase health-related costs by $72.0 million (95 % CI: $5.5 million, $187.4 million). Each additional PD patient due to methomyl exposure would incur $109,327 (95 % CI, $5554, $347,757) in costs per QALY loss due to PD. Exposure to methomyl based on workplace proximity to pesticide applications generated similar estimates. The highest PD burden and associated costs would be incurred from exposure to multiple pesticides simultaneously. CONCLUSION Our study provides an assessment of the cost-effectiveness of banning specific insecticides to reduce PD burden in terms of health-related QALYs and related costs. This information may help policymakers and stakeholders to make decisions concerning the regulation of pesticides.
Collapse
Affiliation(s)
- Shiwen Li
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Roch A Nianogo
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Yuyuan Lin
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Hanwen Wang
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Yu Yu
- Center for Health Policy Research, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Kimberly C Paul
- Department of Neurology, David Geffen School of Medicine, Los Angeles, CA, USA
| | - Beate Ritz
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA; Department of Neurology, David Geffen School of Medicine, Los Angeles, CA, USA.
| |
Collapse
|
4
|
Peng H, Zhao D, Tang W, Peng A. Dienediamine: A safe surrogate for the herbicide paraquat. MOLECULAR PLANT 2023; 16:1962-1975. [PMID: 37924209 DOI: 10.1016/j.molp.2023.10.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 10/23/2023] [Accepted: 10/31/2023] [Indexed: 11/06/2023]
Abstract
Paraquat (PQ) has been used as an herbicide worldwide because of its potent activity against weeds. However, it is highly toxic to humans. The very high fatality of PQ poisoning is due to its inherent toxicity and the lack of any effective treatment. Consequently, developing a non-toxic herbicide with comparable efficacy to PQ will contribute to global food security and help prevent PQ-related fatalities. Herein, we report a new herbicide called dienediamine, which was discovered from how to intervene the redox cycle of PQ, an inherent toxicity nature. Dienediamine, the "reduced" form of PQ with no function as an electron transfer agent, was shown to be non-toxic through comprehensive in vivo and in vitro experiments at molar concentrations equivalent to PQ's absolute lethal dose. Remarkably, dienediamine can undergo conversion to PQ under natural sunlight and ambient air conditions, exhibiting herbicidal activities that are comparable to those of PQ. The conversion of dienediamine to PQ, which is toxic to chloroplasts, is the key mechanism underlying its potent herbicidal activity. Our study discovers that dienediamine is a safe and superior alternative to PQ, possessing significant potential for application in sustainable agriculture globally.
Collapse
Affiliation(s)
- Henian Peng
- State Key Laboratory of Chemical Biology, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, 345 Ling Ling Road, Shanghai 200032, China
| | - Dake Zhao
- Center for Nephrology & Metabolomics, Division of Nephrology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No.301 Yanchangzhong Road, Shanghai 200072, China
| | - Wenjun Tang
- Center for Nephrology & Metabolomics, Division of Nephrology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No.301 Yanchangzhong Road, Shanghai 200072, China; State Key Laboratory of Chemical Biology, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, 345 Ling Ling Road, Shanghai 200032, China; School of Chemistry and Materials Science, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, 1 Sub-lane Xiangshan, Hangzhou 310024, China.
| | - Ai Peng
- Center for Nephrology & Metabolomics, Division of Nephrology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, No.301 Yanchangzhong Road, Shanghai 200072, China.
