International Journal of Epidemiology 2003;32:902-909
© International Epidemiological Association 2003
Editorial |
Suicide by intentional ingestion of pesticides: a continuing tragedy in developing countries
1 Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol BS8 2PR, UK.
2 Ox-Col Collaboration, Department of Clinical Medicine, University of Colombo, Colombo, Sri Lanka.
3 Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
Correspondence: David Gunnell, Department of Social Medicine, Canynge Hall, Whiteladies Road, Bristol BS8 2PR, UK. E-mail: D.J.Gunnell@bristol.ac.uk
| The first 150 words of the full text of this article appear below. |
Deliberate self-poisoning has become an increasingly common response to emotional distress in young adults,1 and it is now one of the most frequent reasons for emergency hospital admission.2 In industrialized countries, the drugs that people commonly take in overdose—analgesics, tranquillisers, antidepressants3—are relatively non-toxic. The estimated case fatality for overdose in England, for example, is around 0.5%.4 Most individuals who self-harm do not intend to die. Studies carried out in industrialized countries have found that only 2% go on to commit suicide in the subsequent 12 months.5
In developing countries the situation is quite different.6 The substances most commonly used for self-poisoning are agricultural pesticides.6–11 Overall case fatality ranges from 10% to 20%.12 For this reason, deaths from pesticide poisoning make a major contribution to patterns of suicide in developing nations, particularly in rural areas.6 In rural China, for example, pesticides account for over 60% of suicides.8 Similarly high proportions
Patterns of suicide in countries where pesticide poisoning is commonplace
Method availability and suicide
Economics of pesticide poisoning
How can the death toll from pesticide poisoning be reduced?
Why has there been a failure to act?
Conclusion
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