Surveillance of pesticide poisoning in an East and a West Malaysian hospital: characteristics of pesticide poisoning and the early impact of a national Paraquat ban
Abstract Background Previous studies have shown that pesticide bans were associated with reduced fatal pesticide self-poisoning cases in high, and low-and-middle-income countries. We aimed to investigate the characteristics of pesticide poisoning patients admitted to two Malaysian hospitals and the...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-06-01
|
| Series: | BMC Psychiatry |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12888-023-04974-8 |
| _version_ | 1797789630885527552 |
|---|---|
| author | Lai Fong Chan Song Jie Chin Tsui Huei Loo Ravivarma Rao Panirselvam Shu-Sen Chang Hwei Yuen Chang Anissa Raudhah Mokhzani Farynna Hana Ab Rahman Leah Utyasheva Michael Eddleston |
| author_facet | Lai Fong Chan Song Jie Chin Tsui Huei Loo Ravivarma Rao Panirselvam Shu-Sen Chang Hwei Yuen Chang Anissa Raudhah Mokhzani Farynna Hana Ab Rahman Leah Utyasheva Michael Eddleston |
| author_sort | Lai Fong Chan |
| collection | DOAJ |
| description | Abstract Background Previous studies have shown that pesticide bans were associated with reduced fatal pesticide self-poisoning cases in high, and low-and-middle-income countries. We aimed to investigate the characteristics of pesticide poisoning patients admitted to two Malaysian hospitals and the early impact of the national paraquat ban implemented on 1st January 2020 in a culturally heterogenous South-East-Asian upper-middle-income setting. Methods Data were collected from an East (Bintulu) and a West (Ipoh) Malaysian hospital medical records in 2015–2021 and 2018–2021, respectively. Logistic regression analyses were conducted to investigate the association of aspects such as socio-demographic and clinical characteristics, paraquat ban with the types of pesticides involved (paraquat versus non-paraquat versus unknown) ,and the outcomes (fatal versus non-fatal). Results From the study sample of 212 pesticide poisoning patients aged 15 years or above, the majority were self-poisoning cases (75.5%) with a disproportionate over-representation of Indian ethnic minority (44.8%). Most pesticide poisoning cases had socio-environmental stressors (62.30%). The commonest stressors were domestic interpersonal conflicts (61.36%). 42.15% of pesticide poisoning survivors had a psychiatric diagnosis. Paraquat poisoning accounted for 31.6% of all patients and 66.7% of fatalities. Case fatality was positively associated with male gender, current suicidal intent, and paraquat poisoning. After the paraquat ban, the proportion of pesticide poisoning cases using paraquat decreased from 35.8 to 24.0%, and the overall case-fatality dropped slightly from 21.2 to 17.3%. Conclusions Socio-environmental stressors in specific domestic interpersonal conflicts, seemed more prominent in pesticide poisoning compared to psychiatric diagnosis. Paraquat accounted for the majority of pesticide-associated deaths occurring in hospitals in the study areas. There was preliminary evidence that the 2020 paraquat ban led to a fall in case fatality from pesticide poisoning. |
| first_indexed | 2024-03-13T01:53:25Z |
| format | Article |
| id | doaj.art-5b861454576f4ffbbdcd67e5be9630a2 |
| institution | Directory Open Access Journal |
| issn | 1471-244X |
| language | English |
| last_indexed | 2024-03-13T01:53:25Z |
| publishDate | 2023-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj.art-5b861454576f4ffbbdcd67e5be9630a22023-07-02T11:22:34ZengBMCBMC Psychiatry1471-244X2023-06-0123111310.1186/s12888-023-04974-8Surveillance of pesticide poisoning in an East and a West Malaysian hospital: characteristics of pesticide poisoning and the early impact of a national Paraquat banLai Fong Chan0Song Jie Chin1Tsui Huei Loo2Ravivarma Rao Panirselvam3Shu-Sen Chang4Hwei Yuen Chang5Anissa Raudhah Mokhzani6Farynna Hana Ab Rahman7Leah Utyasheva8Michael Eddleston9Department of Psychiatry, Faculty of Medicine, National University of MalaysiaDepartment of Psychiatry, Faculty of Medicine, National University of MalaysiaDepartment of Psychiatry, Hospital Raja Permaisuri BainunDepartment of Psychiatry and Mental Health, Hospital MiriInstitute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan UniversityInstitute of Health Behaviors and Community Sciences, College of Public Health, National Taiwan UniversityDepartment of Psychiatry, Faculty of Medicine, National University of MalaysiaDepartment of Psychiatry, Faculty of Medicine, National University of MalaysiaCentre for Pesticide Suicide Prevention, University Of EdinburghCentre for Pesticide Suicide Prevention, University Of EdinburghAbstract Background Previous studies have shown that pesticide bans were associated with reduced fatal pesticide self-poisoning cases in high, and low-and-middle-income countries. We aimed to investigate the characteristics of pesticide poisoning patients admitted to two Malaysian hospitals and the early impact of the national paraquat ban implemented on 1st January 