Journal
CLINICAL TOXICOLOGY
Volume 60, Issue 1, Pages 131-135Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/15563650.2021.1937642
Keywords
Pesticide ban; pesticide suicide; suicide prevention; paraquat
Categories
Funding
- American Foundation for Suicide Prevention [SRG-0-028-1]
- Centre for Pesticide Suicide Prevention, University of Edinburgh [CT-5699(a)]
- Taiwan Ministry of Health and Welfare [M08B8116]
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The ban on the import and production of paraquat in Taiwan resulted in a decrease in pesticide and paraquat suicides as well as suicides among the elderly population. The impact of the ban was more significant in rural areas, males, and the elderly.
Introduction Pesticide ingestion is a leading method for suicide worldwide. Paraquat is a highly lethal herbicide when ingested. We assessed the impact of the first-stage ban on the import and production of paraquat (from February 2018) on suicides by pesticide poisoning in Taiwan. Methods Suicide data by method (pesticide vs. non-pesticide), pesticide (paraquat vs. non-paraquat), and area/sex/age were extracted from the national cause-of-death data files (2011-2019). Negative binomial regression was used to estimate changes in suicide rates in 2019, compared to the expected rates based on pre-ban linear trends (2011-2017). Results The paraquat ban was followed by an estimated 37% (rate ratio [RR] = 0.63, 95% confidence interval [CI] 0.54-0.74) reduction in pesticide suicide rate (190 [95% CI 116-277] fewer suicides) in 2019, mainly due to a 58% (RR = 0.42, 95% CI 0.33-0.54) reduction in paraquat suicides (145 [95% CI 92-213] fewer suicides). Larger absolute reductions in pesticide suicides were found in rural areas, males, and the elderly (aged 65+ years) than their counterparts. Except for a 10% (95% CI 3-18%) reduction in overall suicide rates in the elderly, there was no statistical evidence for a change in non-pesticide and overall (all-method) suicides. Conclusion The ban on the import and production of paraquat was followed by a fall in whole-population pesticide and paraquat suicides and elderly suicides in Taiwan.
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