CoChat
Sign Up
Cited by 249Suicide and Self-Harm StudiesPesticide Exposure and ToxicityAgriculture and Farm Safety

The DOI matches its Crossref record; 65 of the 69 references it cites were found in a registry or an index.

Prevention of suicide with regulations aimed at restricting access to highly hazardous pesticides: a systematic review of the international evidence

Open access
Gunnell, David, Knipe, Duleeka, Chang, Shu-Sen, Pearson, Melissa, Konradsen, Flemming, Lee, Won Jin, Eddleston, Michael·2017·The Lancet Global Health
DOI 10.1016/s2214-109x(17)30299-1
Open this paper in CoChat — free accountOpen PDF

Abstract

BACKGROUND: Pesticide self-poisoning accounts for 14-20% of suicides worldwide. Regulation aimed at restricting access to pesticides or banning highly hazardous pesticides is one approach to reducing these deaths. We systematically reviewed the evidence of the effectiveness of pesticide regulation in reducing the incidence of pesticide suicides and overall suicides. METHODS: We did a systematic review of the international evidence. We searched MEDLINE, PsycINFO, and Embase for studies published between Jan 1, 1960, and Dec 31, 2016, which investigated the effect of national or regional bans, and sales or import restrictions, on the availability of one or more pesticides and the incidence of suicide in different countries. We excluded other interventions aimed at limiting community access to pesticides. We extracted data from studies presenting pesticide suicide data and overall suicide data from before and after national sales restrictions. Two reviewers independently assessed papers for inclusion, extracted data, and assessed risk of bias. We undertook a narrative synthesis of the data in each report, and where data were available for the years before and after a ban, we pooled data for the 3 years before and the 3 years after to obtain a crude estimate of the effect of the ban. This study is registered through PROSPERO, number CRD42017053329. FINDINGS: We identified 27 studies undertaken in 16 countries-five low-income or middle-income countries (Bangladesh, Colombia, India, Jordan and Sri Lanka), and 11 high-income countries (Denmark, Finland, Germany, Greece, Hungary, Ireland, Japan, South Korea, Taiwan, UK, and USA). Assessments largely focused on national bans of specific pesticides (12 studies of bans in six countries-Jordan, Sri Lanka, Bangladesh, Greece [Crete], South Korea, and Taiwan) or sales restrictions (eight studies of restrictions in five countries- India, Denmark, Ireland, the UK and the USA). Only five studies used optimum analytical methods. National bans on commonly ingested pesticides in five of the six countries studied, including four studies using optimum analytical methods, were followed by reductions in pesticide suicides and, in three of these countries, falls in overall suicide mortality. Greece was the only country studied that did not show a decrease in pesticide suicide following a ban. There were no high-quality studies of restricting sales to people for occupational uses; four of the seven studies (in three of the five countries studied-India, Denmark, and the USA) showed sales restrictions were followed by decreases in pesticide suicides; one of the two studies investigating trends in overall suicide mortality reported a fall in deaths in Denmark, but there were also decreases in suicide deaths from other methods. INTERPRETATION: National bans on highly hazardous pesticides, which are commonly ingested in acts of self-poisoning, seem to be effective in reducing pesticide-specific and overall suicide rates. Evidence is less consistent for sales restrictions. A worldwide ban on the use of highly hazardous pesticides is likely to prevent tens of thousands of deaths every year. FUNDING: None.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1016/s2214-109x(17)30299-1

Cites

65 of 65 references verified0 citation errors · 0 not checkable

Statistics

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

Show all 69 references

Research works printed but not linked: 3

  1. Berecz, 2003, [Characteristic features of completed suicides in Hungary between 1994–2001], A befejezett ongyilkossagok jellemzoi Magyarorszagon, 18, 399
  2. Piola, 2001, Intoxicaciones con Evolucion Letal (IEL) Atendidas en Rosario entre 1990 y 1999, Revista Medica de Rosario, 67, 19
  3. Davila, 2016, [Suicide mortality in Colombia and Mexico: Trends and impact between 2000 and 2013], Biomedica, 36, 415

Cited by

Sorted by citations

Items 201–249 of 249

Related

See all

Metadata

Authors
Gunnell, D., Knipe, D., Chang, S.-S., Pearson, M., Konradsen, F., Lee, W. J., & Eddleston, M.
Affiliations
  • University of Peradeniya (LK)
  • National Taiwan University (TW)
  • Korea University (KR)
Corresponding author
Gunnell, David
ORCID
Venue
The Lancet Global Health
Publisher
Elsevier BV
Published
2017-10
Volume
5
Issue
10
Pages
e1026-e1037
ISSN
2214-109X (ISSN-L)
DOI
10.1016/s2214-109x(17)30299-1
OpenAlex
W2744735691
Cited by
246
References
69
Citations by year
2026: 23 · 2025: 24 · 2024: 27 · 2023: 25 · 2022: 37 · 2021: 34 · 2020: 35 · 2019: 24 · 2018: 12 · 2017: 5
FWCI
3.17
Type
journal article
Language
en
Open access
Licence
Locations
  • The Lancet Global Health (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, cc-by)
  • Edinburgh Research Explorer (University of Edinburgh) (publishedVersion, cc-by)
  • Bristol Research (University of Bristol) (publishedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Explore Bristol Research (submittedVersion, cc-by)
Funders
  • National Institute for Health and Care Research (NF-SI-0512-10068)
  • Economic and Social Research Council (ES/P009735/1)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pesticide Exposure and Toxicity
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Agriculture and Farm Safety
Keywords
suicide prevention, pesticide self-poisoning, pesticide regulation, pesticide ban, pesticide availability, suicide mortality, highly hazardous pesticides, suicide prevention policy, low- and middle-income countries, high-income countries, suicide prevention funding, suicide prevention research, suicide prevention training, suicide prevention education
MeSH terms
Suicide Prevention, Commerce, Developing Countries, Humans, Pesticides, Suicide, Randomized Controlled Trials as Topic, Developed Countries

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review