| |
Collapse
|
5
|
Mohd Salleh Sahimi H, Midin M, Lim JTY, Anwar MWA, Abdul Samad FD, Mohamad Kamal NA. An elderly patient with depression and a suicide attempt during the COVID-19 pandemic: a case report. Front Psychiatry 2023; 14:1151482. [PMID: 37840789 PMCID: PMC10568006 DOI: 10.3389/fpsyt.2023.1151482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 09/04/2023] [Indexed: 10/17/2023] Open
Abstract
Objective Elderly individuals are among the age groups with the highest risk of suicide. The coronavirus (COVID-19) pandemic forced isolation and resulted in an increased risk of depression, hopelessness, and perceived burdensomeness among the elderly, thereby increasing the risk of suicide. Methods This is a case report of an elderly single retired school principal with obsessive-compulsive personality traits who developed depression with psychotic symptoms after being isolated following the movement control order (MCO) during the COVID-19 pandemic. The social isolation led to feelings of loneliness and hopelessness. The patient's depressive symptoms worsened after he developed physical illnesses, such as eye floaters, that affected his daily activities. This caused him to have suicidal ideation to the extent that he attempted suicide by ingesting 90 mL of pesticide. Two weeks prior to the attempt, he updated his will and asked his friend to keep it. After the suicide attempt, he vomited and had diarrhea and epigastric pain. He called his friend, who brought him to the hospital emergency room (ER). He was resuscitated and subsequently admitted to the intensive care unit (ICU). After being medically stabilized, he was transferred to the psychiatric ward, where further treatment was administered for his depression. His depressive symptoms and suicidal ideation improved after he was administered antidepressants and psychotherapy. Results The impact of the COVID pandemic has led to a surge in mental health issues such as anxiety and depression. The elderly are among the highest-risk groups of individuals to contract or die of COVID-19 infection, and they are also the most likely to develop mental health issues related to the pandemic. Furthermore, the risk of death by suicide is highest in this age group due to physical illness, social isolation, and the lack of a support system. This case also highlights the need for awareness of suicidal ideation screening among non-medical healthcare professionals and religious organizations to avoid the treatment gap. Conclusion It is essential to enhance suicide risk assessment and management among the elderly after the COVID-19 pandemic.
Collapse
Affiliation(s)
- Hajar Mohd Salleh Sahimi
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
- Hospital Canselor Tuanku Muhriz, Bandar Tun Razak, Kuala Lumpur, Malaysia
| | - Marhani Midin
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
- Hospital Canselor Tuanku Muhriz, Bandar Tun Razak, Kuala Lumpur, Malaysia
| | - Jane Tze Yn Lim
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
- Hospital Canselor Tuanku Muhriz, Bandar Tun Razak, Kuala Lumpur, Malaysia
| | - Mohd Wafiy Ariffin Anwar
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
- Hospital Canselor Tuanku Muhriz, Bandar Tun Razak, Kuala Lumpur, Malaysia
| | - Farah Deena Abdul Samad
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
- Hospital Canselor Tuanku Muhriz, Bandar Tun Razak, Kuala Lumpur, Malaysia
| | - Nurul Ain Mohamad Kamal
- Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
- Hospital Canselor Tuanku Muhriz, Bandar Tun Razak, Kuala Lumpur, Malaysia
| |
Collapse
|
6
|
Yan Y, Jiang Y, Liu R, Eddleston M, Tao C, Page A, Wang L, Feng G, Liu S. Impact of pesticide regulations on mortality from suicide by pesticide in China: an interrupted time series analysis. Front Psychiatry 2023; 14:1189923. [PMID: 37732083 PMCID: PMC10507350 DOI: 10.3389/fpsyt.2023.1189923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 08/08/2023] [Indexed: 09/22/2023] Open
Abstract
Background Pesticide bans and regulatory restrictions have been shown to be effective strategies for preventing suicide in several countries. Suicide and suicide by pesticides have decreased significantly in China over the past two decades. However, whether the reduction was associated with pesticide regulation is unknown. Methods The monthly data on suicide and suicide by pesticide from 2006 to 2018 were obtained from China's Disease Surveillance Point (DSP) system. Information on China's pesticide regulations since 1970 was obtained from Pesticide Action Network International (PAN International), Joint Meeting on Pesticide Management Highly Hazardous Pesticides (JMPM HHP) lists, the website of the Ministry of Agriculture of China, Pesticide Information Network of China, and the Wan Fang database. Change point detection and policy analysis were combined to identify the time of any trend change breakpoint of suicide and suicide by pesticide. Interrupted time series analysis was used to investigate the pre- and post-breakpoint trends of monthly standardized rates in suicide and suicide by pesticide. Results The standardized pesticide suicide rate decreased by 60.5% from 6.50 in 2006 to 2.56 per 100,000 in 2018. Larger declines were evident among people in urban areas (67.3%), female individuals (63.5%), and people aged 15-44 years (68.1%). The effect of policies banning highly hazardous organophosphorus pesticides (HHOP) [rate ratio (RR) = 0.993, 95% CIs (0.991-0.994)] in December 2008 and stopping domestic sales and use of paraquat aqueous solution (RR = 0.992, 95% CIs: 0.990-0.994) in July 2016 were more pronounced than regulating the paraquat-related products (RR = 1.003, 95% CIs: 1.002-1.004) in April 2012. Conclusion Declines in suicide by pesticide in China occurred contemporaneously with regulatory bans and restrictions implemented on several pesticides, particularly in urban areas, among female individuals, and the relatively low age profile. These findings indicate the potential influence of these bans on trends of suicide by pesticides.
