Emerging pesticides responsible for suicide in rural Sri Lanka following the 2008–2014 pesticide bans

Abstract

Background: Sri Lanka has reduced its overall suicide rate by 70% over the last two decades through means restriction, through a series of government regulations and bans removing highly hazardous pesticides from agriculture. We aimed to identify the key pesticide(s) now responsible for suicides in rural Sri Lanka to provide data for further pesticide regulation. Methods: We performed a secondary analysis of data collected prospectively during a cluster randomized controlled trial in the Anuradhapura district of Sri Lanka from 2011 to 16. The identity of pesticides responsible for suicides were sought from medical or judicial medical notes, coroners' records, and the person's family. Trend analysis was done using a regression analysis with curve estimation to identify relative importance of key pesticides. Results: We identified 337 suicidal deaths. Among them, the majority 193 (57.3%) were due to ingestion of pesticides while 82 (24.3%) were due to hanging. A specific pesticide was identified in 105 (54.4%) of the pesticide suicides. Ingestion of carbosulfan or profenofos was responsible for 59 (56.2%) of the suicides with a known pesticide and 17.5% of all suicides. The increasing trend of suicides due to carbosulfan and profenofos over time was statistically significant (R square 0.846, F 16.541, p 0.027). Conclusion: Ingestion of pesticides remains the most important means of suicides in rural Sri Lanka. The pesticides that were once responsible for most pesticide suicides have now been replaced by carbosulfan and profenofos. Their regulation and replacement in agriculture with less hazardous pesticides will further reduce the incidence of both pesticide and overall suicides in rural Sri Lanka.

From decision to action: Suicidal history and time between decision to die and actual suicide attempt

“…Therefore, these attempts do not seem to be implemented 'out of a whim'. Nonetheless, there was a difference with regard to the amount of previous In terms of clinical implications, the present results underscore the importance of two therapeutical tasks: restricting access to lethal means and safety planning (Weerasinghe et al, 2020;Zortea et al, 2020). There is strong evidence that restricting access to lethal means is associated with a decrease in community suicide probability and that substitution to other methods appears to be limited (Yip et al, 2012).…”

Differences in the characteristics of people who purchase pesticides from shops for self‐harm versus those who use pesticides available in the domestic environment in Sri Lanka

“…Purposely purchasing an insecticide is evidence observed in this study to support to the argument of having higher suicide intent of those who purchase pesticides for self‐poisoning. Based on our previous experiences in the study area, insecticides cause more deaths comparatively weedicides or fungicides [22]. This may be the reason more shop cases purposely purchasing an insecticide for self‐poisoning.…”

Characteristics and patterns of individuals who have self-harmed: a retrospective descriptive study from Karachi, Pakistan

“…Government regulations and bans on pesticides can be effective measures learning from the example of Sri Lanka [ 38 ] and India [ 32 ]. Such measures are also considered cost-effective and affordable strategies for suicide prevention [ 39 , 40 ].…”