Abstract:
Abstract
Background: Sri Lanka has reduced its overall suicide rate by 70% over the last two decades through means
restriction, through a series of government regulations and bans removing highly hazardous pesticides from
agriculture. We aimed to identify the key pesticide(s) now responsible for suicides in rural Sri Lanka to provide data
for further pesticide regulation.
Methods: We performed a secondary analysis of data collected prospectively during a cluster randomized
controlled trial in the Anuradhapura district of Sri Lanka from 2011 to 16. The identity of pesticides responsible for
suicides were sought from medical or judicial medical notes, coroners’ records, and the person’s family. Trend
analysis was done using a regression analysis with curve estimation to identify relative importance of key pesticides.
Results: We identified 337 suicidal deaths. Among them, the majority 193 (57.3%) were due to ingestion of
pesticides while 82 (24.3%) were due to hanging. A specific pesticide was identified in 105 (54.4%) of the pesticide
suicides. Ingestion of carbosulfan or profenofos was responsible for 59 (56.2%) of the suicides with a known
pesticide and 17.5% of all suicides. The increasing trend of suicides due to carbosulfan and profenofos over time
was statistically significant (R square 0.846, F 16.541, p 0.027).
Conclusion: Ingestion of pesticides remains the most important means of suicides in rural Sri Lanka. The pesticides
that were once responsible for most pesticide suicides have now been replaced by carbosulfan and profenofos.
Their regulation and replacement in agriculture with less hazardous pesticides will further reduce the incidence of
both pesticide and overall suicides in rural Sri Lanka.
Keywords: Pesticide, Pesticide regulation, Self-poisoning, Suicide, Sri Lank