Collapse
Affiliation(s)
- Yongfu Yan
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yingying Jiang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Rong Liu
- The George Institute for Global Health, Faculty of Medicine, The University of New South Wales (UNSW), Sydney, NSW, Australia
| | - Michael Eddleston
- Centre for Pesticide Suicide Prevention, University of Edinburgh, Edinburgh, United Kingdom
| | - Chuanjiang Tao
- Institute for the Control of Agrochemicals, Ministry of Agriculture and Rural Affairs, Beijing, China
| | - Andrew Page
- Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Lijun Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Guoshuang Feng
- Big Data Center, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Shiwei Liu
- Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing, China
| |
Collapse
|
7
|
Chan LF, Chin SJ, Loo TH, Panirselvam RR, Chang SS, Chang HY, Mokhzani AR, Rahman FHA, Utyasheva L, Eddleston M. Surveillance of pesticide poisoning in an East and a West Malaysian hospital: characteristics of pesticide poisoning and the early impact of a national Paraquat ban. BMC Psychiatry 2023; 23:472. [PMID: 37380953 DOI: 10.1186/s12888-023-04974-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 06/21/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND Previous studies have shown that pesticide bans were associated with reduced fatal pesticide self-poisoning cases in high, and low-and-middle-income countries. We aimed to investigate the characteristics of pesticide poisoning patients admitted to two Malaysian hospitals and the early impact of the national paraquat ban implemented on 1st January 2020 in a culturally heterogenous South-East-Asian upper-middle-income setting. METHODS Data were collected from an East (Bintulu) and a West (Ipoh) Malaysian hospital medical records in 2015-2021 and 2018-2021, respectively. Logistic regression analyses were conducted to investigate the association of aspects such as socio-demographic and clinical characteristics, paraquat ban with the types of pesticides involved (paraquat versus non-paraquat versus unknown) ,and the outcomes (fatal versus non-fatal). RESULTS From the study sample of 212 pesticide poisoning patients aged 15 years or above, the majority were self-poisoning cases (75.5%) with a disproportionate over-representation of Indian ethnic minority (44.8%). Most pesticide poisoning cases had socio-environmental stressors (62.30%). The commonest stressors were domestic interpersonal conflicts (61.36%). 42.15% of pesticide poisoning survivors had a psychiatric diagnosis. Paraquat poisoning accounted for 31.6% of all patients and 66.7% of fatalities. Case fatality was positively associated with male gender, current suicidal intent, and paraquat poisoning. After the paraquat ban, the proportion of pesticide poisoning cases using paraquat decreased from 35.8 to 24.0%, and the overall case-fatality dropped slightly from 21.2 to 17.3%. CONCLUSIONS Socio-environmental stressors in specific domestic interpersonal conflicts, seemed more prominent in pesticide poisoning compared to psychiatric diagnosis. Paraquat accounted for the majority of pesticide-associated deaths occurring in hospitals in the study areas. There was preliminary evidence that the 2020 paraquat ban led to a fall in case fatality from pesticide poisoning.