2020 in a culturally heterogenous South-East-Asian upper-middle-income setting. Methods Data were collected from an East (Bintulu) and a West (Ipoh) Malaysian hospital medical records in 2015–2021 and 2018–2021, respectively. Logistic regression analyses were conducted to investigate the association of aspects such as socio-demographic and clinical characteristics, paraquat ban with the types of pesticides involved (paraquat versus non-paraquat versus unknown) ,and the outcomes (fatal versus non-fatal). Results From the study sample of 212 pesticide poisoning patients aged 15 years or above, the majority were self-poisoning cases (75.5%) with a disproportionate over-representation of Indian ethnic minority (44.8%). Most pesticide poisoning cases had socio-environmental stressors (62.30%). The commonest stressors were domestic interpersonal conflicts (61.36%). 42.15% of pesticide poisoning survivors had a psychiatric diagnosis. Paraquat poisoning accounted for 31.6% of all patients and 66.7% of fatalities. Case fatality was positively associated with male gender, current suicidal intent, and paraquat poisoning. After the paraquat ban, the proportion of pesticide poisoning cases using paraquat decreased from 35.8 to 24.0%, and the overall case-fatality dropped slightly from 21.2 to 17.3%. Conclusions Socio-environmental stressors in specific domestic interpersonal conflicts, seemed more prominent in pesticide poisoning compared to psychiatric diagnosis. Paraquat accounted for the majority of pesticide-associated deaths occurring in hospitals in the study areas. There was preliminary evidence that the 2020 paraquat ban led to a fall in case fatality from pesticide poisoning.https://doi.org/10.1186/s12888-023-04974-8Pesticide poisoningSelf-poisoningSuicide preventionParaquat ban |
| spellingShingle | Lai Fong Chan Song Jie Chin Tsui Huei Loo Ravivarma Rao Panirselvam Shu-Sen Chang Hwei Yuen Chang Anissa Raudhah Mokhzani Farynna Hana Ab Rahman Leah Utyasheva Michael Eddleston Surveillance of pesticide poisoning in an East and a West Malaysian hospital: characteristics of pesticide poisoning and the early impact of a national Paraquat ban BMC Psychiatry Pesticide poisoning Self-poisoning Suicide prevention Paraquat ban |
| title | Surveillance of pesticide poisoning in an East and a West Malaysian hospital: characteristics of pesticide poisoning and the early impact of a national Paraquat ban |
| title_full | Surveillance of pesticide poisoning in an East and a West Malaysian hospital: characteristics of pesticide poisoning and the early impact of a national Paraquat ban |
| title_fullStr | Surveillance of pesticide poisoning in an East and a West Malaysian hospital: characteristics of pesticide poisoning and the early impact of a national Paraquat ban |
| title_full_unstemmed | Surveillance of pesticide poisoning in an East and a West Malaysian hospital: characteristics of pesticide poisoning and the early impact of a national Paraquat ban |
| title_short | Surveillance of pesticide poisoning in an East and a West Malaysian hospital: characteristics of pesticide poisoning and the early impact of a national Paraquat ban |
| title_sort | surveillance of pesticide poisoning in an east and a west malaysian hospital characteristics of pesticide poisoning and the early impact of a national paraquat ban |
| topic | Pesticide poisoning Self-poisoning Suicide prevention Paraquat ban |
| url | https://doi.org/10.1186/s12888-023-04974-8 |
| work_keys_str_mv | AT laifongchan surveillanceofpesticidepoisoninginaneastandawestmalaysianhospitalcharacteristicsofpesticidepoisoningandtheearlyimpactofanationalparaquatban AT songjiechin surveillanceofpesticidepoisoninginaneastandawestmalaysianhospitalcharacteristicsofpesticidepoisoningandtheearlyimpactofanationalparaquatban AT tsuihueiloo surveillanceofpesticidepoisoninginaneastandawestmalaysianhospitalcharacteristicsofpesticidepoisoningandtheearlyimpactofanationalparaquatban AT ravivarmaraopanirselvam surveillanceofpesticidepoisoninginaneastandawestmalaysianhospitalcharacteristicsofpesticidepoisoningandtheearlyimpactofanationalparaquatban AT shusenchang surveillanceofpesticidepoisoninginaneastandawestmalaysianhospitalcharacteristicsofpesticidepoisoningandtheearlyimpactofanationalparaquatban AT hweiyuenchang surveillanceofpesticidepoisoninginaneastandawestmalaysianhospitalcharacteristicsofpesticidepoisoningandtheearlyimpactofanationalparaquatban AT anissaraudhahmokhzani surveillanceofpesticidepoisoninginaneastandawestmalaysianhospitalcharacteristicsofpesticidepoisoningandtheearlyimpactofanationalparaquatban AT farynnahanaabrahman surveillanceofpesticidepoisoninginaneastandawestmalaysianhospitalcharacteristicsofpesticidepoisoningandtheearlyimpactofanationalparaquatban AT leahutyasheva surveillanceofpesticidepoisoninginaneastandawestmalaysianhospitalcharacteristicsofpesticidepoisoningandtheearlyimpactofanationalparaquatban AT michaeleddleston surveillanceofpesticidepoisoninginaneastandawestmalaysianhospitalcharacteristicsofpesticidepoisoningandtheearlyimpactofanationalparaquatban |