Bans of WHO Class I Pesticides in Bangladesh—Suicide Prevention without Hampering Agricultural output

Fazle Rabbi Chowdhury, Gourab Dewan, Vasundhara R Verma, Dee Knipe, Ishrat Tahsin Isha, M Abul Faiz, David Gunnell, Michael Eddleston

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Abstract

Background: Pesticide self-poisoning is a major problem in Bangladesh. Over the last 20-years, the Bangladesh government has introduced pesticide legislation and banned highly hazardous pesticides (HHPs) from agricultural use. We aimed to assess the impact on suicide and agricultural production of pesticide bans.

Methods: We obtained data on unnatural deaths from the Statistics Division of Bangladesh Police and used negative binomial regression to quantify changes in pesticide suicides and unnatural deaths following removal of WHO Class I toxicity HHPs from agriculture in 2000. We assessed contemporaneous trends in other risk factors, pesticide usage, and agricultural production in Bangladesh from 1996 to 2014.

Result: Mortality in hospital from pesticide poisoning fell after the 2000 ban (15.1% vs 9.5%, relative reduction 37.1% [95% CI 35.4 to 38.8%]). The pesticide poisoning suicide rate fell from 6.3/100,000 in 1996 to 2.2/100,000 in 2014, a 65.1% (52.0 to 76.7%) decline. There was a modest simultaneous increase in hanging suicides (20.0% [8.4 to 36.9%] increase) but the overall incidence of unnatural deaths fell from 14.0/100,000 to 10.5/100,000 (25.0% [18.1 to 33.0%] decline). There were 35,042 (95% CI 25,502 to 45,666) fewer pesticide suicides in 2001 to 2014 compared the number predicted based on trends between 1996 to 2000. This reduction in rate of pesticide suicides occurred despite increased pesticide use and no change in admissions for pesticide poisoning, with no apparent influence on agricultural output.

Conclusion: Strengthening pesticide regulation and banning WHO Class I toxicity HHPs in Bangladesh was associated with major reductions in deaths and hospital mortality, without any apparent effect on agricultural output. Our data indicate that removing HHPs from agriculture can rapidly reduce suicides without imposing substantial agricultural costs.
Original languageEnglish
Article numberdyx157
Number of pages10
JournalInternational Journal of Epidemiology
Early online date18 Aug 2017
DOIs
Publication statusE-pub ahead of print - 18 Aug 2017

Keywords

  • Bangladesh
  • pesticides
  • suicide
  • prevention
  • agriculture

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  • Projects

    Dee Knipe GCRF Fellowship

    Knipe, D.

    4/01/173/01/18

    Project: Research

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