Collapse
Affiliation(s)
- Lai Fong Chan
- Department of Psychiatry, Faculty of Medicine, National University of Malaysia, Cheras, Kuala Lumpur, Malaysia.
| | - Song Jie Chin
- Department of Psychiatry, Faculty of Medicine, National University of Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Tsui Huei Loo
- Department of Psychiatry, Hospital Raja Permaisuri Bainun, Ipoh, Perak, Malaysia
| | | | - Shu-Sen Chang
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Hwei Yuen Chang
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
- Global Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Anissa Raudhah Mokhzani
- Department of Psychiatry, Faculty of Medicine, National University of Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Farynna Hana Ab Rahman
- Department of Psychiatry, Faculty of Medicine, National University of Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Leah Utyasheva
- Centre for Pesticide Suicide Prevention, University Of Edinburgh, Edinburgh, UK
| | - Michael Eddleston
- Centre for Pesticide Suicide Prevention, University Of Edinburgh, Edinburgh, UK
| |
Collapse
|
8
|
Lin CY, Hsu CY, Gunnell D, Chang SS. Factors associated with fewer than expected suicides in Taiwan during the COVID-19 pandemic in 2020. Asian J Psychiatr 2023; 80:103379. [PMID: 36502779 PMCID: PMC9721156 DOI: 10.1016/j.ajp.2022.103379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 11/22/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Chien-Yu Lin
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan; Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Chia-Yueh Hsu
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
| | - David Gunnell
- Centre for Academic Mental Health, Population Health Sciences, University of Bristol, Bristol, UK; National Institute of Health and care Research Biomedical Research Centre, University Hospitals Bristol and Weston National Health Service Foundation Trust, Bristol, UK
| | - Shu-Sen Chang
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan; Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Global Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan.
| |
Collapse
|
9
|
Stuart AM, Merfield CN, Horgan FG, Willis S, Watts MA, Ramírez-Muñoz F, U JS, Utyasheva L, Eddleston M, Davis ML, Neumeister L, Sanou MR, Williamson S. Agriculture without paraquat is feasible without loss of productivity-lessons learned from phasing out a highly hazardous herbicide. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:16984-17008. [PMID: 36622585 PMCID: PMC9928820 DOI: 10.1007/s11356-022-24951-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
A small proportion of the thousands of pesticides on the market today are associated with a disproportionately high incidence of severe acute pesticide poisoning and suicide. Paraquat stands out as one of the most lethal pesticides in common use, frequently involved in fatal incidents due to suicides or accidental exposure. Even though paraquat has been banned in over 67 countries, it is still widely used in many others, particularly in Asia and Latin America. Based on a literature review and consultations, this paper identifies options for replacing paraquat and distils practical lessons from numerous successes around the world. Our aim is to support regulators, policymakers, agronomists and the supply chain sector with practical information related to phasing out paraquat. Production data consistently failed to show any negative effects of banning paraquat on agricultural productivity. A wide range of alternative approaches to weed management and crop defoliation are available, many of which do not rely on herbicides. Over 1.25 million farmers in low- and middle-income countries (LMICs) successfully produce a range of crops for private voluntary standards (PVS) in food and fiber supply chains which prohibit paraquat use. We conclude from the findings of this study that eliminating paraquat will save lives without reducing agricultural productivity. Less hazardous and more sustainable alternatives exist. To enhance successful adoption and uptake of these methods on a wide scale, farmers require training and support within an enabling policy environment.
