Suicide by pesticide poisoning in India: a review of pesticide regulations and their impact on suicide trends

Abstract

Background Pesticide self-poisoning is a common means of suicide in India. Banning highly hazardous pesticides (HHPs) from agricultural use has been successful in reducing suicides in several Asian countries without affecting agricultural output. Here, we describe national and state-level regulation of HHPs and explore how they might relate to suicide rates across India.Methods Information on pesticide regulation was collated from agriculture departments of the central and state governments. National and state-level data on suicides from 1995 to 2015 were obtained from the National Crime Records Bureau (NCRB). We used joinpoint analysis and negative binomial regression to investigate any effects on trends in suicide rates nationally and in Kerala.Results As of October 2019, 318 pesticides were registered for use in India, of which 18 were extremely (Class Ia) or highly (Class Ib) hazardous according to World Health Organization criteria. Despite many HHPs still being available, several bans have been implemented during the period studied. In our quantitative analyses we focused on the permanent bans in Kerala in 2005 (of endosulfan) and 2011 (of 14 other pesticides); and nationally in 2011 (of endosulfan). NCRB data indicate that pesticides were used in 441,918 reported suicides in India from 1995-2015, 90.3% of which occurred in 11 of the 29 states. There was statistical evidence of lower than expected rates of pesticide suicides (rate ratio [RR] 0.52, 95% CI 0.49-0.54) and total suicides nationally by 2014 (0.90, 0.87-0.93) after the 2011 endosulfan ban. In Kerala, there was a lower than expected pesticide suicide rate (0.45, 0.42-0.49), but no change to the already decreasing trend in total suicides after the 2011 ban of 14 pesticides. The 2005 ban on endosulfan showed a similar effect. Agricultural outputs continued growing following the bans.Discussion Highly hazardous pesticides continue to be used in India and pesticide suicide remains a serious public health problem. However, some pesticide bans do appear to have impacted previous trends in the rates of both pesticide suicides and all suicides. Comprehensive national bans of HHPs could lead to a reduction in suicides across India, in addition to reduced occupational poisoning, with minimal effects on agricultural yield.

Suicidality among Chinese college students: A cross-sectional study across seven provinces

“…Examples include regulatory changes in the use of pesticides, or the implementation of the lock-box method for safe pesticide storage [48], the success of which was facilitated by urbanisation and migration from rural areas to the cities, where there is less access to pesticides. The success of such means restriction policies has also been successfully implemented in other Lower-and Middle-Income Countries such as India [49], and may inform firearm regulation policies in the US [50].…”

Mortalidade por suicídio: realidade de uma cidade no interior do nordeste brasileiro

“…Os trabalhadores ligados à ocupação de serviços agropecuários apresentaram maior frequência relativa de mortalidade por suicídio no município, com representação de 64,2% da amostra populacional. O suicídio tem sido relatado como preocupante problema em populações rurais, inclusive entre trabalhadores agrícolas, em diferentes regiões do mundo, como Brasil, Índia e Espanha (24,30,31) .…”

“…Os resultados de um estudo brasileiro, realizado em um município do Rio de Janeiro com uso elevado de pesticidas, apontou que a classe agropecuária apresentou razão de chance para óbito por suicídio com variação entre 4,5 a 9,4 em comparação à população geral (25) . Na Índia, em 2015, cerca de 20.000 habitantes faleceram em consequência da autointoxicação por pesticidas (31) . Em 2011, após regulação e banimento do inseticida Endosulfan, houve pequena, porém relevante, diminuição das taxas gerais de suicídio e maior declínio nos coeficientes de suicídio ocasionados pelos pesticidas (31) .…”

A hospital-based cross-sectional study on suicidal poisoning in Western Uttar Pradesh

“…Our study shows that consuming Agriculture poisons (Aluminum Phosphide and Organophosphates) are most common (52%) poisons consumed by suicidal poisoning cases. Despite several banning attempts,[ 30 ] agriculture poisons (Aluminum Phosphide and Organophosphates) are easily available in market in India and they are easily accessible to everybody who want to commit suicide. Therefore, government need to take concrete steps to regulate purchase of these agriculture poisons, so that they would not be easily available for everybody who have an impulse of committing suicide.…”