Effect of prohibiting the use of Paraquat on pesticide-associated mortality

Abstract

BackgroundParaquat is associated with a high rate of fatalities in acute poisoning. This study aimed to examine the association between the national public health policy that banned the use of paraquat and the incidence of pesticide-associated mortality.MethodsAll external causes of death from 2009 to 2013 of Korea were analyzed. The intervention was a national public health policy that annulled the authorized use (2011) and banned the purchase of paraquat (2012). Two periods were compared as follows: before (2009-2010) and after (2012-2013) the intervention period. The main outcome was pesticide-associated death coded on the death certificate. Multivariable logistic regression analysis adjustment for gender, age, season and weekday of death, province, education level, marital status, and occupation was performed to calculate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for pesticide-associated mortality. The effect sizes of the intervention across all intents (Accident, Suicide, Homicide, and Undetermined) were compared by adding an interaction term (intervention*intent group) to the above model.ResultsA total of 127,866 deaths from for all external causes were analyzed, including 65,538 from 2009 to 2010 and 62,373 from 2012 to 2013. Pesticide-associated mortality decreased from 9.7% (2009-2010) to 6.5% (2012-2013) (p < 0.001). The AOR (95% CI) of the intervention on pesticide-associated mortality was 0.59 (0.56-0.62). The AORs of the intervention according to intent were 0.72 (0.55-0.96) in the Accident group, 0.61 (0.58-0.64) in the Suicide group, 1.29 (0.43-3.87) in the Homicide group, and 0.44 (0.38-0.50) in the Undetermined group.ConclusionThe national public health policy that banned paraquat resulted in a significant decrease in pesticide-associated mortality.

Retrospective study of clinical features and prognosis of edaravone in the treatment of paraquat poisoning

“…Lung injury is characterized by acute chemical pulmonary interstitial lesions and the rapid development of pulmonary fibrosis, resulting in intractable hypoxemia and respiratory failure, which eventually leads to multiple organ damage or failure. [9,19] Currently, there is no specific method for clinical treatment of PQ poisoning. It is mainly treated through gastric lavage, catharsis, hemoperfusion, hemodialysis clearance of poisons, steroid impact therapy against organ damage and symptomatic support therapy, and so on.…”

Autophagy and Redox Homeostasis in Parkinson’s: A Crucial Balancing Act

“…Rotenone acts by inducing an increase in ROS production, elevating mitochondria bioenergetics, dysregulating intracellular calcium homeostasis, dysregulating autophagy, and altering lipid and glutamine metabolism [ 417 , 430 – 433 ]. Other examples of neurotoxins affecting mitochondrial function that are commonly used as Parkinson's models include 6-hydroxydopamine (6-OHDA) and paraquat, causing neurodegeneration via mitochondrial dysfunction and increase in free radicals [ 424 , 434 ]. In the following sections, we discuss how redox imbalance in the Parkinson's brain affects autophagy pathways to exacerbate the disease.…”

The Characteristics of Elderly Individuals Who Attempted Suicide by Poisoning: a Nationwide Cross-sectional Study in Korea

“…In Korea, paraquat has been prohibited since 2011, and several studies have reported a decrease in suicide rates using this method since then. 25 26 However, strong regulation and control of pesticides should be maintained as the suicide rate through pesticide poisoning is still high among the elderly. 27 Similarly, in Korea, there is an effort to establish a poisoning information database to provide emergency treatment information for patients presenting to the ED with poisoning.…”