Collapse
Affiliation(s)
| | | | - Finbarr G Horgan
- Centre for Pesticide Suicide Prevention, University of Edinburgh, Edinburgh, UK
- Facultat de Ciencias Agrarias Y Forestales, Escuela de Agronomía, Universidad Católica del Maule, Casilla 7-D, 3349001, Curico, Chile
- EcoLaVerna Integral Restoration Ecology, Bridestown, Kildinan, T56 P 499, Cork, Ireland
| | - Sheila Willis
- Pesticide Action Network UK, Brighthelm Centre, Brighton, UK
| | | | - Fernando Ramírez-Muñoz
- Central American Institute for Studies On Toxic Substances (IRET), Universidad Nacional, Heredia, Costa Rica
| | | | - Leah Utyasheva
- Centre for Pesticide Suicide Prevention, University of Edinburgh, Edinburgh, UK
| | - Michael Eddleston
- Centre for Pesticide Suicide Prevention, University of Edinburgh, Edinburgh, UK
| | - Mark L Davis
- Centre for Pesticide Suicide Prevention, University of Edinburgh, Edinburgh, UK
| | | | - Manoé R Sanou
- Department of Plant Protection and Packaging, Ministry of Agriculture, Ouagadougou, Burkina Faso
| | | |
Collapse
|
10
|
Indira M, Chowallur MJ, M K A, Lin CY, Chang SS, Sooraj M, Thomas J. Effect of pesticide ban on suicide trend - a 20-year study from a tertiary care center in Central Kerala from 2001 to 2020. Clin Toxicol (Phila) 2022; 60:1214-1219. [PMID: 36263906 DOI: 10.1080/15563650.2022.2129671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Introduction: We assessed the effect of the pesticide regulations implemented in 2011 on suicide trend in Kerala state of India.Materials and methods: Data were collected from case records of suicide autopsies done in a single tertiary care hospital in Thrissur district of Kerala in 2001-2020. Linear trends in overall suicide rates were identified using joinpoint regression analysis. We used Poisson regression models to estimate the annual expected number of suicides in 2011-2020 and calculated the rate ratios between the observed number of suicide and that expected according to the linear pre-ban suicide trend (2005-2010).Results: There were a total of 14,593 suicide autopsies (2501 pesticide autopsies) in 2001-2020. Carbofuran was the commonest pesticide identified, followed by quinalphos, zinc phosphide, and chlorpyrifos. In 2011-2020, overall suicide rates were 22%-48% and pesticide suicide rates were 20%-55% lower than those expected according to pre-ban suicide trends (2005-2010), with the only exception of a 16% higher-than-expected pesticide suicide rate in 2011. There was no change in trend in hanging suicides.Conclusion: Lower-than-expected overall and pesticide suicide rates were found in Thrissur district after the 2011 bans of pesticides in Kerala, with no evidence of means replacement to hanging.
Collapse
Affiliation(s)
- M Indira
- Department of General Medicine, Government Medical College, Thrissur, India
| | | | - Aryamol M K
- Department of General Medicine, Government Medical College, Thrissur, India
| | - Chien-Yu Lin
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Shu-Sen Chang
- Institute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Mannil Sooraj
- Department of General Medicine, Government Medical College, Thrissur, India
| | - Jithin Thomas
- Department of General Medicine, Government Medical College, Thrissur, India
| |
Collapse
|
11
|
Anetor GO, Nwobi NL, Igharo GO, Sonuga OO, Anetor JI. Environmental Pollutants and Oxidative Stress in Terrestrial and Aquatic Organisms: Examination of the Total Picture and Implications for Human Health. Front Physiol 2022; 13:931386. [PMID: 35936919 PMCID: PMC9353710 DOI: 10.3389/fphys.2022.931386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 06/24/2022] [Indexed: 11/13/2022] Open
Abstract
There is current great international concern about the contribution of environmental pollution to the global burden of disease particularly in the developing, low- and medium-income countries. Industrial activities, urbanization, developmental projects as well as various increased anthropogenic activities involving the improper generation, management and disposal of pollutants have rendered today’s environment highly polluted with various pollutants. These pollutants include toxic metals (lead, cadmium, mercury, arsenic), polycyclic aromatic hydrocarbons, polychlorinated biphenyls, pesticides and diesel exhaust particles most of which appear to be ubiquitous as well as have long-term environmental persistence with a wide range of toxicities such as oxidative stress among others. Oxidative stress, which may arise from increased production of damaging free radicals emanating from increased pollutant burden and depressed bioavailability of antioxidant defenses causes altered biochemical and physiological mechanisms and has been implicated in all known human pathologies most of which are chronic. Oxidative stress also affects both flora and fauna and plants are very important components of the terrestrial environment and significant contributors of nutrients for both man and animals. It is also remarkable that the aquatic environment in which sea animals and creatures are resident is also highly polluted, leading to aquatic stress that may affect the survival of the aquatic animals, sharing in the oxidative stress. These altered terrestrial and aquatic environments have an overarching effect on human health. Antioxidants neutralize the damaging free radicals thus, they play important protective roles in the onset, progression and severity of the unmitigated generation of pollutants that ultimately manifest as oxidative stress. Consequently, human health as well as that of aquatic and terrestrial organisms may be protected from environmental pollution by mitigating oxidative stress and employing the principles of nutritional medicine, essentially based on antioxidants derived mainly from plants, which serve as the panacea of the vicious state of environmental pollutants consequently, the health of the population. Understanding the total picture of oxidative stress and integrating the terrestrial and aquatic effects of environmental pollutants are central to sustainable health of the population and appear to require multi-sectoral collaborations from diverse disciplinary perspectives; basically the environmental, agricultural and health sectors.
