Research article

Pattern of pesticide storage before pesticide self-poisoning in rural Sri Lanka

Fahim Mohamed¹ , Gamini Manuweera² , David Gunnell³ , Shifa Azher⁴ , Michael Eddleston^1,5 , Andrew Dawson¹ and Flemming Konradsen⁶

¹South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Sri Lanka

²The Registrar of Pesticides, Government Department of Agriculture, Peradeniya, Sri Lanka

³Department of Social Medicine, University of Bristol, Bristol, UK

⁴Polonnaruwa General Hospital, North Central Province, Sri Lanka

⁵National Poisons Information Service - Edinburgh, Royal Infirmary of Edinburgh, and Clinical Pharmacology Unit, University of Edinburgh, UK

⁶Department of International Health, Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark

author email corresponding author email

BMC Public Health 2009, 9:405doi:10.1186/1471-2458-9-405

Published:	5 November 2009

Abstract

Background

Deliberate self-poisoning with agricultural pesticides is the commonest means of suicide in rural Asia. It is mostly impulsive and facilitated by easy access to pesticides. The aim of this large observational study was to investigate the immediate source of pesticides used for self-harm to help inform suicide prevention strategies such as reducing domestic access to pesticides.

Methods

The study was conducted in a district hospital serving an agricultural region of Sri Lanka. Patients who had self-poisoned with pesticides and were admitted to the adult medical wards were interviewed by study doctors following initial resuscitation to identify the source of pesticides they have ingested.

Results

Of the 669 patients included in the analysis, 425 (63.5%) were male; the median age was 26 (IQR 20-36). In 511 (76%) cases, the pesticides had been stored either inside or immediately outside the house; among this group only eight patients obtained pesticides that were kept in a locked container. Ten percent (n = 67) of the patients used pesticides stored in the field while 14% (n = 91) purchased pesticides from shops within a few hours of the episode. The most common reasons for choosing the particular pesticide for self-harm were its easy accessibility (n = 311, 46%) or its popularity as a suicide agent in their village (n = 290, 43%).

Conclusion

Three quarters of people who ingested pesticides in acts of self-harm used products that were available within the home or in close proximity; relatively few patients purchased the pesticide for the act. The study highlights the importance of reducing the accessibility of toxic pesticides in the domestic environment.