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Cited by 378Suicide and Self-Harm StudiesPesticide Exposure and ToxicityHomicide, Infanticide, and Child Abuse

The impact of pesticide regulations on suicide in Sri Lanka

Open access
Gunnell, D, Fernando, R, Hewagama, M, Priyangika, W D D, Konradsen, F, Eddleston, M·2007·International Journal of Epidemiology
DOI 10.1093/ije/dym164PMC PMC3154644
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Abstract

BACKGROUND: Between 1950 and 1995 suicide rates in Sri Lanka increased 8-fold to a peak of 47 per 100,000 in 1995. By 2005, rates had halved. We investigated whether Sri Lanka's regulatory controls on the import and sale of pesticides that are particularly toxic to humans were responsible for these changes in the incidence of suicide. METHODS: Ecological analysis using graphical and descriptive approaches to identify time trends in suicide and risk factors for suicide in Sri Lanka, 1975-2005. RESULTS: Restrictions on the import and sales of WHO Class I toxicity pesticides in 1995 and endosulfan in 1998, coincided with reductions in suicide in both men and women of all ages. 19,769 fewer suicides occurred in 1996-2005 as compared with 1986-95. Secular trends in unemployment, alcohol misuse, divorce, pesticide use and the years associated with Sri Lanka's Civil war did not appear to be associated with these declines. CONCLUSION: These data indicate that in countries where pesticides are commonly used in acts of self-poisoning, import controls on the most toxic pesticides may have a favourable impact on suicide. In Asia, there are an estimated 300,000 deaths from pesticide self-poisoning annually. National and international policies restricting the sale of pesticides that are most toxic to humans may have a major impact on suicides in the region.

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  • Pesticides are highly lethal and the leading suicide method worldwide, and the decline in suicide deaths worldwide is largely due to restricting access to pesticides in rural China, India, and Sri Lanka.

    “Pesticides are highly lethal, the leading suicide method worldwide, and the decline in suicide deaths worldwide is largely due to restricting access to pesticides where those deaths happen, namely in rural China,(138, 158) India(129) and Sri Lanka.(159)”

    From Improving Suicide Prevention Through Evidence-Based Strategies: A Systematic Review (2021) · cites this paper as [159]

    The Introduction and Abstract Results report high case-fatality from pesticide self-poisoning and a decline in Sri Lankan suicides coinciding with restrictions on the most toxic pesticides. But the Discussion’s Limitations section cautions that the ecological data cannot establish causation. The paper calls pesticides one of the most frequently used suicide methods worldwide, not the leading method, and does not establish that a worldwide decline in suicide deaths was largely due to pesticide restrictions. (LLM, conf=0.88)

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  • After Sri Lanka's complete ban in 1995 on the import of pesticides commonly used in suicide, rates of suicide by self-poisoning fell by 50%.

    “After the complete ban, rates of suicide by self-poisoning fell by 50%.”

    From Natural Experiments: An Overview of Methods, Approaches, and Contributions to Public Health Intervention Research (2017) · cites this paper as [32]

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Research works printed but not linked: 3

  1. [10]Abeyasinghe R International Water Management Institute Smit LAM Psychiatric aspects of pesticide poisoning 12 15 Pesticides: Health Impacts and Alternatives Proceedings of a workshop held in Colombo 24 January 2002 2002 Working Paper 45 Sri Lanka
  2. [28]Sumith JA Proceedings Asia Regional Workshop on the Implementation, Monitoring and Observance of the International Code of Conduct on the Distribution and Use of pesticides Bangkok, Thailand 2005 Sri Lanka
  3. [33]Ganeshamoorthy R Spectrum of acute poisoning in Jaffna – a one year survey Jaffna Medical Journal 1985 XX 3 12

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Authors
Gunnell, D., Fernando, R., Hewagama, M., Priyangika, W. D. D., Konradsen, F., & Eddleston, M.
Affiliations
  • University of Bristol (GB)
  • South Asian Clinical Toxicology Research Collaboration (LK)
  • University of Colombo (LK)
  • University of Copenhagen (DK)
  • Edinburgh Royal Infirmary (GB)
Corresponding author
Gunnell, D
ORCID
Venue
International Journal of Epidemiology
Publisher
Oxford University Press (OUP)
Published
2007-08-27
Volume
36
Issue
6
Pages
1235-1242
ISSN
  • 0300-5771 (ISSN-L)
  • 1464-3685
DOI
10.1093/ije/dym164
PMC
PMC3154644
OpenAlex
W2135889734
Cited by
378
References
55
Citations by year
2026: 3 · 2025: 13 · 2024: 18 · 2023: 22 · 2022: 13 · 2021: 24 · 2020: 25 · 2019: 19 · 2018: 20 · 2017: 29 · 2016: 34 · 2015: 22 · 2014: 22 · 2013: 22 · 2012: 22
FWCI
17.75
Type
journal article
Language
en
Open access
Locations
  • International Journal of Epidemiology (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • Bristol Research (University of Bristol) (submittedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
  • Explore Bristol Research (submittedVersion)
Funders
  • Wellcome Trust (071669, GR063560MA, 071669MA, 063560)
  • Medical Research Council
  • National Health and Medical Research Council (GR063560MA, 071669MA)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Life Sciences › Agricultural and Biological Sciences › Plant Science › Pesticide Exposure and Toxicity
  • Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
Keywords
pesticide regulation, suicide, pesticide self-poisoning, endosulfan, suicide prevention policy, Sri Lanka, suicide trends, suicide risk factors
MeSH terms
Suicide Prevention, Developing Countries, Drug and Narcotic Control, Female, Humans, Male, Pesticides, Risk Factors, Sri Lanka, Suicide, Incidence, Government Regulation

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