Collapse
Affiliation(s)
- Gloria Oiyahumen Anetor
- Department of Human Kinetics and Health Education, National Open University of Nigeria, Abuja, Nigeria
| | - Nnenna Linda Nwobi
- Department of Chemical Pathology, BenCarson School of Medicine, Babcock University, Ilishan, Nigeria
| | - Godwin Osaretin Igharo
- Department of Medical Laboratory Science, School of Basic Medical Sciences, College of Medical Sciences, University of Benin, Benin, Nigeria
| | | | - John Ibhagbemien Anetor
- Department of Chemical Pathology, College of Medicine, University of Ibadan, Ibadan, Nigeria
- *Correspondence: John Ibhagbemien Anetor,
| |
Collapse
|
12
|
Tu CY, Yen TH, Chang CM, Chen HY, Yen YC, Guo MC, Lu TH, Wu CS, Chen IM, Cheng HC, Huang WL, Chen CC, Eddleston M, Chang SS. Characteristics and psychopathology of 1,086 patients who self-poisoned using pesticides in Taiwan (2012-2019): A comparison across pesticide groups. J Affect Disord 2022; 300:17-26. [PMID: 34952117 DOI: 10.1016/j.jad.2021.12.058] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/09/2021] [Accepted: 12/18/2021] [Indexed: 10/19/2022]
Abstract
Background Previous studies, mainly from low- and middle-income settings, showed that pesticide self-poisonings were mostly impulsive with low levels of psychopathology. We aimed to investigate whether pesticide self-poisoning in a high-income country showed similar profiles, and whether those with certain characteristics and psychopathology were more likely to use specific pesticides. Methods Data were extracted from hospital records of pesticide self-poisoning patients treated at eight major hospitals in Taiwan between 2012 and 2019. Multinomial logistic regression was used to investigate the association of interpersonal conflicts, triggers of self-poisoning, and psychopathology with the groups of pesticides ingested. Results A total of 1,086 patients who self-poisoned using pesticides were identified; 67.0% were male and 39.8% aged 65+ years. Approximately three quarters (75.7%) of patients who received psychiatric assessment had at least one psychiatric diagnosis, and the prevalence was 48.3% in all patients. No association was found between the pesticide groups ingested and interpersonal conflicts, most of the triggers, past psychiatric service use, or having psychiatric diagnoses. Limitations Data were collected from hospital records retrospectively. Only 60.3% of the patients received a psychiatric assessment. Conclusions The majority of patients who self-poisoned using pesticides and received psychiatric assessment in Taiwan had psychiatric illness. Patients who ingested different groups of pesticides were similar in their characteristics. The choice of pesticides used in self-poisoning more likely relates to availability rather than intentional selection. Psychiatric assessment and treatment are important in patients who self-poisoned using pesticides, while restricting access to highly hazardous pesticides is likely to prevent many deaths from pesticide self-poisoning.
