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2018 ; 47
(1
): 175-184
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Bans of WHO Class I Pesticides in Bangladesh-suicide prevention without hampering
agricultural output
#MMPMID29024951
Chowdhury FR
; Dewan G
; Verma VR
; Knipe DW
; Isha IT
; Faiz MA
; Gunnell DJ
; Eddleston M
Int J Epidemiol
2018[Feb]; 47
(1
): 175-184
PMID29024951
show ga
BACKGROUND: Pesticide self-poisoning is a major problem in Bangladesh. Over the
past 20-years, the Bangladesh government has introduced pesticide legislation and
banned highly hazardous pesticides (HHPs) from agricultural use. We aimed to
assess the impacts of pesticide bans on suicide and on agricultural production.
METHODS: We obtained data on unnatural deaths from the Statistics Division of
Bangladesh Police, and used negative binomial regression to quantify changes in
pesticide suicides and unnatural deaths following removal of WHO Class I toxicity
HHPs from agriculture in 2000. We assessed contemporaneous trends in other risk
factors, pesticide usage and agricultural production in Bangladesh from 1996 to
2014. RESULTS: Mortality in hospital from pesticide poisoning fell after the 2000
ban: 15.1% vs 9.5%, relative reduction 37.1% [95% confidence interval (CI) 35.4
to 38.8%]. The pesticide poisoning suicide rate fell from 6.3/100?000 in 1996 to
2.2/100?000 in 2014, a 65.1% (52.0 to 76.7%) decline. There was a modest
simultaneous increase in hanging suicides [20.0% (8.4 to 36.9%) increase] but the
overall incidence of unnatural deaths fell from 14.0/100?000 to 10.5/100?000
[25.0% (18.1 to 33.0%) decline]. There were 35?071 (95% CI 25?959 to 45?666)
fewer pesticide suicides in 2001 to 2014 compared with the number predicted based
on trends between 1996 to 2000. This reduction in rate of pesticide suicides
occurred despite increased pesticide use and no change in admissions for
pesticide poisoning, with no apparent influence on agricultural output.
CONCLUSIONS: Strengthening pesticide regulation and banning WHO Class I toxicity
HHPs in Bangladesh were associated with major reductions in deaths and hospital
mortality, without any apparent effect on agricultural output. Our data indicate
that removing HHPs from agriculture can rapidly reduce suicides without imposing
substantial agricultural costs.
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