TY - JOUR

T1 - Risk factors for acute pesticide poisoning in Sri Lanka

AU - van der Hoek, Wim

AU - Konradsen, Flemming

N1 - Keywords: Acute Disease; Adolescent; Adult; Age Distribution; Agriculture; Endosulfan; Female; Herbicides; Humans; Insecticides; Life Change Events; Male; Mental Disorders; Paraquat; Pesticides; Poisoning; Risk Factors; Rural Health; Sex Distribution; Socioeconomic Factors; Sri Lanka; Suicide

PY - 2005

Y1 - 2005

N2 - This report describes the characteristics of patients with acute pesticide poisoning in a rural area of Sri Lanka and, for intentional self-poisoning cases, explores the relative importance of the different determinants. Data were collected for 239 acute pesticide-poisoning cases, which were admitted to two rural hospitals in Sri Lanka. Sociodemographic characteristics, negative life events and agricultural practices of the intentional self-poisoning cases were compared with a control group. Most cases occurred among young adults and the large majority (84%) was because of intentional self-poisoning. Case fatality was 18% with extremely high case fatality for poisoning with the insecticide endosulfan and the herbicide paraquat. Cases were generally younger than controls, of lower educational status and were more often unemployed. No agricultural risk factors were found but a family history of pesticide poisoning and having ended an emotional relationship in the past year was clearly associated with intentional self-poisoning. The presence of mental disorders could only be assessed for a subsample of the cases and controls and this showed that alcohol dependence was a risk factor. This study shows that acute pesticide poisoning in Sri Lanka is determined by a combination of sociodemographic and psychological factors. Suggestions are given for interventions that could control the morbidity and mortality due to acute pesticide poisoning in developing countries.

AB - This report describes the characteristics of patients with acute pesticide poisoning in a rural area of Sri Lanka and, for intentional self-poisoning cases, explores the relative importance of the different determinants. Data were collected for 239 acute pesticide-poisoning cases, which were admitted to two rural hospitals in Sri Lanka. Sociodemographic characteristics, negative life events and agricultural practices of the intentional self-poisoning cases were compared with a control group. Most cases occurred among young adults and the large majority (84%) was because of intentional self-poisoning. Case fatality was 18% with extremely high case fatality for poisoning with the insecticide endosulfan and the herbicide paraquat. Cases were generally younger than controls, of lower educational status and were more often unemployed. No agricultural risk factors were found but a family history of pesticide poisoning and having ended an emotional relationship in the past year was clearly associated with intentional self-poisoning. The presence of mental disorders could only be assessed for a subsample of the cases and controls and this showed that alcohol dependence was a risk factor. This study shows that acute pesticide poisoning in Sri Lanka is determined by a combination of sociodemographic and psychological factors. Suggestions are given for interventions that could control the morbidity and mortality due to acute pesticide poisoning in developing countries.

U2 - 10.1111/j.1365-3156.2005.01416.x

DO - 10.1111/j.1365-3156.2005.01416.x

M3 - Journal article

C2 - 15941423

VL - 10

SP - 589

EP - 596

JO - Tropical Medicine & International Health

JF - Tropical Medicine & International Health

SN - 1360-2276

IS - 6

ER -