Collapse
Affiliation(s)
- Chao-Ying Tu
- Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Tzung-Hai Yen
- Department of Nephrology and Clinical Poison Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chia-Ming Chang
- Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Hsien-Yi Chen
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou and College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yung-Chieh Yen
- Department of Psychiatry, E-Da Hospital, Kaohsiung, Taiwan; School of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Ming-Chao Guo
- Department of Psychiatry, Camillian Saint Mary's Hospital Luodong, Yilan, Taiwan
| | - Tsung-Hua Lu
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chi-Shin Wu
- Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan; National Center for Geriatrics and Welfare Research, National Health Research Institutes
| | - I-Ming Chen
- Department of Psychiatry, National Taiwan University, Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hai-Ching Cheng
- Department of Psychiatry, National Taiwan University Hsin-Chu Hospital, Hsinchu, Taiwan
| | - Wei-Lieh Huang
- Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan; Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Cheng-Che Chen
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Psychiatry, National Taiwan University BioMedical Park Hospital, Hsinchu, Taiwan
| | - Michael Eddleston
- Department of Psychiatry, National Taiwan University BioMedical Park Hospital, Hsinchu, Taiwan; Center for Pesticide Suicide Prevention, University of Edinburgh, Edinburgh, UK; Pharmacology, Toxicology and Therapeutics, University and British Heart Foundation Center for Cardiovascular Science, University of Edinburgh, Edinburgh, UK; South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka
| | - Shu-Sen Chang
- South Asian Clinical Toxicology Research Collaboration, University of Peradeniya, Peradeniya, Sri Lanka; Institute of Health Behaviors and Community Sciences and Global Health Program, and College of Public Health, National Taiwan University, Taipei, Taiwan; Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei City, Taiwan.
| |
Collapse
|
13
|
Chen CK, Yeh YT, Mégarbane B, Chen YC, Chen KF, Chang CH, Lin CC. A novel flowchart to predict mortality and analyse effectiveness of routinely used pharmacological regimens in paraquat poisoning. Basic Clin Pharmacol Toxicol 2021; 129:496-503. [PMID: 34478614 DOI: 10.1111/bcpt.13652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 08/27/2021] [Accepted: 09/01/2021] [Indexed: 11/29/2022]
Abstract
Paraquat is responsible for an extremely high case-fatality rate poisoning. Mortality prediction remains a major issue since evidence to support benefits of routinely used treatments is lacking. We aimed to develop an easy-to-use prediction flowchart not requiring the ingestion time, for which accuracy is frequently questionable, and to evaluate the effectiveness of routinely used pharmacological therapies on mortality. We designed a two-centre cohort study including consecutive paraquat-poisoned adults with confirmed diagnosis based on serum/urine paraquat measurement. We built a flowchart using a multivariate analysis of death predictors and analysed the outcome according to the administered therapies. Overall, 256 patients were enrolled. Mortality rate was 75%. Independent death predictors on admission were serum creatinine (odds ratio [OR], 5.07; 95% confidence interval [CI], 1.97-13.05) and serum paraquat concentration (OR, 2.26; CI, 1.66-3.09). The area-under-the flowchart curve was 0.91. Overall sensitivity and specificity were 81.5% and 94.8%, respectively. More survivors than non-survivors of severe poisoning received methylprednisolone (P = 0.04). While not significantly differing in severity, methylprednisolone-treated patients had better survival (P = 0.04). To conclude, we defined an efficient flowchart to predict mortality in paraquat poisoning at presentation, even if ingestion time is undetermined. Methylprednisolone seems effective to improve the outcome, especially in the most severe cases.
Collapse
Affiliation(s)
- Chun-Kuei Chen
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Medical and Toxicological Critical Care, Lariboisière Hospital, AP-HP, Paris University, INSERM UMRS-1144, Paris, France
| | - Ying-Tse Yeh
- Department of Emergency Medicine, Taipei Veterans General Hospital, Yuli Branch, Hualian, Taiwan
| | - Bruno Mégarbane
- Department of Medical and Toxicological Critical Care, Lariboisière Hospital, AP-HP, Paris University, INSERM UMRS-1144, Paris, France
| | - Yen-Chia Chen
- Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Emergency Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Kuan-Fu Chen
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chia-Hsun Chang
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
| | - Chih-Chuan Lin
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| |
Collapse
|