斯里兰卡对农药的限制和故意的自我毒害
Firouzeh Noghrehchi1, Andrew H Dawson1,2, Jacques Raubenheimer1,2
1Translational Australian Clinical Toxicology, Faculty of Medicine and Health, The University of Sydney, Australia.
JAMA network open
|August 6, 2024
概括
在斯里兰卡禁止使用高度有毒的农药,大大减少了农药自我中毒和死亡. 然而,限制使用毒性较低的农药导致死亡人数增加,这凸显了需要仔细监管农药的必要性.
科学领域:
- 公共卫生 公共卫生
- 毒理学 毒理学 毒理学
- 流行病学 流行病学
背景情况:
- 蓄意用农药自我中毒是一个主要的公共卫生问题,特别是在低收入和中等收入国家.
- 斯里兰卡实施了对高毒性农药的禁令 (2008-2011) 和对低毒性农药的限制 (2015).
- 这些农药法规对自我中毒结果的影响需要进一步调查.
研究的目的:
- 检查农药禁令与农药自我中毒和住院死亡率之间的关联.
- 分析限制高毒性农药与少毒性农药的影响.
主要方法:
- 采用了采用中断时间序列设计的横截面研究.
- 2002年至2019年间,斯里兰卡10家医院收集了有关故意自我中毒的数据.
- 用分段波桑回归来分析医院呈现和死亡的变化.
主要成果:
- 禁止使用高度有毒的农药与农药中毒的显著下降有关 (RR,0.85) 和整体病例死亡率 (RR,0.33).
- 在禁止高毒性农药后,药物和家用化学品中毒事件增加.
- 2015年对少毒农药的限制并没有改变住院率,但与死亡人数的增加有关 (RR, 1.98).
结论:
- 限制急性毒性农药是一种有效的策略,以减少农药自我中毒,在资源贫困的环境中减少住院和死亡.
- 对毒性较低的农药的任意禁令应谨慎处理,特别是当更有毒的替代品仍然可获得时.
- 基于证据的农药监管对于减轻自我中毒的自杀至关重要.
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