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Suicide by pesticide poisoning in India: a review of pesticide regulations and their impact on suicide trends
Toby Bonvoisin
University of York
Corresponding Author
ORCiD: https://orcid.org/0000-0001-9566-0973
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Public Health.
Background
Pesticide self-poisoning is a common means of suicide in India. Banning highly hazardous pesticides (HHPs) from agricultural use has been successful in reducing suicides in several Asian countries without affecting agricultural output. Here, we describe national and state-level regulation of HHPs and explore how they might relate to suicide rates across India.Methods
Information on pesticide regulation was collated from agriculture departments of the central and state governments. National and state-level data on suicides from 1995 to 2015 were obtained from the National Crime Records Bureau (NCRB). We used joinpoint analysis and negative binomial regression to investigate any effects on trends in suicide rates nationally and in Kerala.Results
As of October 2019, 318 pesticides were registered for use in India, of which 18 were extremely (Class Ia) or highly (Class Ib) hazardous according to World Health Organization criteria. Despite many HHPs still being available, several bans have been implemented during the period studied. In our quantitative analyses we focused on the permanent bans in Kerala in 2005 (of endosulfan) and 2011 (of 14 other pesticides); and nationally in 2011 (of endosulfan). NCRB data indicate that pesticides were used in 441,918 reported suicides in India from 1995-2015, 90.3% of which occurred in 11 of the 29 states. There was statistical evidence of lower than expected rates of pesticide suicides (rate ratio RR 0.52, 95% CI 0.49-0.54) and total suicides nationally by 2014 (0.90, 0.87-0.93) after the 2011 endosulfan ban. In Kerala, there was a lower than expected pesticide suicide rate (0.45, 0.42-0.49), but no change to the already decreasing trend in total suicides after the 2011 ban of 14 pesticides. The 2005 ban on endosulfan showed a similar effect. Agricultural outputs continued growing following the bans.Discussion
Highly hazardous pesticides continue to be used in India and pesticide suicide remains a serious public health problem. However, some pesticide bans do appear to have impacted previous trends in the rates of both pesticide suicides and all suicides. Comprehensive national bans of HHPs could lead to a reduction in suicides across India, in addition to reduced occupational poisoning, with minimal effects on agricultural yield.
Keywords
India, suicide, poisoning, pesticides, endosulfan, prevention, means restriction
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On 19 Feb, 2020
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On 19 Dec, 2019
Editor assigned
On 17 Dec, 2019
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On 16 Dec, 2019
Editor invited
On 16 Dec, 2019
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Editorial decision: Major revision
On 11 Nov, 2019
Review #2 received
Received 10 Nov, 2019
Reviewer #2 agreed
On 23 Oct, 2019
Review #1 received
Received 22 Oct, 2019
Reviewers invited
Invitations sent on 17 Oct, 2019
Reviewer #1 agreed
On 17 Oct, 2019
Submission checks complete
On 26 Sep, 2019
Editor assigned
On 24 Sep, 2019
Editor invited
On 23 Sep, 2019
First submitted
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This preprint is under consideration at BMC Public Health. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Suicide by pesticide poisoning in India: a review of pesticide regulations and their impact on suicide trends
Toby Bonvoisin
University of York
Corresponding Author
ORCiD: https://orcid.org/0000-0001-9566-0973
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 2
Posted 19 Dec, 2019
Published
On 19 Feb, 2020
No community comments so far
Review #1 received
Received 19 Jan, 2020
Reviewers invited
Invitations sent on 19 Dec, 2019
Reviewer #1 agreed
On 19 Dec, 2019
Editor assigned
On 17 Dec, 2019
Submission checks complete
On 16 Dec, 2019
Editor invited
On 16 Dec, 2019
No comments provided
Editorial decision: Major revision
On 11 Nov, 2019
Review #2 received
Received 10 Nov, 2019
Reviewer #2 agreed
On 23 Oct, 2019
Review #1 received
Received 22 Oct, 2019
Reviewers invited
Invitations sent on 17 Oct, 2019
Reviewer #1 agreed
On 17 Oct, 2019
Submission checks complete
On 26 Sep, 2019
Editor assigned
On 24 Sep, 2019
Editor invited
On 23 Sep, 2019
First submitted
On 22 Sep, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Health Policy
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Public Health.
Background
Pesticide self-poisoning is a common means of suicide in India. Banning highly hazardous pesticides (HHPs) from agricultural use has been successful in reducing suicides in several Asian countries without affecting agricultural output. Here, we describe national and state-level regulation of HHPs and explore how they might relate to suicide rates across India.Methods
Information on pesticide regulation was collated from agriculture departments of the central and state governments. National and state-level data on suicides from 1995 to 2015 were obtained from the National Crime Records Bureau (NCRB). We used joinpoint analysis and negative binomial regression to investigate any effects on trends in suicide rates nationally and in Kerala.Results
As of October 2019, 318 pesticides were registered for use in India, of which 18 were extremely (Class Ia) or highly (Class Ib) hazardous according to World Health Organization criteria. Despite many HHPs still being available, several bans have been implemented during the period studied. In our quantitative analyses we focused on the permanent bans in Kerala in 2005 (of endosulfan) and 2011 (of 14 other pesticides); and nationally in 2011 (of endosulfan). NCRB data indicate that pesticides were used in 441,918 reported suicides in India from 1995-2015, 90.3% of which occurred in 11 of the 29 states. There was statistical evidence of lower than expected rates of pesticide suicides (rate ratio RR 0.52, 95% CI 0.49-0.54) and total suicides nationally by 2014 (0.90, 0.87-0.93) after the 2011 endosulfan ban. In Kerala, there was a lower than expected pesticide suicide rate (0.45, 0.42-0.49), but no change to the already decreasing trend in total suicides after the 2011 ban of 14 pesticides. The 2005 ban on endosulfan showed a similar effect. Agricultural outputs continued growing following the bans.Discussion
Highly hazardous pesticides continue to be used in India and pesticide suicide remains a serious public health problem. However, some pesticide bans do appear to have impacted previous trends in the rates of both pesticide suicides and all suicides. Comprehensive national bans of HHPs could lead to a reduction in suicides across India, in addition to reduced occupational poisoning, with minimal effects on agricultural yield.
Figure 1
Figure 2
Figure 3