J Korean Med Sci.  2015 Oct;30(10):1517-1521. 10.3346/jkms.2015.30.10.1517.

Common Pesticides Used in Suicide Attempts Following the 2012 Paraquat Ban in Korea

• Lee JW
• Hwang IW
• Kim JW
• Moon HJ
• Kim KH
• Park S
• Gil HW
• Hong SY

• KMID: 2344188
• DOI: http://doi.org/10.3346/jkms.2015.30.10.1517

Abstract

To determine the change in pesticides used during suicide attempts after the 2012 paraquat (PQ) ban, we evaluated the annual number of suicide attempts by pesticide ingestion between 2011 and 2014. We extracted demographic, clinical outcome, and pesticide class data from the medical records of 1,331 patients that attempted suicide by pesticide ingestion. Pesticides were sorted into 5 groups: herbicides, insecticides, fungicides, other pesticides, and combined pesticides. Each group was subdivided into various classes based on publications by the respective Resistance Action Committees. The chi-square test for trends was used to compare the annual incidence of categorical variables. The total number of suicide attempts decreased each year, from 399 in 2011 to 245 in 2014. Simultaneously, PQ ingestion decreased from 253 patients in 2011 to 60 in 2014. The proportion of PQ to pesticides also decreased from 63.4% in 2011 to 24.5% in 2014. Furthermore, the rate of decrease in the proportion of PQ to all herbicide categories increased by calendar year. In conclusion, there is a significant trend in increased annual number of suicides and proportion of suicides using glyphosates and glufosinates versus total herbicides. However, the number of suicide attempts using glyphosate and glufosinate is lower than that using PQ. The ratio of persons completing suicide to those attempting suicide after pesticide ingestion has decreased every year after the PQ ban.

Keyword

Paraquat; Paraquat Ban, Suicide Attempted; Suicide Completion; Pesticides

MeSH Terms

Female
Humans
Male
Middle Aged
Paraquat
Pesticides/classification/*poisoning
Republic of Korea
*Suicide, Attempted
Treatment Outcome
Paraquat
Pesticides

Figure

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  Fig. 1 Pesticide classes and the ratio of suicide completion to suicide attempts (%) in each category, between 2011 and 2014. Combined pesticides*: two active ingredients in a pesticide formulation, or two or three active ingredients in more than two different pesticides. In general, pesticide formulations include various kinds of surfactants as an emulsifier. However, in some instances, the surfactant** is sold separately. For details, please see the "Discussion".

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  Fig. 2 Change in the annual number of suicide attempts in each pesticide category after the PQ ban in 2012. Note that the annual attempt numbers decreased dramatically after the 2012 PQ ban in the herbicide category, where no significant change was observed in the other pesticide categories. The "other group" comprised of surfactant, warfarin (rodenticide), mite growth inhibitor (acaricide), and aluminum phosphide (fumigant). For the "combined" category, note the "Results" section in the manuscript.

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  Fig. 3 Change in the annual number of total suicide, suicide attempts with PQ, and PQ fatality. PQ attempts = suicide attempts using PQ ingestion. PQ fatality (%) = suicide completion using PQ versus attempts using PQ. Note a marked decrease in the annual number of both people attempting suicide with total herbicides and with PQ, (P < 0.001). The annual PQ fatality was between around 60%-70%.

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  Fig. 4 Change in the annual number of suicide attempters who ingested herbicide and the proportion of glyphosate and glufosinate. Note that the proportion of both glyphosate and glufosinate increased considerably, between 2011 and 2014 (P < 0.001).

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